ANCA Test Results

[Sadie2111]

Hello,

For the past several years, I have been receiving treatment for hyperthyroidism & rheumatoid arthritis. Meds include methimazole, weekly injection of methotrexate, and monthly infusion of Orencia.

Due to recent relocation, I now have new doctors. My recent blood tests show that I have gone from hyperthyroid to hypothyroid. I will be seeing my new Endo next week.

What I am concerned about is that my P-ANCA test is positive/abnormal. The result has been verified. Negative is <1:10 and mine is 1:2560. Both my prior and my new rheumatologist have advised me to consult with my new primary physician. My new primary physician said that he does not know how to interpret the ANCA results and that he would research. It has been a week now. I followed up, but have not heard back.

From my research and my symptoms (cold, painful hands/feet, purple at times, skin is getting very thin) it sounds as though this may be vasculitis.

My question is: What type of doctor should I contact to help me interpret the ANCA results and recommend the appropriate treatment?

Thank you!

[Sadie2111]

Thank you both very much for your feedback. I greatly appreciate it! In the meantime, my primary doctor did contact me this week with advice. It is likely that I'll need a blood vessel biopsy. Although, the symptoms that I am having may just be another complication from the RA or thyroid. Thanks again!

[quakies]

ps - the hypothyroidism can also cause dry, fragile skin and feeling cold more easily, so you got double tendencies there, along with the RA

[quakies]

Your cold feet sound suspiciously like Raynauds, which is a vascular problem that is so often linked with RA. It is a spasm of the blood vessels to the hands/and/or feet which can be triggered by a draught, cold, or even stress. The affected digits (although it can affect the nose, lips, ears and even the nipples, rarely) turn white, and as they are deprived of oxygen and blood, the can sometimes turn blue. When they warm up, the blood supply returns and the affected areas become red/purple and tingle, often this is painful.

I have very thin fragile  skin now and was diagnosed with RA a year ago. (my current rheumy has disputed the diagnosis, but that's another story!)  I also have sjogrens symptoms, and my skin eyes and mouth get very dry too. I know that steroids can cause fragile skin also, but think RA is a major factor.

You can have the cold areas examined through thermal imaging, which confirms vascular problems such as Raynauds. Mine was verified over summer with a thermal camera - really useful bit of equipment as it showed up the inflamation in my wrists too! The digits turn navy blue with Raynauds after a slight drop in temp, and even to a patient, the difference in temp and blood supply distribution shows up very clearly during a Raynauds vasospasm.

I hope this has been at least a little helpful. I dont know much about lab markers, but know a little about raynauds and RA.

Hope you get sorted out soon, keep us informed how you get on.

Best wishes

[Red_Star]

p-ANCA (Perinuclear Anti-Neutrophil Cytoplasmic Antibodies) is associated with various medical conditions:

Churg-Strauss syndrome
Classic polyarteritis nodosa
Microscopic polyarteritis
Wegener's granulomatosis
Primary sclerosing cholangitis
Focal necrotising and crescentic glomerulonephritis
Systemic lupus erythematosus (SLE)
Rheumatoid arthritis
Ulcerative colitis
Chronic IBD

See a clinical immunology/allergy specialist.