29th January 2024

Diagnosis

Blood tests can demonstrate an acute kidney injury with a rise in urea and creatinine. Inflammatory markers are typically raised. PR3, c-ANCA is highly sensitive and positive in around 90% of patients. Patients can also have normocytic normochromic anaemia. Urinalysis typically shows microscopic haematuria and mild to moderate proteinuria, with urine sediments of dysmorphic RBC and RBC casts (nephrotic sediment) with sterile pyuria. 

CXR or CT chest are done to look for bilateral cavitating nodule lesions and pulmonary haemorrhage. 

Diagnosis of condition is typically by biopsy of the affected tissue (primarily lung or kidney), which can show necrotic, partially granulomatous vasculitis of small and medium-sized vessels with necrotising granulomas.