Calculators & Tools

Granulomatosis with Polyangiitis (Wegener)

EULAR/PRINTO/PRES paediatric criteria - ≥3 of 6 features classify GPA.

1 What is the Granulomatosis with Polyangiitis (Wegener)?

The Granulomatosis with Polyangiitis (Wegener) is a rheumatology scoring tool used in paediatric practice. EULAR/PRINTO/PRES paediatric criteria - ≥3 of 6 features classify GPA. It scores 6 criteria and interprets the total across 2 bands, so the number always arrives with the severity it implies rather than on its own. In PediAid each criterion is shown as a labelled option with the weight it carries, so the total can be checked rather than taken on trust.

2 When to use it

  • Grading severity at the bedside in rheumatology
  • Recording an objective severity band in the case notes
  • Deciding when a total crosses the threshold for escalation
  • Re-scoring to track whether a child is improving or deteriorating
  • Checking the exact criteria of a score used infrequently

3 Formula & method

The score sums 6 criteria: Histopathology - granulomatous inflammation within the vessel wall or peri/extravascular area; Upper airway involvement - nasal discharge, recurrent epistaxis, crusts, sinus inflammation, subglottic/tracheal stenosis; Laryngo-tracheo-bronchial stenosis; Pulmonary involvement - chest X-ray or CT showing nodules, cavities or fixed infiltrates; ANCA positivity (by immunofluorescence or ELISA - MPO/p-ANCA or PR3/c-ANCA); Renal involvement - proteinuria, haematuria/red-cell casts, necrotising pauci-immune glomerulonephritis. Totals are then banded: any score - Criteria not met: fewer than 3 criteria - does not classify as childhood GPA; 3 criteria or more - Criteria MET: ≥3 of 6 criteria - classifies as childhood granulomatosis with polyangiitis (sensitivity 93%, specificity 99%). Induction with corticosteroids plus rituximab or cyclophosphamide.
  • Source: Ozen S et al. EULAR/PRINTO/PRES Ankara 2008 criteria. Ann Rheum Dis 2010;69:798-806.

4 Frequently asked questions

How many criteria does the Granulomatosis with Polyangiitis (Wegener) use?

6. They are Histopathology - granulomatous inflammation within the vessel wall or peri/extravascular area; Upper airway involvement - nasal discharge, recurrent epistaxis, crusts, sinus inflammation, subglottic/tracheal stenosis; Laryngo-tracheo-bronchial stenosis; Pulmonary involvement - chest X-ray or CT showing nodules, cavities or fixed infiltrates; ANCA positivity (by immunofluorescence or ELISA - MPO/p-ANCA or PR3/c-ANCA); Renal involvement - proteinuria, haematuria/red-cell casts, necrotising pauci-immune glomerulonephritis.

What do the bands of the Granulomatosis with Polyangiitis (Wegener) mean?

The total is interpreted as: any score - Criteria not met: fewer than 3 criteria - does not classify as childhood GPA; 3 criteria or more - Criteria MET: ≥3 of 6 criteria - classifies as childhood granulomatosis with polyangiitis (sensitivity 93%, specificity 99%). Induction with corticosteroids plus rituximab or cyclophosphamide.

Does the score replace clinical judgement?

No. It is a structured way to record and communicate severity. A clinician concerned about a child should act on that concern regardless of the total.

Where does this score come from?

Source: Ozen S et al. EULAR/PRINTO/PRES Ankara 2008 criteria. Ann Rheum Dis 2010;69:798-806.

Does it work offline?

Yes. Score definitions are bundled with the PediAid app, so the score computes without a connection.

For qualified clinicians. This page and the PediAid app are a clinical aid only. Calculations and reference data must be verified against the patient's clinical context, the source guideline and your local protocols before any treatment decision is made.