The FEV1 35% predicted. FEV25-75% 29% predicted. There was evidence of restrictive lung defect and suggestion of a mild to moderate obstructive airflow limitation with partial reversibility with bronchodilator.
WHAT GOES AGAINST THE DIAGNOSIS OF ASTHMA FROM THE HISTORY?
There was no history of exacerbations or need for systemic steroids, and there was no response to well administered inhaled corticosteroids nor beta-adrenergic medications.
WHAT DIFFERENTIAL DIAGNOSIS MIGHT BE BASED ON THE PFT FINDINGS?
We thought of chest wall deformity, scoliosis, pleural disease or mediastinal mass. After history and examination of the patient, mediastinal mass was on the top of the differential.
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