Q. My c-ANCA levels are 5. 6 U/ml. What is the general prognosis?

Answered by
Dr. Anshul Varshney
and medically reviewed by iCliniq medical review team.

Last reviewed at: Jan 10, 2019

Hello doctor,

My c-ANCA levels are 5.6 U/ml (borderline positive). I have hypertension and proteinuria (3g), high serum creatinine (2.4) and UTI. My other autoimmune tests and serum electrophoresis results are negative. What should I do and what is the general prognosis?

Dr. Anshul Varshney

Critical Care Physician Diabetology General Medicine Internal Medicine Medical Gastroenterology Nephrology Pulmonology (Asthma Doctors) Rheumatology
#

Hi,

Welcome to icliniq.com.

Based on your query, my opinion is as follows:

C-ANCA (Antineutrophil cytoplasmic antibodies) positivity indicates Wegener's Granulomatosis. In this condition, there is involvement of upper and lower respiratory tract and kidneys. Most common diagnosis, while kidneys are effected, is Lupus. But I suppose your ANA and anti-Ds DNA are negative.

I would like to see all your reports, and I also recommend you to get an x-ray of paranasal sinuses to see for any polyps that are associated with Wegener's Granulomatosis. A chest x-ray may show a cavitary lesion.

You need a kidney biopsy, first of all, followed by which you will be started on immunosuppressive therapy. Steroids and other immunosuppressive agents like Cyclophosphamide, Azathioprine are used. Prognosis and life expectancy can be commented after the report of kidney biopsy, as most of the times fatality occur due to renal failure.

I hope it helps.

Hello doctor,

I have attached my reports for your review. Any suggestion or recommendation is highly appreciated. These issues started after the flu and throat infection before three months. Blood pressure is currently 140/90 after medication (4 different medicines) and hemoglobin is 9.5g/dL, with prescription Vintor (Erythropoietin) and Encicarb (Iron). Reports of platelet counts are also attached. Do autoimmune diseases progress that quick? Is it safe to have a biopsy? Is there a possibility that ANCA is false positive? Please advise.

Dr. Anshul Varshney

Critical Care Physician Diabetology General Medicine Internal Medicine Medical Gastroenterology Nephrology Pulmonology (Asthma Doctors) Rheumatology
#

Hello,

Welcome back to icliniq.com.

I have gone through your reports (attachments removed to protect patient identity). Following are the answers for your query:

Yes, autoimmune disease can progress very rapidly. However, the progression can be delayed with appropriate treatment. A biopsy is relatively safe. Every procedure has its own risk but it is important in your case for your diagnosis.

Yes, ANCA (Antineutrophil cytoplasmic antibodies) can be false positive, but chances are less in your case. Get the investigations that I have advised and you need to start immunosuppressive treatment as soon as possible.

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