Table 2 Differential diagnosis for WG
From: Wegener's granulomatosis presenting as an abdominal aortic aneurysm: a case report
Condition | Feature | Vascular involvement | Diagnosis | Comments |
|---|---|---|---|---|
Churg-Strauss syndrome | Usually associated with asthma | Necrotising vasculitis affecting small to medium sized vessels | Eosinophilia and p-ANCA will be elevated | In WG c- ANCA will be high |
Microscopic polyarteritis | Necrotising glomerulonephritis common | Mainly small vessel vasculitis | Negative for PR 3 | Antiglomerular antibody will ne negative |
Temporal arteritis | >50 years Head ache, jaw claudication | Granulomatous arteritis aorta and its major branches, especially extra cranial branches of carotid artery | Often affects temporal artery | Temporal artery biopsy is negative in 50% |
Takayasu's arteritis | Absent upper limb pulses, systemic features such as fever, weight loss and joint pains | Granulomatous inflammation of aorta and its major branches Periaortitis, aortic dissection aneurysm and thrombosis of subclavian left gastric, hepatic and renal artery aneurysms | Diagnosis based upon American college of rheumatology criteria | Mainly affects Asian women |
Ankylosing Spondylytis | Chronic back pain in young | 5% can get aortitis Patchy destruction of both muscle and elastic tissue of media Fibrosis of intima | Radiologically there will sacroilitis | Seronegative arthropathy |