Wegener Granulomatosis (cont.)
Exams and Tests
Lab tests, imaging studies, and biopsies may be performed.
- There are no blood tests that can establish the diagnosis of Wegener's granulomatosis with 100% certainty. Instead, blood tests are used to rule out other causes of the symptoms and to confirm the presence of inflammation in the body. Blood tests are also used to check the blood for antibodies the body is making to attack itself. One specific antibody that is often found in people with Wegener's
granulomatosis is called antineutrophil cytoplasmic antibody (ANCA). Antibodies are proteins that fight disease. If the ANCA test is positive, it would be a strong indicator the person has Wegener's granulomatosis.
- The red blood cell count may be low, and the white blood cell count may be high (indicating infection).
- A urine test will look for certain red blood cell markers in the urine caused by problems with the kidneys.
- X-ray films are taken of the chest and sinus cavities in the head.
- CT scans of the chest and sinuses may give a clearer view of the process.
- The definitive way to establish the diagnosis is examination of affected tissues under a microscope (biopsy). Small samples of tissue (biopsies) may be taken from areas of inflammation, such as the nose or throat. These samples are taken with a bronchoscope, an instrument that is guided down the throat to view the airway and snip out a tissue sample. Tissue samples from the lung are taken through a small cut in the chest wall. Tissue samples from the kidney are also taken through a small cut.
If a person has two or more of these indicators, under guidelines established by the American College of Rheumatology, a diagnosis of Wegener's granulomatosis can be made:
- Inflammation of the mouth or nose, bloody nose, and sores in the mouth (that may or may not be painful) are present.
- Abnormalities are seen on a chest x-ray film.
- A high number of red blood cells are present in the urine (can be seen under a microscope).
- There is a certain type of inflammation in tissue taken as a sample during a surgical biopsy.
- Tissue from the sinuses, lungs, or kidneys is examined under a microscope.
- Vasculitis (inflammation) and the specific type of inflammation called granulomas may be found, indicating a diagnosis of Wegener's granulomatosis.
Sat Sharma, MD, FRCPC, FCCP
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