Hamman-Rich syndrome differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Chandrakala Yannam, MD [2]

Overview

Acute interstitial pneumonitis must be differentiated from other diseases that present with respiratory failure and diffuse radiologic infiltrates including ARDS, acute eosinophilic pneumonitis, Infections, hypersensitivity pneumonitis, connective tissue diseases, and drug-induced lung toxicity.

Differentiating Acute interstitial pneumonitis from other Diseases

• Acute interstitial pneumonitis present with acute onset of respiratory symptoms resulting in severe hypoxia and respiratory failure.
• Any acute lung disease presenting with respiratory failure and show diffuse infiltrates on radiograph should be included in the differential diagnosis of acute interstitial pneumonitis.
  • Acute respiratory distress syndrome
  • Acute eosinophilic pneumonia
  • Acute hypersensitivity pneumonitis
  • Acute cryptogenic organizing pneumonia
  • Congestive heart failure
  • Acute exacerbation of Idiopathic pulmonary fibrosis
  • Diffuse alveolar hemorrhage:
    • Vasculitis-induced:
      • Antiphospholipid antibody syndrome
      • Behcet’s syndrome
      • Goodpasture’s syndrome
      • Microscopic polyangiitis
      • Wegener’s granulomatosis
    • Bland hemorrhage
      • coagulopathy
      • idiopathic pulmonary hemosiderosis
      • Mitral stenosis
  • Drug toxicity
  • Infection
  • Inhalation/toxic exposures

Preferred Table

Diseases	History and Symptoms				Physical Examination				Laboratory Findings				Other Findings
	Finding 1	Finding 2	Finding 3	Finding 4	Physical Finding 1	Physical Finding 2	Physical Finding 3	Physical Finding 4	Lab Test 1	Lab Test 2	Lab Test 3	Lab Test 4
Differential Diagnosis 1			+
Differential Diagnosis 2	↑			-
Differential Diagnosis 3		↓
Differential Diagnosis 4
Differential Diagnosis 5