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ANCA positive?
Mar 5, 2015
I got my recent bloods back, as expected my ANA was still 1:1280, but also my ANCA was weakly positive...this is a new one to me. And googling doesn't really help, it all sounds complicated. I've been told me ANA is coincidence but I don't think my ANCA is...not according to what I'm reading. But this isn't usually a lupus indicator is it? It says more systemic vasculitis and things like Wegners and churg strauss. There seems to be a lot of similar symptoms between things like Wegners and lupus, so I'm a little freaked out, but considering it's been like 8 years and I'm still here and not at death's door, it doesn't make sense for it to be something like that, and all my kidney tests are normal - but I am getting blood in my urine intermittently for no reason.

I haven't seen my doctor yet, these are just preliminary results but recently my rheumy wrote my off as "post viral", maybe we are getting somewhere, but where is the question? Any one have this? I'm not sure which ANCA it is yet.
Re: ANCA positive?
Mar 5, 2015
angryt, like you, I'd think that an ANA of 1:1280 seems too high to be "post-viral". One of my lupus hardcovers says that the specificity of ANCA to lupus is considered "poor". The author says ANCA is more likely a flag for what he calls "non-lupus vasculitis". He then he names two kinds: Wegener's granulomatosis (c-ANCA subset) and microscopic polyangiitis (p-ANCA subset).

I know nothing about those two conditions (so sorry), but I imagine that each has its own diagnostic criteria, and probably some additional tests that are typically done to confirm them or to rule them out. When do you see your rheumatologist? I'd probably ask (1) if your tests showed which subset of ANCA tested as positive (the c or p subset), and (2) which, if any, of the various ANCA-positive conditions your symptoms & labs so far might possibly point to.

While you must be very weary of not knowing, I think you're clear-headed with your remark that you're NOT at death's door. My lupus dx played out VERY slowly, but rationally, I sensed that whatever was going on wasn't going to kill me, because I'd had issues for so many years. But even so, I think you do need answers: why let whatever it is get any worse? I'll add more if I can think of anything else that I'd ask if I were in your shoes. Sending hugs, Vee

P.S. I just read something very important about ANCA, that it alone NEVER diagnoses Wegener's. You'd ALSO have to have various of the symptoms strongly associated with the condition. So I hope during your appointment, your doctor reviews your symptoms with you and explains how they might fit or might not fit!
Re: ANCA positive?
Mar 5, 2015
I agree that a titer of 1:1280 on ANA is more than "Post viral" and having even a weakly + ANCA lends support to the fact that something is going on with you that needs attention. If nothing else, it should make the rheumy sit up and take notice, and look for any signs of vasculitis. I think ANCA can be + in lupus, and an explanation should be sought as well for the intermittent blood in urine, which can also happen in lupus. If your current rheum dismisses all this, I would seek a second opinion from another rheum, and not settle for no answers.

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