Anti-neutrophil Cytoplasmic Antibodies (ANCA) Vasculitis: Symptoms, Treatment and Diets

Anti-neutrophil cytoplasmic antibodies (ANCA) vasculitis is an autoimmune disease which can cause blood vessels to swell and form vasculitis. This disease is rare, affects about one in 50,000 people and is more common in middle-aged, Caucasian men and women.

Causes

ANCAs (the autoantibodies) attach to neutrophils (a type of white blood cell) which makes the neutrophils attack small blood vessels in the body. Thus, vasculitis (inflammation in blood vessels) has formed which makes blood vessels become swollen and inflamed. In fact, most people do not have these ANCAs.

Symptoms & Types

ANCA vasculitis can cause different symptoms depending on its types.

Renal limited vasculitis
Renal limited vasculitis affects blood vessels only in the kidneys. It can interfere with normal kidney functions. It is characterized by blood and protein in the urine and can lead to permanent kidney failure.

Microscopic polyangiitis (MPA)
MPA is associated with inflamed vasculature in many body’s organ systems, including but not limited to the kidneys, peripheral nervous system, skin, and lungs.

The most common symptoms of MPA include:

  • kidney inflammation
  • weight loss (affecting about 80 percent of patients)
  • fevers (seen in about 60 percent of patients)
  • fatigue
  • skin lesions
  • nerve damage

Other symptoms depend on where blood vessel inflammation is located. For example, when it occurs in respiratory capillaries, blood will flow into alveoli (the air sacs make up the lung) which causes patients to cough up blood.

Granulomatosis with polyangiitis (GPA)
Similar to MPA, swelling of blood vessels can appear in nearly any part of the body. The most commonly parts are lungs, kidneys, and respiratory tract (sinuses, nose, trachea, or ears).

If it occurs on uncommon parts, such as skin and joints, symptoms may be confused with other inflammatory diseases easily.

Symptoms in the lungs usually include heavy coughing and occasionally coughing up blood, while in the kidneys mainly include brown and bloody urine which are easy to identify.

Respiratory tract symptoms may include:

  • Ear infections cannot resolve within normal healing time, or reduced hearing abilities.
  • Inflammation in various parts of the eye, sometimes resembling a recurring pink eye infection, blurry vision, and pain in the eye region.
  • Worsening runny nose, nose pain, and trouble breathing through the nose. Nosebleeds and nasal crusting may be more common.
  • Shortness of breath.

Eosinophilic granulomatosis with polyangiitis (EGPA)
EGPA is mainly limited to the lungs and respiratory tract. Symptoms mainly include:

  • asthma-like symptoms
  • nasal polyps and
  • allergic rhinitis (also known as hay fever)
  • tingling, numbness, shooting pains, and extreme muscle degradation in the hands or feet

EGPA patients also may share some GPA symptoms associated with damage to the lungs, kidneys, and skin.

Diagnosis

Doctors use a combination of tests and historical symptoms and physical exam to diagnose ANCA vasculitis. These tests usually focus on the part(s) of the body that are affected.

Following are some tests that are often used to diagnose vasculitis:

  • Blood tests that show inflammation in the body (including the blood vessels).
  • Blood tests for kidney function (creatinine), urine tests for blood and protein.
  • X-rays and CT scans of the chest. Further tests may include bronchoscopy.
  • Endoscopic exam of the sinuses.
  • Biopsy of an affected tissue or organ.

Treatment

Treatments of ANCA vasculitis are complicated. Because of different affected part, patients need specialists major in different part give combined therapies.

Treatments and medicines usually depend on following things:

  • Type of ANCA vasculitis
  • Serious degree of symptoms
  • The speed of disease progress
  • The affected organs

According to some studies, treatment process of ANCA vasculitis mainly divided into two parts:

  • The first part is called induction therapy, which is aimed at making the disease under control and into remission.
  • Once the disease goes into remission, the second part of treatment is called maintenance therapy. Maintenance therapy will continue use immunosuppressive medications to keep the disease in remission and decrease the recurrence chance. Due to the inflammation and damage caused by the immune system (antibodies and white blood cells), mainly treatments involve suppress or quiet the immune system. Medicines used for that are often called immunosuppressive medicines.

Some of medicines may be also helpful:

Besides that, plasmapheresis, also known as plasma exchange or PLEX can be used. It is a procedure that can remove antibodies from the bloodstream – including the ANCA autoantibodies.

Diets

According to the condition of disease or treatments, doctors may advise patients changing their diets, such as:

  • Patients with high blood pressure need to reduce salt intake.
  • Patients with kidney failure need to restrict protein and potassium intake.
  • Patients with osteoporosis or diabetes need to monitor their diets with the help of a healthcare professional.

Please remember to consult your doctors for your symptoms and specific treatments.

Keywords: anti-neutrophil cytoplasmic antibodies vasculitis; ANCA vasculitis; ANCA; anti-neutrophil cytoplasmic antibodies; autoimmune disease; vasculitis.

* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
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