Question

[Cathywithwegs]

I have been diagnosed for 2 years now and just had some regular blood work done. My sed rate is 44 and my C-reactive protein is 4.4. The anti neutrophil cytoplasmic antibody shows negative. I am on prednisone and methotrexate and doctor increased prednisone from 7.5 to 20. Does anyone know if an antiproteinase test is included within the ANCA test. When I was first diagnosed it was very high but kept coming down and was within normal range. I have since switched doctors and he just orders the ANCA test. I haven't been feeling well. Is this considered a flare because I had been considered in a medically induced remission. Thanks for any help,

[mrtmeo]

Hi Cathy,
Yes, I believe it is normal protocol for ANCA with pr3 or mpo which ever you had high or both.
I have read in the literature that people with ANCA negative, but symptoms of vasculitis can have a high mpo or pr3.
Your inflammation markers are a bit high.
Did your dr do any immunoglobulin tests?

[mrtmeo]

I found this explanation from labsonline
ANCA/MPO/PR3 Antibodies: The Test (http://labtestsonline.org/understanding/analytes/anca/tab/test/)

"Some laboratories will perform all three tests, ANCA, MPO and PR3, as a panel while others will perform MPO and PR3 only if an initial ANCA test is positive."

IMHO, I think the mpo and pr3 are more important if leaving one out.

[Cathywithwegs]

Thanks for the link. I will check this out. I appreciate the reply!

[lag713]

Related to your question, the ANCA test isn't the best measure for disease activity. The sed rate and CRP are better indicators of inflammation and disease activity as you monitor your status. My ANCA test was positive at dx then became negative after treatment however, the ANCA test doesn't always show as being positive during disease activity or become negative in remission.

[NikkiNicole]

My ANCA test that I do often includes MPO and PR-3. My PR-3 has always been high. Of course, I don't think I've ever actually achieved any sort of remission so ... that could be why. The PR-3 portion of the ANCA test is what tipped my doctors in the direction of a Vasculitis related disease.
But, like has been said before ... it's not a guarantee of Weg's activity and your inflammation is definitely pointing towards something.