ANCA Vasculitis Part 2 MPA

Question 1

Microscopic polyangitis (MPA)

Answer 1

c-ANCA which is PR3 - 40%

p-ANCA which is MPO - 50%

Negative ANCA in about 10 to 30%

Question 2

Microscopic polyangitis (MPA)

Answer 2

Age of onset is 5th to 7th decade of life with a slight male predominance. More common in white than black.

Question 3

Microscopic polyangitis (MPA)

Answer 3

In the lungs you see necrotizing vasculitis without granulomatous inflammation.

Question 4

Microscopic polyangitis (MPA)

Answer 4

In the kidneys you often see rapidly progressive disease but can be indolent acute or chronic nephritis. In the gastrointestinal 50% of patients with MPA, GPA, EGPA have abdominal pain, bloody stool with mesenteric ischemia or intestinal infarction or perforation, pancreatitis, or hepatitis.

Question 5

Microscopic polyangitis (MPA)

Answer 5

In the skin using nodular cutaneous lesions this is rare.

Question 6

Microscopic polyangitis (MPA)

Answer 6

Neurologically you see peripheral neuropathy, usually mononeuritis multiplex pattern. Up to 70% in the EGPA and a 50% GPA and 30% MPA.

Question 7

Microscopic polyangitis (MPA)

Answer 7

Central nervous system involvement is less common, may present as vasculitis within the meninges.

Question 8

Microscopic polyangitis (MPA)

Answer 8

Other organ involvements include 20% cardiac involvement in which you will get heart blocks and possible ventricular hypokinesis.