Information ⬇
- Thorough history and physical examination: special reference to ischemic manifestations and systemic inflammatory signs/symptoms (Fig. 159-1).
- Laboratories: important in assessing organ involvement: CBC with differential, ESR, renal function tests, UA. Should also be obtained to rule out other diseases: ANA, rheumatoid factor, anti-GBM, hepatitis B/C serologies, HIV.
- Antineutrophil cytoplasmic autoantibodies (ANCA): associated with granulomatosis with polyangiitis (Wegener's), microscopic polyangiitis, and some pts with eosinophilic granulomatosis with polyangiitis (Churg-Strauss); presence of ANCA is adjunctive and should not be used in place of biopsy as a means of diagnosis or to guide treatment decisions.
- Radiographs: CXR should be performed even in the absence of symptoms in small-vessel vasculitides.
- Diagnosis: can usually be made only by arteriogram or biopsy of affected organ(s).
Outline ⬆