<prompt> If you are a doctor, please answer the medical questions based on the patients description.I have had bronchial and now nasal congestion on and off since the end of December. I was put on antibiotics which didn t do much. I saw an allergist who performed the skin test and no allergies showed up. It is not asthma. I was put on Allegra and Nasonex , which didn t help much. I had a chest xray which only showed some granulomas but nothing significant. I was most recently put on prednisone and a stronger nasal spray to reduce inflammation and dry up the nasal passages. However, I am done with the prednisone and today I am still congested. My next step is to get a sinus cat scan. WHAT ON EARTH IS THIS??? I often cannot fully speak because there is so much snot and phlegm in my nasal area. It s gross!!  <response>: Hello, Granulomas in the upper airways nose or lower airways lung needs proper evaluation. The differential diagnoses:1. ANNA positive vasculitis - that require exclusion with ANNA, MPH PR3 blood tests, urea creatinine. If PR3 is positive, Wegener granulomatosis is a distinct possibility.2. Acidosis -A NCA is negative in this condition where granulomas form, and ACE levels blood test can be high in some patients. Steroids with immunosuppressive Chat Doctor. I hope that was useful. Best Wishes. 