Blood tests to help in the investigations of these conditions are listed below and a guide to their use may be found in Test Profiles.
Connective Tissue Disease
This covers a wide range of relatively rare conditions including systemic lupus erythematosus (SLE), scleroderma, polymyositis and Sjorgren's syndrome. Rheumatoid arthritis is common, and may present initially with similar features. However, the early involvement of other organs (e.g. skin, kidneys, eyes, Raynaud's) may suggest an alternative diagnosis.
Includes a heterogeneous group of diseases, characterised by inflammation and necrosis of blood vessel walls. Presenting features may include fever, weight loss, fatigue, multi-system involvement (skin, nasal bleeding/crusting, arthralgia, myalgia, neuropathy), with raised inflammatory markers and abnormal urinalysis. As with connective tissue disease, rapid diagnosis and treatment is essential to prevent organ damage and death. Serological markers such as ANCA may be helpful, but are not diagnositc and their absence does not exclude vasculitis. Biopsy evidence of vasculitis is always preferable to confirm the clinical suspicion.
Clinical advice regarding the management of these conditions may be obtained from the department Medical Staff, or from the relevant clinical specialty (e.g. renal, medicine, rheumatology). Patients may be referred to Immunology or to Rheumatology for assessment.
Advice for Medical Practitioners
Advice regarding the investigation, treatment or referral of all patients with possible connective tissue disease and vasculitis is available from the medical staff. Advice out of normal working hours can be obtained from the on-call rheumatology, renal or medical teams (depending on the patient's particular problem).