Exertional dyspnea and persistent nonproductive cough

A 33-year-old female presents to the ER with exertional dyspnea and persistent nonproductive cough. Past medical history is significant for Scleroderma diagnosed 15-years ago. Physical examination shows JVD. Auscultation of the anterior chest reveals bibasilar inspiratory crackles. A single breath diffusing capacity study is preformed and shows a ↓DLCO and ↑A-a gradient. Which of the following pulmonary conditions is associated with the clinical presentation in this patient?



(B) Bronchiectasis


(C) Emphysema


(D) Interstitial pulmonary fibrosis


(E) Pneumothorax