A 16 yr old girl admitted in our ward with c/o dyspne on exertion and cough and loss of appetite since 3 years and joint pain in swelling since 5 months RA factor is positive ana negative and urine calcium and blood calcium level within normal limit and also hiv negative Hrct suggestive of mosaic attenution and air trapping and septal thickening . spirometry suggested small airway obstruction

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