ANCA

Question 1

What is ANCA?

Answer 1

Anti-Neutrophil Cytoplasmic Antibodies

Question 2

Types of ANCA

Answer 2

​2 types:

• cANCA (cytoplasmic anti-nuclear antibody)
• pANCA (perinuclear anti-nuclear antibody)

Question 3

Name 2 most common diseases associated with c-ANCA and p-ANCA

Answer 3

Do your C.W. on P.C

• cANCA >>> Wegner’s granulomatosis
• pANCA >>> Churg-Struss syndrome

Question 4

cANCA: the most common target

Answer 4

Serine proteinase 3 (PR3)

Question 5

cANCA >>> associated diseases

Answer 5

• Wegener’s granulomatosis (positive in >90%)
• Microscopic polyangitis (positive in 40%)

Question 6

pANCA: the most common target

Answer 6

MPO (Myeloperoxidase)

Question 7

ANCA to monitor disease activity

Answer 7

• cANCA levels has some correlation with disease activity (so, we can use for this purpose)
• pANCA levels do NOT have any correlation with disease activity (so, we can NOT use this)

Question 8

pANCA >>> associated diseases

Answer 8

• Churg Strauss syndrome (CSS) (positive in 60% cases)
• Immune cresentic GN (glomerulonephritis) = RPGN (Rapidly progressing glomerulonephritis)
  
  • Goodpsture’s syndrome (positive in 80% cases)
  • Wegner’s granulomatosis (positive in 25% cases)
• ​Microscopic polyangitis (positive in 50-75% cases)

Question 9

Other/less common causes of positive ANCA (usually pANCA)

Answer 9

• IBD (Inflammatory Bowel disease (UC >> Crohn’s disease)
• Connective tissue disorders
  
  • RA
  • SLE
  • Sjogren’s syndrome
• Autoimmune hepatitis