How Is Vasculitis Diagnosed?

Your doctor will diagnose vasculitis based on your signs and symptoms, your medical history, a physical exam, and the results from tests.

Specialists Involved

Depending on the type of vasculitis you have and which organs are affected, your doctor may refer you to various specialists, including:

• A rheumatologist (a joint and muscle specialist)
• An infectious disease specialist
• A dermatologist (a skin specialist)
• A pulmonologist (a lung specialist)
• A nephrologist (a kidney specialist)
• A neurologist (a nervous system specialist)
• A cardiologist (a heart specialist)
• An ophthalmologist (an eye specialist)
• A urologist (a urinary tract and urogenital system specialist)

Diagnostic Tests and Procedures

A number of tests are used to diagnose vasculitis.

Blood Tests

Blood tests can show whether you have abnormal levels of certain blood cells and antibodies in your blood. These tests may look at:

• Hemoglobin and hematocrit. A low hemoglobin or hematocrit level suggests anemia, which may be a complication of vasculitis. Vasculitis can interfere with the body's ability to make enough red blood cells.
• Antineutrophil cytoplasmic antibodies (ANCA). These antibodies can be seen in certain types of vasculitis.
• Erythrocyte sedimentation rate (ESR). If the ESR is high, it can be a nonspecific sign of inflammation in the body.
• The amount of C-reactive protein (CRP) in your blood. A higher than normal CRP level suggests inflammation.

Biopsy

A biopsy often is the best way for your doctor to make a firm diagnosis of vasculitis. During a biopsy, your doctor takes a small sample of your body tissue to examine under a microscope.

To diagnose vasculitis, he or she will take a tissue sample from a blood vessel or an affected organ.

A pathologist will examine the sample for signs of inflammation or tissue damage. A pathologist is a doctor who specializes in identifying diseases by studying cells and tissues under a microscope.

Blood Pressure

Blood pressure should be closely monitored in all cases of vasculitis. Blood pressure can become elevated in vasculitis that damages the kidneys.

Urinalysis

For this test, you'll provide a sample of urine for analysis. This test identifies abnormal levels of protein or blood cells in the urine. Abnormal levels of these substances can be a sign of vasculitis affecting the kidneys.

EKG

An EKG (electrocardiogram) is a simple, painless test that records the heart's electrical activity. You might have this test to show whether vasculitis is affecting your heart.

Echocardiography

Echocardiography is a painless test that uses sound waves to create pictures of your heart. The test provides your doctor with information about the size and shape of your heart and how well your heart's chambers and valves are working.

Chest X Ray

A chest x ray is a painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Abnormal chest x-ray results may show changes that suggest that vasculitis is affecting your lungs or your large arteries (such as the aorta or the pulmonary arteries).

Lung Function Tests

Lung function tests measure the size of your lungs, how much air you can breathe in and out, how fast you can breathe air out, and how well your lungs deliver oxygen to your blood.

Lung function tests can help your doctor find out whether airflow into and out of your lungs is restricted or blocked.

Abdominal Ultrasound

An abdominal ultrasound uses sound waves to create a picture of the organs and structures in your abdomen. If vasculitis affects your abdominal organs, this test may show abnormalities.

Computed Tomography Scan

A computed tomography (CT) scan is a type of x ray that creates more detailed pictures of your internal organs than standard x rays. If you have a type of vasculitis that affects your abdominal organs or blood vessels, this test can show abnormalities that have developed.

Magnetic Resonance Imaging

A magnetic resonance imaging (MRI) test uses radio waves, magnets, and a computer to create detailed pictures of your internal organs.

Angiography

Angiography (an-jee-OG-ra-fee) is a test that uses dye and special x rays to show blood flow through your blood vessels. The dye is injected into your bloodstream.

Special x-ray pictures are taken while the dye flows through your blood vessels. The dye helps highlight the vessels on the x-ray pictures.

Angiography is used to help find out whether your blood vessels are narrowed, swollen, deformed, or blocked as a result of inflammation.