Answers on p 588. A 54 year old white male first presented in 1978 to the medical department of the hospital with a six month history of shortness of breath and productive cough. His symptoms became progressively worse and necessitated two hospital admissions. He had vitiligo for 14 years and hereditary icthyosis. He was a non-smoker and he worked in a chemical factory with lacquers and thinners. Examination revealed both inspiratory and expiratory wheeze and a few crepitations at the right lung base. Abdominal examination showed a palpable spleen of about 8 cm and …