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Tests and diagnosis
By Mayo Clinic staffBesides asking you about your signs and symptoms, conducting a physical exam, and taking a medical history, your doctor may request several tests, including:
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Blood tests. If your doctor suspects Wegener's granulomatosis, you may have a blood test that can detect certain proteins (autoantibodies) in your blood called anti-neutrophil cytoplasmic autoantibodies (ANCA). These autoantibodies appear in the blood of 90 to 95 percent of people with active Wegener's granulomatosis. The presence of these autoantibodies lends support to a diagnosis of Wegener's granulomatosis, but it isn't enough to confirm that you have the disease.
Your blood test also can measure your erythrocyte sedimentation rate — commonly referred to as sed rate. By measuring how quickly red blood cells fall to the bottom of a tube of your blood over a period of one hour, this test may indicate the level of inflammation in your body. Generally, red blood cells fall faster when inflammation is present. Your sed rate will also be measured during treatment, to check the activity of your disease.
Another blood test can check for anemia, which is common in people with this disease. A blood test for creatinine can assess if your kidneys are properly filtering waste products from your blood.
- Urine tests. These tests evaluate kidney function to determine whether the disease is affecting your kidneys.
- Chest X-ray. This test shows cavities or masses in your lungs. However, it can't distinguish between Wegener's granulomatosis and other lung diseases.
- Biopsy of affected tissue. The only sure way to confirm a diagnosis of Wegener's granulomatosis is to remove a small piece of tissue from an affected organ (biopsy) and examine it under a microscope. Your doctor may remove tissue from your nasal passages, airways or lungs to confirm or rule out the presence of both vasculitis and granulomas. Other areas for biopsy may include your skin or your kidneys. Some biopsies can be performed in an outpatient setting using a numbing medication (local anesthetic). Others, such as an open-lung biopsy, may require hospitalization.
- Wegener's granulomatosis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec04/ch033/ch033k.html#sec04-ch033-ch033k-362. Accessed July 26, 2010.
- Wegener's granulomatosis. National Institute of Allergy and Infectious Diseases. http://www.niaid.nih.gov/topics/wegeners/Pages/Default.aspx. Accessed July 26, 2010.
- Hellmann DB, et al. Musculoskeletal and immunologic disorders. In: McPhee SJ, et al. Current Medical Diagnosis and Treatment 2010. 49th ed. New York, N.Y.: McGraw Hill; 2010. http://www.accessmedicine.com/content.aspx?aID=10083. Accessed July 30, 2010.
- Langford CA, et al. The vasculitis syndromes. In: Fauci AS, et al. Harrison's Principles of Internal Medicine. 17th ed. New York, N.Y.: McGraw Hill; 2008. http://www.accessmedicine.com/content.aspx?aID=2859426. Accessed July 30, 2010.
- King TE, et al. Clinical manifestations and diagnosis of Wegener's granulomatosis and microscopic polyangiitis. http://www.uptodate.com/home/index.html. Accessed July 26, 2010.
- Stone JH, et al. Rituximab versus cyclophosphamide for ANCA-associated vasculitis. New England Journal of Medicine. 2010;363:221.
- Turnball J, et al. Adverse effects of therapy for ANCA-associated vasculitis. Best Practice and Research Clinical Rheumatology. 2009;23:391.
- Rosenow E (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 3, 2010.
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