49 一位39歲男性，因為持續3週的血痰與呼吸喘促到院求治。胸部X光與胸部電腦斷層顯示兩側多發性實質化與毛玻璃樣浸潤。尿液檢查有許多紅血球。理學檢查發現後鼻腔有黏膜增厚，疑似腫塊。下列那種檢驗對於確立診斷效益最低？

cytoplasmic antineutrophil cytoplasmic antibody（c-ANCA）

anti-glomerular basement membrane（GBM）antibody

anti-cardiolipin antibody

鼻腔腫塊活體切片

CASE OF GOODPASTURE VS WEDGNER GRANULOMATOSIS

ANTI GBM FOR GOOD PASTURE

C ANCA FOR W GRANULOMATOSIS

ANS C

Anti-cardiolipin antibodies (ACA) are antibodies often directed against cardiolipin and found in several diseases includingsyphilis^[1], antiphospholipid syndrome, livedoid vasculitis, vertebrobasilar insufficiency, Behçet's syndrome^[2], idiopathic spontaneous abortion,^[3] and systemic lupus erythematosus(SLE).^[4] They are a form of anti-mitochondrial antibody. In SLE, The anti-DNA antibodies and anti-cardiolipin act independently.^[5] In rheumatoid arthritis^[6] w/systemic sclerosis (scleroderma)^[7] these antibodies may tie two conditions together.