What is ANCA vasculitis?
Anti-neutrophil cytoplasmic autoantibody (ANCA) vasculitis is a group of autoimmune disorders characterized by inflammation and damage to small blood vessels due to an abnormally functioning immune system that creates antibodies which attack the body’s own white blood cells.
What are the Causes of ANCA vasculitis?
Some of the possible causes of ANCA vasculitis include:
- Genetic abnormalities
- Environmental factors including exposure to pollutants such as silica or chemical substances used in agriculture (pesticides) or industry inhalation (alcohols and glues)
- Certain medications such as those used to treat thyroid disease and rheumatoid arthritis.
- Certain illicit drugs such as long-term cocaine use
- Infections with certain viruses and bacteria
What are the Symptoms of ANCA vasculitis?
Some of the signs and symptoms of the ANCA vasculitis include:
- Vascular damage in the kidneys and lungs
- Presence of blood and protein in the urine, making it appear brownish and foamy
- High blood pressure
- Fatigue
- Nerve problems like numbness, tingling, burning sensation, and muscle weakness
- Respiratory problems
- Gastrointestinal problems such as blood in stools, diarrhea, nausea, vomiting, and abdominal pain
Types of ANCA vasculitis
There are three main types of ANCA vasculitis. The symptoms and histology results under a microscope are commonly used to identify ANCA vasculitis.
- Microscopic Polyangiitis (MPA): Patients with this condition mainly experience renal inflammation, skin lesions, and nerve damage. Weight loss and fevers may also occur.
- Granulomatosis with Polyangiitis (GPA): Patients with this condition can have blood vessel damage mainly in the lungs, kidneys, and upper respiratory tract (nose, trachea, and ears). The inflammation is caused by granulomas, which are immune cell aggregates that form in the blood vessels.
- Eosinophilic Granulomatosis with Polyangiitis (EGPA): This condition usually affects the lungs and gastrointestinal tract, however, it can also impact other organs like the heart and kidneys. Granulomas, which are predominantly composed of eosinophils, another type of white blood cell in the immune system, cause it.
Diagnosis of ANCA vasculitis
Your doctor will review your medical history and symptoms and conduct a physical examination. The following diagnostic tests may be ordered:
- Blood and urine tests: These are performed to detect autoantibodies, inflammatory indicators, and renal disease.
- Tissue samples or biopsies: This is an image-guided procedure in which a small sample of tissue is taken and observed under the microscope.
To assess the lungs or the head and neck region, imaging studies such as X-rays and computed tomography may be indicated. Bronchoscopy and nasal endoscopy are procedures that use a flexible tube with a light and camera to examine the airways and sinuses respectively.
Treatment for ANCA vasculitis
There are several treatments available to manage the condition. These help to minimize and, in some circumstances, eliminate vascular inflammation and swelling that trigger uncomfortable symptoms.
Normally, treatment is divided into two phases: one to induce symptom remission (induction treatment) and another to keep you in remission for as long as feasible (maintenance treatment).
Treatments are targeted to reduce immune system reactions with medications such as corticosteroids (prednisolone), cyclophosphamide, rituximab, azathioprine, and methotrexate. The dosage and combination of the medications will depend on the degree and subtype of the condition.
