Note – Most of these procedures are undertaken generally in the diagnosis and treatment of illnesses and diseases, and are not specific to vasculitis. However, they may be used as part of diagnosis and treatment of vasculitis.
Uses sound waves to create a picture of the organs and structures in the abdomen. This test may show if abnormalities are present in the abdomen.
Angiography is a way of looking at the blood vessels either to identify blockages, inflammation or other abnormalities. There are many ways of performing angiography. Ultrasound can be used to look at large vessels without needing to use x-rays or dyes. Magnetic resonance imaging (MRI) uses magnets to create detailed images of some blood vessels and may or may not need special dyes (contrast agents) to be injected into the patient. Computed tomography (CT) scanning uses x-rays to look at the blood vessels and usually needs contrast dyes to be injected. Positron emission tomography (PET) scanning requires the injection of radioactive drugs into the patient and may be helpful in locating areas of blood vessel inflammation. The best test to use depends on the clinical question that the medical team need answering.
A treatment for narrowed, scarred or “furred up” blood vessels. It involves widening one or more of the narrowed arteries to allow blood to flow more easily through to the organ or limb it supplies. Stenting may also be performed as part of angioplasty. This is where a narrow metal tube is inserted into the blood vessel at the site of the narrowing to help keep the blood vessel open and prevent the narrowing recurring.
Anticoagulants (INR test)
For patients taking anticoagulant (blood thinners) eg Warfarin. (INR = International normalised ratio). A system for reporting the results of blood coagulation (clotting) tests.
A procedure whereby a small piece of tissue is taken from the affected area or organ, eg the skin or the kidney. The tissue is then examined by a pathologist and special tests can be done to identify the disease affecting the organ.
Blood pressure monitoring
Should be monitored in all cases of vasculitis. Elevated blood pressure in vasculitis can lead to kidney damage.
A procedure where the physician looks into the large airways (trachea and bronchi) and identify areas of damage or collect samples (biopsy or washings) to identify the disease or infection. These are the main tubes that carry air into the lungs. A fibre-optic bronchoscope is usually used (a thin, flexible, telescope).
Computerised tomography (CT scan)
Gives greater detail of the internal organs than a normal radiograph (x-ray).
DEXA scan (Dual energy x-ray absorptiometry)
A test that measures the density of bones. This can be used to identify or monitor the strength of bones particularly for patients on long term steroid medication.
When the kidneys do not work adequately toxins, acid and fluid accumulate in the body. The process of dialysis helps removes this from the body to keep patients with severe kidney failure alive. Sometimes this treatment is only needed temporarily (days, weeks or months) to give time for the kidneys to recover where the cause of kidney damage is treatable. Where the kidney damage is not reversible dialysis treatment is permanent. For patients needing long term dialysis this can be done at home or as an outpatient.
An ultrasound test using sound waves to create pictures of the heart. The test will indicate the size and shape of the heart and how the chambers and valves are working.
Electrocardiogram (EKG) (ECG)
A simple and painless test to record the heart’s electrical activity. This can provide useful information about the state of the heart and can give indications if the heart is affected by vasculitis.
This is an electrical stimulation test of the muscles (usually in the arms or legs) to look for evidence of abnormal muscle function such as can be seen in vasculitis. Often it is performed in conjunction with a nerve conduction test.
Lung function tests
Magnetic Resonance Imaging (MRI)
Uses magnets and a computer to create detailed pictures of the internal organs.
Plasma exchange or plasmapheresis
This treatment is sometimes used in patients with severe vasculitis where antibodies in the blood are thought to be important in causing the disease. The treatment involves removing antibodies from the blood using a machine and returning the “cleaned” blood back to the patient. The treatment may necessitate giving blood products to the patient including plasma, albumin or immunoglobulin. It may also involve giving drugs to thin the blood and prevent it clotting in the machine.
Positive emission tomography (PET scans)
Produce 3-dimensional pictures which show the level of metabolic activity – and indicator of inflammation.
Spirometry (lung function test)
Measures the size of the lungs, the amount of air inspired and expired and how well the lungs deliver oxygen to the blood. This can be useful for monitoring patients whose lungs or airways have been affected by vasculitis.
Tracheostomy is sometimes necessary for patients whose main airway has become blocked or narrowed as a result of damage caused by vasculitis. It provides direct access to the trachea, bypassing the blockage, by surgically making an opening in the neck. This allows air to enter the lungs and permits patients to breathe properly. Tracheostomy can be either a temporary measure, particularly for patients who are severely ill on a ventilator, or a permanent measure where irreversible damage has occurred. Patients with permanent tracheostomies have a tube to keep the opening open and allow normal speech and otherwise live a normal life.
See Abdominal Ultrasound
A simple but very important test of the urine, commonly undertaken using “dipsticks”, which identifies abnormal levels of protein or blood cells in the urine. Abnormal levels of protein or blood can be a sign of kidney involvement.
Vasculitis patients who are immuno-compromised should not receive live vaccines. Influenza and Pneumonia vaccines are not live vaccines and are recommended.