Understanding the cANCA test

**darl-p** · 04-15-2014, 07:52 AM

I will jump in with info passed along by my docs. In the beginning I had my ANCA levels monitored. Now they no longer checked for it and I asked why not. It seems that it is not reliable as a great indicator of inflammation. There does appear to be a correlation between the Erythrocyte Sedimentation Rate or Sed Rate and inflammation when you compare it to the WBC. My docs look at the cReactive Protein (CRP), ESR and the WBC to determine if things are falling apart. Each of these is a marker for inflammation, but any one of them could be out of line and not be conclusive for a problem. My ANCA has been over 100 but the ESR and the CRP were normal. The Sed Rate appears to be the most telling. This is why the docs make the big bucks but it is also why we need to ask the questions.

**chrisTIn@** · 04-15-2014, 08:50 AM

Originally Posted by greenjeep

I was worried that I would relapse and not know it. So I asked my doc. How would I know if I just had a sinus infection or if I was in a relapse. He told me not to worry. That I would have routine bloodwork for rest of my life and if the ANCA became positive again, he would treat it. I later found out that a positive ANCA didn't necessarily mean a relapse either.
So what happened? I relapsed while on Methatrexate and quickly went into renal failure without knowing it.

Sent from my iPhone while driving on the freeway.

Renal failure can indeed happen very quickly, within one or two weeks.
My husband and I visited a meeting of the Dutch Vasculitis Foundation about a week ago and talked to a lady who was treated for GPA three years ago, went into remission and then got renal problems without knowing it. She now has a renal function of 20 to 30 %. Quite scary, we thought. She looked good now, and felt reasonably good, so she told us. She does a lot of volunteering work for the GPA-foundation, but is sometimes quite tired. She had to quit her 'official' job.

How are you feeling now, Greenjeep?
Please don't answer while driving...

**Alysia** · 04-15-2014, 09:09 PM

just one more link: Value of ANCA measurements during remission to predict a relapse of ANCA-associated vasculitis?a meta-analysis

**jvilner** · 04-15-2014, 10:01 PM

I had psoratic arthritis for 2 years before other symptoms started to appear and then was diagnosed with wegs. I sometimes wonder if I had been checked for wegs then I could have started earlier treatment. Too bad docs don't know abt this disease. (And all my first cousins, 11 of us, have some form of an sutoi

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**jvilner** · 04-15-2014, 10:04 PM

Sorry abt that. Post came up twice. Was for another forum

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**mishb** · 04-15-2014, 11:46 PM

Originally Posted by darl-p

I will jump in with info passed along by my docs. In the beginning I had my ANCA levels monitored. Now they no longer checked for it and I asked why not. It seems that it is not reliable as a great indicator of inflammation. There does appear to be a correlation between the Erythrocyte Sedimentation Rate or Sed Rate and inflammation when you compare it to the WBC. My docs look at the cReactive Protein (CRP), ESR and the WBC to determine if things are falling apart. Each of these is a marker for inflammation, but any one of them could be out of line and not be conclusive for a problem. My ANCA has been over 100 but the ESR and the CRP were normal. The Sed Rate appears to be the most telling. This is why the docs make the big bucks but it is also why we need to ask the questions.

Same tests my doctors look at - I don't think I have had an Anca test done for possibly 3 years now.

**Alysia** · 04-15-2014, 11:49 PM

Originally Posted by mishb

Same tests my doctors look at - I don't think I have had an Anca test done for possibly 3 years now.

you should do an anca test, according to my wg-doc, every 4 months.

**MaxD** · 04-16-2014, 02:50 AM

Chadwyck,

Here is an informative presentation that also addresses your question: http://www.stritch.luc.edu/cme/sites...13_hariman.pdf
The short answer is that while high PR3 levels alone are not a strong indicator for the general population, they can (under specific circumstances, such as when PR3 levels go down under treatment) be an early warning sign for individuals. That's why it is so important to have an expert looking at your numbers (at least as a backup to whoever is treating you).

By the way, there is a wealth of valuable information on the vasculitisfoundation.org website for GPA, including talks by leading GPA specialists.

Good luck to you (and to all fellow GPAers)!

**greenjeep** · 04-16-2014, 06:29 AM

Originally Posted by chrisTIn@

How are you feeling now, Greenjeep?
Please don't answer while driving...

I am doing better. My nephrologist put me on a Cytoxan infusion regimen that has brought my kidney function back close to normal. My old friend fatigue and wrestling wit the mental ramifications of this disease are my main issues today.

Sent from my iPhone while driving on the freeway.