Hey Carol, redrose. My ANA is around 360, sometimes higher, but always up. It's not really high high, which puzzled me why it would effect the P-ANCA. It also made me wonder if most rheumies bother to test patients with ANA for the P-ANCA, since there seems to be some confusion between them. P-ANCA indicative of autoimmune hepatitis type I, a couple type of severe kidney disease, and I believe also autoimmune vascular problems. C-ANCA is indicative of Wegeners granulomatosis which is a really bad disease that causes a lot of problems. Luckily, I did not have C-ANCA.
Since so many people have liver and kidney and vascular problems as part of their lupus, it seems logical that before they assume that a problem is caused by lupus, like kidney problems, that they should test for these autoantibodies, since you might have another problem and it might help them to get a better picture of the overall problem and the direction the diseases will go. Since most of the autoimmune problems get treated with immunosuppressants and steroids, I suppose some docs feel it's a waste of money, but it would be nice to know early on that you have autoimmune kidney or liver problems before you have serious problems. And at least its a blood test that can be done that is predictive.
Mayo did it along with all the complete antibody study they did. It was really good to know. Still, even though it's positive, and I have had kidney problems since a child, I still can't get a referral to a nephrologist or any imaging or dx tests done on my kidneys. Just goes to show you have to keep pushing.
My rheumatologist said the P-ANCA is not good, but at least I don't have the C-ANCA. I asked him about
it and he said he had to do further testing and I haven't seen him since. I think the general consensus is that I have a bunch of autoantibodies, probably from the interferon tx I took, and that I'm just beginning to "bloom" and develop a bunch of problems. I'm pretty sure I have vascular problems because it was mentioned to me by a doc when I first got sick and she knew me before and after and saw me get gravely ill in a matter of a month or two. She felt the excess pigment loss in my left leg was due to a vascular problem, especially with the increased swelling in that leg. What a mess.
Anyway, I didn't know if anyone else had that test run. My docs refuse to diagnose me with lupus and keep holding out and running more tests. I should be grateful. They realize I'm really sick, they just want to rule out the other stuff.
Take care and maybe ask for the test when you get bloodwork done. It's fairly common and might help your rheumie. They should do both ANCAs to make sure to rule out Wegeners.
The P-ANCA can be involved in lung disease:
"Churg-Strauss syndrome (also known as allergic granulomatosis) is a medium and small vessel autoimmune vasculitis, leading to necrosis. It involves mainly the blood vessels of the lungs (it begins as a severe type of asthma), gastrointestinal system, and peripheral nerves, but also affects the heart, skin and kidneys. It is a rare disease that is non-inheritable, non-transmissible and often mis-diagnosed. Churg-Strauss syndrome was once considered a type of Polyarteritis nodosa (PAN) due to their similar morphologies."
"Diagnostic markers include eosinophil granulocytes and granulomas in affected tissue and Anti-neutrophil cytoplasmic antibodies (ANCA) against neutrophil granulocytes. Differentiation from Wegener's granulomatosis can be difficult, though the increasing use of ANCA assays has made the distinction more routine. Wegener's is closely associated with c-ANCA, unlike Churg-Strauss, which shows elevations of p-ANCA."
"This disease [Churg-Strauss] has three distinct stages.
The first stage often involves the sinuses and the onset of allergies not previously had or the worsening of pre-existing allergies.
The second stage involves the onset of acute asthma. Normally, the person would not have had asthma previously.
The third and final stage involves the various organ systems. Stage three is by far the most life threatening and painful. Often the person will develop severe nerve pain in their legs, arms and hands. Purple marks will appear on the skin and often sores will appear in the mouth or nose. The disease will affect the heart and lungs or it will affect the kidneys and liver.
People can live for many years in the first two stages before progressing to stage three."
Here's a link on the ANCAs:
Thanks for the kind replies. Since there is so much misdiagnosis, it's good to know about
this stuff. Mayo has been good on the testing stuff.
Take care and I hope you are doing fine!
--Sometimes I think the surest sign that intelligent life exists elsewhere in the universe is that none of it has tried to contact us. Bill Watterson (1958-) cartoonist "Calvin and Hobbes"
Ills--Sjogrens-Lupus-like AI Disease, Hashis, Vitiligo, spinal stenosis/fusion with plate, salivary/lymphectomies, Diabetes, NAFLD, COPD, RLS, neuropathy, trigonitis, hystero, diffuse brain atrophy, GI nightmare
Meds--Plaquenil, Evoxac, Metformin, Synthroid, HCTZ, Estradiol patch, Prosed, Detrol, Klonopin, Ultram, Vicodin, Restasis, Albuterol, steroid injections and pred prn