Granulocyte cytoplasmic antibody (antineutrophil cytoplasmic antibody; auto-Ak against granulocyte cytoplasm; ANCA) is an antibody directed against granulocytes (immune defense cells).
One can distinguish a diffuse (cANCA) from a perinuclear pattern (pANCA) in ANCA.
The procedure
Material needed
- Blood serum
Preparation of the patient
- Not necessary
Disruptive factors
- Therapy with corticoids
- Immunosuppressive therapy
Normal value
| Normal value | Negative |
Indications
- Suspected granulomatosis with polyangiitis (GPA), formerly Wegener’s granulomatosis (necrotizing (tissue dying) vasculitis (vascular inflammation) of small to medium-sized vessels (small-vessel vasculitides), which is accompanied by granuloma formation (nodule formation) in the upper respiratory tract (nose, sinuses, middle ear, oropharynx) as well as the lower respiratory tract (lungs)) or other vasculitides (vascular inflammation).
- Suspected rapid progressive glomerulonephritis (RPGN) – form of kidney disease, with inflammation of the renal filterlets (glomeruli).
- Suspicion of pulmonary hemorrhage
- Follow-up of granulomatosis with polyangiitis.
Interpretation
Interpretation of increased values
- Amoebic dysentery – infectious disease occurring in the (sub)tropics; the causative agents are protozoans belonging to the species Entamoeba histolytica and Entamoeba dispar; symptom: pulpy, mucopurulent, bloody stools (raspberry jelly-like stools).
- Arthritis (inflammation of the joints)
- Ulcerative colitis – chronic inflammatory disease of the mucous membrane of the colon (large intestine) or rectum (rectum).
- Endocarditis (inflammation of the inner lining of the heart).
- Eosinophilic granulomatosis with polyangiitis (EGPA; formerly Churg-Strauss syndrome (CCS)) (pANCA 65%, cANCA 10%) (CSS) – granulomatous (roughly: “granule-forming”) inflammation of small to medium-sized blood vessels in which the affected tissue is infiltrated (“walked through”) by eosinophilic granulocytes (inflammatory cells)
- Granulomatosis with polyangiitis (v. a. cANCA).
- Hepatitis (inflammation of the liver)
- Microscopic polyangiitis (cANCA/pANCA 45%) – vasculitis (inflammation of blood vessels), which belongs to the group of autoimmune diseases.
- Crohn’s disease – chronic inflammatory bowel disease (IBD); usually progresses in relapses and can affect the entire digestive tract; characteristic is the segmental affection of the intestinal mucosa (intestinal mucosa), that is, several intestinal segments may be affected, which are separated from each other by healthy sections.
- Kawasaki disease (acute febrile mucocutaneous lymphadenopathy syndrome; mucocutaneous lymph node syndrome) – probably immunologically mediated diffuse vasculitis occurring predominantly in childhood, characterized clinically by high fever, enlarged cervical lymph nodes, skin and mucosal involvement.
- Panarteritis nodosa (pANCA 15%, cANCA 5%) – necrotizing vasculitis that usually affects medium-sized vessels; in this case, the inflammation involves all wall layers (pan = Greek all; arteri- from artery = arteries; -itis = inflammatory).
- Primary biliary cirrhosis – mostly occurring in women form of liver cirrhosis, which is caused by chronic bile duct inflammation.
- Primary sclerosing cholangitis – chronic disease in which the bile ducts are narrowed/closed by inflammation.
- Rheumatoid arthritis – chronic inflammatory multisystem disease that usually manifests as synovitis (inflammation of the synovium, which produces synovial fluid). It is also called primary chronic polyarthritis (PcP).
- Takayasu arteritis – autoimmune disease in which there is granulomatous inflammation of the aorta and its main branches.