A 50-yr-old female primary school teacher presented with a 4-month history of cough, productive of scanty mucoid sputum without any haemoptysis. Her general practitioner had treated her with antibiotics, inhaled steroids and inhaled bronchodilators without effect. She then gradually developed progressive exertional breathlessness, particularly on climbing stairs. There was a history of occasional wheezing. She denied any history of nocturnal cough, orthopnoea or ankle swelling. She also complained of tiredness but no weight loss. There was no history of eye, joint or skin problems. The patient was a life-long non-smoker with no history of exposure to industrial dust or asbestos. She kept a dog but never kept birds. There was no history of recent foreign travel.
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