ANCA-ASSOZIIERTE VASKULITIDEN (WEGENER-GRANULOMATOSE, CHURG-STRAUSS-SYNDROM, MIKROSKOPISCHE POLYANGIITIS). 2. DIAGNOSTISCHES PROCEDERE

The ANCA-associated vasculitides (Wegener's granulomatosis, Churg-Strauss syndrome, microscopic polyangiitis) are characterized by a broad spectrum of clinical manifestations and a highly variable clinical course. Due to greatly improved diagnostic techniques the number of newly diagnosed cases has increased rapidly within the past few years. This facilitated more individualized treatment and led to the concept of stage-adapted treatment. Immunodiagnostic parameters are being utilized inceasingly to supplement clinical and radiological findings. Inflammatory lesions are visualized by, for example, e.g. rhinoscopy, sinoscopy, and bronchoscopy or by radiological techniques including cranial and skeletal muscle magnetic resonance imaging, pulmonary high-resolution computed tomography, and digital subtraction angiography. These techniques not only serve to detect the extent of tissue and organ involvement, but also to direct bioptic procedures. Conventional histopathology must be supplemented by immunohistology in order to distinguish between the 'immune complex vasculitides' and the ANCA-associated 'pauci-immune vasculitides'.