ANCA vasculitis Flashcards
What does ANCA stand for
Anti-neutrophil cytoplasmic antibodies (ANCA)
give examples of small-vessel ANCA associated vasculitides
granulomatosis with polyangiitis (Wegner’s)
eosinophilic granulomatosis with polyangiitis (Churg-Strauss)
microscopic polyangiitis
ANCA associated vasculitis is more common with increasing age TRUE/FALSE?
TRUE
Name clinical findings which are common to all ANCA associated vasculitis
Renal impairment (immune complex glomerulonephritis)
Respiratory symptoms - dyspnoea/ haemoptysis
Systemic symptoms - fatigue/fever/weight loss
vasculitic rash (rare)
sinusitis
First line investigations for ANCA vasculitis
urinalysis- haematuria/proteinuria
bloods:
- U&E for renal function
- FBC for normocytic anaemia/thrombocytosis
- CRP: raised
- ANCA testing
CXR: nodular, fibrotic or infiltrative lesions may be seen
Name the two types of ANCA
cytoplasmic (cANCA)
perinuclear (pANCA)
cANCA is associated with which small vessel vasculitis
Granulomatosis with Polyangitis (GPA)
pANCA is associated with which small vessel vasculitis?
Eosinophilic granulomatosis with polyangiitis (Churg Strauss)
Microscopic polyangiitis is associated with both c-ANCA and p-ANCA. Which is mroe prevalent?
p-ANCA
c-ANCA acts on which target. PR3 or MPO?
PR3
pANCA acts on which target. PR3 or MPO?
MPO
Which ANCA can be used to somewhat monitor disease activity?
c-ANCA levels
Other conditions associated with p-ANCA
Ulcerative colitis (70%)
Primary sclerosing cholangitis (70%)
Anti-GBM disease (25%)
Crohn’s disease (20%)
What organ biopsies can be used to aid diagnosis of ANCA vasulitis?
Kidney or lung biopsies
Management of ANCA associated vasculitis
Immunosuppressant treatment