Diagnosis Suggestive Features for Differential Diagnosis of COPD:

COPD

  • Onset in mid-life
  • Symptoms slowly progressive
  • Long smoking history
  • Dyspnea during exercise
  • Largely irreversible airflow limitation

Asthma

  • Onset early in life (often childhood)
  • Symptoms vary from day to day
  • Symptoms at night/early morning
  • Allergy/rhinitis and/or eczema also present
  • Family history of asthma
  • Largely reversible airflow limitation

Congestive Heart Failure

  • Fine basilar crackles on auscultation
  • Chest X-ray shows dilated heart, pulmonary edema
  • Pulmonary function tests indicated volume restriction, not airflow limitation

Bronchiectasis

  • Large volumes of purulent sputum
  • Commonly associated with bacterial infection
  • Coarse crackles/clubbing on auscultation
  • Chest X-ray/computed tomography (CT) shows bronchial dilation, bronchial wall-thickening

Tuberculosis

  • Onset all ages
  • Chest X-ray shows lung infiltrate
  • Microbiological confirmation
  • High local prevalence of tuberculosis

Obliterative Bronchiolitis

  • Onset in younger-aged nonsmokers
  • May have history of rheumatoid arthritis or toxic fume exposure
  • CT on expiration shows hypodense areas

Diffuse Pan­bronchiolitis

  • Most patients are male and nonsmokers
  • Almost all have chronic sinusitis
  • Chest X-ray and high-resolution CT show diffuse, small centrilobular nodular opacities and hyperinflation