2017 ACR/EMA Revised Criteria for too Early Diagnosis of Granulomatosis with Polyangiitis (GPA)

Granulomatosis with polyangiitis (GPA) or Wegener's granulomatosis is a systemic necrotizing vasculitis with small sized vessel involvement and granulomatous inflammation of ENT and/or Lung and/or Kidney that is associated with ANCA positivity. Upon the clinical/laboratory/imaging judgement of an expert Rheumatologist in cooperation with an expert otolaryngologist and an expert infectious disease specialist the diagnosis of GPA can be established. There have been three criteria for GPA including: • The 1990 ACR classification criteria for Wegener's granulomatosis • The EMA diagnostic criteria of systemic GPA • Iran criteria for early diagnosis of GPA The 1990 ACR criteria is not sensitive enough and it can not detect the cases of GPA in early stages. The EMA criteria has been made for diagnosis of systemic GPA in the absence of biopsy and its sensitivity is too much low. Iran criteria for early diagnosis of GPA is highly sensitive but there is a lag period of about a few months between the initial presentation of disease and the time of confirmation of it. You have to know that with a little changes within Iran criteria a new criteria is created by the author of this letter called2017 ACR/EMA revised criteria by which the diagnosis of GPA can be established too earlier with a lag period of a few weeks only.