Hi Nathaniel. Nasal biopsy is a tricky call. My doctors didn't even consider it because of damage already caused to sinus cavity plus the fact that it has a high rate of false negatives. If you are on rtx though I don't know if they will find another area of inflammation to test. My diagnosis involved a needle biopsy of my lung with infected tissue. As for the prednisone horse you may already be on it and not realize it. I was not aware my rtx infusion had methylprednisolone, which while technically different is very similar and almost the same thing, as part of the infusion. Getting on a high dose is always no fun. But many have gone with a low dose prednisone for managing symptoms after they are under control. Not ideal but if your doctor suggests it I would give it serious consideration. Only other advise I really have for you is keep looking and pushing for a diagnosis. It sounds like they are treating you for WG but kind of touch and go. If it is Wg it will allow your doctor to be a bit more aggressive knowing this. And if it ends up being something else your treatment options may vary from alittle to ALOT and go a long way to making you feel better.