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Table 4 Clues for specific diagnoses from blood and urine testing

From: Diagnosis and management of interstitial lung disease

Laboratory test Abnormal result Suggested disorder
CBC Microcytic anemia Occult pulmonary hemorrhage
Normocytic anemia CTD, chronic disease
Leukocytosis Infection, hematologic malignancy
Eosinophilia Eosinophilic pneumonia, drug toxicity
Thrombocytopenia CTD, sarcoidosis
Calcium Hypercalcemia Sarcoidosis
Creatinine CTD, pulmonary-renal syndrome, sarcoidosis; amyloidosis
Liver function ↑ GGT, ALT, AST Sarcoidosis, amyloidosis, CTD (polymyositis)
Urine Abnormal sediment with RBC casts and/or dysmorphic RBCs Vasculitis (CTD, PAG, GPS, MPA)
Muscle enzymes ↑Increased CK, aldolase PM, DM-PM
Angiotensin Converting Enzyme (ACE) Sarcoidosis (non-specific; can be increased in other ILD)
Lymphocyte proliferation Stimulated by beryllium CBD
Serum antibodies ↓ Quantitative immunoglobulins Immunodeficiency (CVID)
↑ ANA, RF, anti-CCP CTD, RA
↑ C-ANCA PAG
↑ P-ANCA CTD, vasculitis
↑ anti-GBM GPS
Positive specific precipitin Supportive of HP
↑ anti-Jo-1 or other anti-synthetase autoantibodies PM, DM-PM
↑ SS-A, SS-B Sjögren’s syndrome
  1. CBD = chronic beryllium diseases; COP = cryptogenic organizing pneumonia; CTD = connective tissue disease; CVID = common variable immunodeficiency; DAH = diffuse alveolar hemorrhage; DM-PM = dermatopolymyositis; DIP = desquamative interstitial pneumonia; GPS = Goodpasture’s syndrome; HP = hypersensitivity pneumonitis; MPA = microscopic polyangiitis; PM = polymyositis; PAG = polyangiitis with granulomatosis; RA = rheumatoid arthritis;
  2. Reprinted with permission from Interstitial Lung Disease: A Practical Approach. Meyer KC, Raghu G: Patient evaluation. Second Edition, New York: Springer; 2011:3–16.