COPD Differential Diagnosis
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 PanÂbronchiolitis
- 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
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