Granulomas in the upper airways (nose) or lower airways (lung) needs proper evaluation.
The differential diagnoses:
1. ANCA positive vasculitides - that require exclusion with ANCA, MPO PR3 blood tests, urea creatinine
. If PR3 is positive, Wegener's granulomatosis is a distinct possibility.
- ANCA is negative in this condition where granulomas form, and ACE levels (blood test) can be high in some patients. Steroids
with immunosuppressive drugs are the treatment options.
I hope that was useful.