Wegener's Granulomatosis: Likelihood Ratios

Finding	+LR	-LR	Comments, Study
c-ANCA Duplicate	91	0.1	for active disease Study: Ann Intern Med. 1995 Dec 15;123(12):925-32. PMID: 7486487
ACR Criteria	11	0.1	2 of the 4 criteria must be met from the 1990 Criteria for the Classification of Wegener's Granulomatosis: 1. Nasal or oral inflammation Development of painful or painless oral ulcers or purulent or bloody nasal discharge 2. Abnormal chest radiograph Chest radiograph showing the presence of nodules, fixed infiltrates, or cavities 3. Urinary sediment Microhematuria (>5 red blood cells per high power field) or red cell casts in urine sediment 4. Granulomatous inflammation on biopsy Histologic changes showing granulomatous inflammation within the wall of an artery or in the perivascular or extravascular area (artery or arteriole) Study: PMID 2202308 Leavitt RY, Fauci AS, Bloch DA, et al. The American College of Rheumatology 1990 criteria for the classification of Wegener's granulomatosis. Arthritis Rheum. Aug 1990;33(8):1101-1107.
c-ANCA and anti-PR3	73	0.3	specificity vs healthy people Study: Kidney Int. 1998 Mar;53(3):743-53. PMID: 9507222
c-ANCA Duplicate	inf	0.4	for inactive disease Study: Ann Intern Med. 1995 Dec 15;123(12):925-32. PMID: 7486487
c-ANCA Duplicate	12.8	0.4	specificity vs healthy people Study: Kidney Int. 1998 Mar;53(3):743-53. PMID: 9507222
anti-PR3	5.1	0.4	specificity vs healthy people Study: Kidney Int. 1998 Mar;53(3):743-53. PMID: 9507222

Good Positive Likelihood Ratio

2.7

0.8

specificity vs healthy people

Study: Kidney Int. 1998 Mar;53(3):743-53. PMID: 9507222

Poorly Diagnostic Findings

1.1

specificity vs healthy people

Study: Kidney Int. 1998 Mar;53(3):743-53. PMID: 9507222

Findings With Unspecified Accuracy

Finding	+LR	-LR	Comments, Study
Sensorineural hearing loss (SNHL)	No accuracy specified.		2.8 to 13% incidence of SNHL in WG patients. Study: Hearing loss in Wegener's granulomatosis. Bakthavachalam S, Driver MS, Cox C, Spiegel JH, Grundfast KM, Merkel PA. Otol Neurotol. 2004 Sep;25(5):833-7. PMID 15354019
Leukopenia	No accuracy specified.		Leukopenia is NOT a feature of WG. A Leukocyte count < 4000/mm3 can be seen in patients with lymphomatoid granulomatosis which evolves into lymphoma. It is often confused with WG. Study: PMID 6336643 See pages 79-80: Fauci AS, Haynes BF, Katz P, Wolff SM. Wegener's granulomatosis: prospective clinical and therapeutic experience with 85 patients for 21 years. Ann Intern Med. 1983 Jan;98(1):76-85. Review. PubMed PMID: 6336643.
Erythematous painful pinna	No accuracy specified.		Study: no study specified.