ANCA positive should be alert to three diseases

ANCA positivity usually indicates immune-related diseases, and we need to be alert to three major diseases associated with anti-neutrophil cytoplasmic antibodies: microscopic polyangiitis, granulomatosis with polyangiitis, and eosinophilic granulomatosis with polyangiitis. These diseases may affect multiple organ systems, so it is recommended to seek medical attention as soon as possible for comprehensive evaluation and treatment.

1Microscopic polyangiitis

This disease is characterized by inflammation of small blood vessels, involving the kidneys, lungs, or skin. It often causes renal symptoms such as hematuria, hypertension, and proteinuria, and may lead to acute renal failure in severe cases. Some patients may have respiratory symptoms such as cough, wheezing, and difficulty breathing. Confirmation requires a combination of ANCA testing, urine analysis, renal biopsy, and other methods. Treatment usually includes glucocorticoids such as prednisone, immunosuppressants cyclophosphamide or mycophenolate mofetil, and possible supportive dialysis therapy.

2 Granulomatosis with polyangiitis

This disease, also known as Wegener's granulomatosis, mainly affects the respiratory tract and kidneys. The upper respiratory tract manifests as nasal congestion, sinusitis or bloody nasal discharge, and the lower respiratory tract may present with cough, chest pain or lung nodules, and even hemoptysis. When the kidneys are affected, it can cause hematuria and proteinuria. The diagnosis depends on ANCA testing and pathological biopsy. Treatment is mainly based on glucocorticoids combined with immunosuppressants, and biological agents such as rituximab can be added in severe cases.

3Eosinophilic granulomatosis with polyangiitis

The disease often presents as asthma and allergic rhinitis, and in the late stage it may enter the vasculitis stage, leading to peripheral neuropathy, myocardial damage, or skin lesions such as hemorrhages and rashes. Those who are ANCA positive often have nerve and kidney involvement. A routine blood test is required to confirm the diagnosis by detecting an increase in eosinophils, combined with ANCA testing and histopathological analysis. Treatment is effective with high-dose hormones, gradually combined with immunosuppressants such as methotrexate or cyclophosphamide, and those with cardiac involvement may need specific cardiac protection measures.

The above diseases are all critical illnesses. ANCA positive indications need to be taken seriously. Seek medical attention in time for a clear diagnosis and receive standardized treatment. Even if the symptoms are mild, strict treatment and long-term follow-up are required to prevent disease progression or recurrence. Maintaining good living habits and paying attention to monitoring changes in the condition are crucial to the long-term health of patients.