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Vasculitis (cont.)

Exams and Tests

Diagnosis of vasculitis may be challenging because of significant overlap of signs and symptoms with other more common conditions. A careful medical history and complete physical exam are the initial steps if the diagnosis of some type of vasculitis is suspected.

Depending on the organ that may be affected, certain laboratory tests and X-rays may be ordered. For example, routine blood work (complete blood count, electrolytes, and kidney and liver blood tests), urinalysis, and chest X-ray may be the basic diagnostic tests ordered. In general, some markers of vasculitis can be measured, which may provide additional supporting information in the evaluation of vasculitis. These tests include levels of ANCA, tests for specific viral infections, and markers of rheumatic diseases for lupus and rheumatoid arthritis.

Biopsy of an organ affected by vasculitis is essential in making or supporting the diagnosis of a vasculitis disease. The biopsy is typically done from the skin, kidneys, or the lungs. Brain biopsy can be performed if brain vasculitis is suspected.

Angiograms are sometimes done to assess the physical appearance of blood vessels. This can be done by injecting a dye into the blood vessels and taking specific X-rays as it is traveling inside the vessels. This test may be useful in vasculitis involving larger blood vessels.

Vasculitis may be diagnosed upon the examination of the eyes by an eye doctor (ophthalmologist). Diagnosis of the retinal vasculitis (vasculitis involving the retina or the inner surface of the eye) may trigger an investigation to find a systemic cause including lupus vasculitis, temporal arteritis, PAN, Wegener's disease, or Behcet's disease.

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