Antineutrophil Cytoplasmic Antibodies (ANCA) Test

What is an antineutrophil cytoplasmic antibodies (ANCA) test?

This test looks for antineutrophil cytoplasmic antibodies (ANCA) in your blood. Antibodies are proteins that your immune system makes to fight foreign substances like viruses and bacteria. But ANCAs attack healthy cells known as neutrophils (a type of white blood cell) by mistake. This can lead to a disorder known as autoimmune vasculitis. Autoimmune vasculitis causes inflammation and swelling of the blood vessels.

Blood vessels carry blood from your heart to your organs, tissues, and other systems, and then back again. Types of blood vessels include arteries, veins, and capillaries. Inflammation in the blood vessels can cause serious health problems. Problems vary depending on which blood vessels and body systems are affected.

There are two main kinds of ANCA. Each targets a specific protein inside white blood cells:

• pANCA, which targets a protein called MPO (myeloperoxidase)
• cANCA, which targets a protein called PR3 (proteinase 3)

The test can show whether you have one or both types of antibodies. This can help your health care provider diagnose and treat your disorder.

Other names: ANCA antibodies, cANCA pANCA, cytoplasmic neutrophil antibodies, serum, anticytoplasmic autoantibodies

What is it used for?

An ANCA test is most often used to find out if you have a type of autoimmune vasculitis. There are different types of this disorder. They all cause inflammation and swelling of blood vessels, but each type affects different blood vessels and parts of the body. Types of autoimmune vasculitis include:

• Granulomatosis with polyangiitis (GPA), previously called Wegener’s disease. It most often affects the lungs, kidneys, and sinuses.
• Microscopic polyangiitis (MPA). This disorder can affect several organs in the body, including the lungs, kidneys, nervous system, and skin.
• Eosinophilic granulomatosis with polyangiitis (EGPA), previously called Churg-Strauss syndrome. This disorder usually affects the skin and lungs. It often causes asthma.
• Polyarteritis nodosa (PAN). This disorder most often affects the heart, kidneys, skin, and central nervous system.

An ANCA test may also be used to monitor treatment of these disorders.

Why do I need an ANCA test?

Your health care provider may order an ANCA test if you have symptoms of autoimmune vasculitis. Symptoms include:

• Fever
• Fatigue
• Weight loss
• Muscle and/or joint aches

Your symptoms may also affect one or more specific organs in your body. Commonly affected organs and the symptoms they cause include:

• Eyes
  • Redness
  • Blurred vision
  • Loss of vision
• Ears
  • Ringing in the ears (tinnitus)
  • Hearing loss
• Sinuses
  • Sinus pain
  • Runny nose
  • Nose bleeds
• Skin
  • Rashes
  • Sores or ulcers, a type of deep sore that’s slow to heal and/or keeps coming back
• Lungs
  • Cough
  • Trouble breathing
  • Chest pain
• Kidneys
  • Blood in the urine
  • Foamy urine, which is caused by protein in the urine
• Nervous system
  • Numbness and tingling in different parts of the body

What happens during an ANCA test?

A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?

You don’t need any special preparations for an ANCA test.

Are there any risks to the test?

There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?

If your results were negative, it means your symptoms are probably not due to autoimmune vasculitis.

If your results were positive, it may mean you have autoimmune vasculitis. It can also show if cANCAs or pANCAs were found. This can help determine which type of vasculitis you have.

No matter which type of antibodies were found, you may need an additional test, known as biopsy, to confirm the diagnosis. A biopsy is a procedure that removes a small sample of tissue or cells for testing. Your health care provider may also order more tests to measure the amount of ANCA in your blood.

If you are currently being treated for autoimmune vasculitis, your results may show whether your treatment is working.

If you have questions about your results, talk to your health care provider.

Is there anything else I need to know about an ANCA test?

If your ANCA results show you have autoimmune vasculitis, there are ways to treat and manage the condition. Treatments may include medicine, therapies that temporarily remove ANCAs from your blood, and/or surgery.

References

1. Allina Health [Internet]. Minneapolis: Allina Health; C-ANCA measurement; [cited 2019 May 3]; [about 3 screens]. Available from: https://account.allinahealth.org/library/content/49/150100
2. Allina Health [Internet]. Minneapolis: Allina Health; P-ANCA measurement; [cited 2019 May 3]; [about 3 screens]. Available from: https://account.allinahealth.org/library/content/49/150470
3. Cleveland Clinic [Internet]. Cleveland (OH): Cleveland Clinic; c2019. Leg and Foot Ulcers; [cited 2019 May 3]; [about 3 screens]. Available from: https://my.clevelandclinic.org/health/diseases/17169-leg-and-foot-ulcers
4. Lab Tests Online [Internet]. Washington D.C: American Association for Clinical Chemistry; c2001–2019. ANCA/MPO/PR3 Antibodies; [updated 2019 Apr 29; cited 2019 May 3]; [about 2 screens]. Available from: https://labtestsonline.org/tests/ancampopr3-antibodies
5. Lab Tests Online [Internet]. Washington D.C.: American Association for Clinical Chemistry; c2001–2019. Biopsy; [updated 2017 Jul 10; cited 2019 May 3]; [about 2 screens]. Available from: https://labtestsonline.org/glossary/biopsy
6. Lab Tests Online [Internet]. Washington D.C.: American Association for Clinical Chemistry; c2001–2019. Vasculitis; [updated 2017 Sep 8; cited 2019 May 3]; [about 2 screens]. Available from: https://labtestsonline.org/conditions/vasculitis
7. Mansi IA, Opran A, Rosner F. ANCA-Associated Small-Vessel Vasculitis. Am Fam Physician [Internet]. 2002 Apr 15 [cited 2019 May 3]; 65(8):1615–1621. Available from: https://www.aafp.org/afp/2002/0415/p1615.html
8. Mayo Clinic Laboratories [Internet]. Mayo Foundation for Medical Education and Research; c1995–2019. Test ID: ANCA: Cytoplasmic Neutrophil Antibodies, Serum: Clinical and Interpretive; [cited 2019 May 3]; [about 4 screens]. Available from: https://www.mayocliniclabs.com/test-catalog/Clinical+and+Interpretive/9441
9. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Blood Tests; [cited 2019 May 3]; [about 3 screens]. Available from: https://www.nhlbi.nih.gov/health-topics/blood-tests
10. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Vasculitis; [cited 2019 May 3]; [about 2 screens]. Available from: https://www.nhlbi.nih.gov/health-topics/vasculitis
11. Radice A, Sinico RA. Antineutrophil Cytoplasmic Antibodies (ANCA). Autoimmunity [Internet]. 2005 Feb [cited 2019 May 3]; 38(1): 93–103. Available from: https://www.ncbi.nlm.nih.gov/pubmed/15804710
12. UNC Kidney Center [Internet]. Chapel Hill (NC): UNC Kidney Center; c2019. ANCA Vasculitis; [updated 2018 Sep; cited 2019 May 3]; [about 3 screens]. Available from: https://unckidneycenter.org/kidneyhealthlibrary/glomerular-disease/anca-vasculitis