The anti-neutrophil cytoplasmic antibody called ANCA (anti-neutrophil cytoplasmic for antibodies) are autoantibodies recognizing antigens neutrophil cytoplasmic. They are found in systemic vasculitis, particularly in Wegener’s granulomatosis or Wegener’s granulomatosis (WG).
They are of two types:
• inducing ANCA by indirect immunofluorescence (IIF), a diffuse cytoplasmic staining (c-ANCA);
• perinuclear ANCA fluorescence (p-ANCA).
Finding a GW before a drawling rhinosinusitis or pulmonary infection resistant to antibiotic therapy, or repeated epistaxis, hemoptysis.
Venous blood collected in a dry tube.
negative if <1/20
The antibodies are sought IFIs. If this search is positive specificity (pANCA or cANCA) is determined by Elisa.
ANCA were found in systemic necrotizing vasculitis affecting small caliber vessels, such as GW (90% of cases) or Churg-Strauss syndrome (30%).
Wegener’s granulomatosis (WG):
GW is revealed by rhinitis, sinusitis drawling, epistaxis or pulmonary symptoms: dyspnea, chest pain, hemoptysis. The X-ray shows pulmonary nodules with thick walls, excavated, infiltrates the disease is complicated by glomerulonephritis Extracapillary croissant (lung-kidney syndrome) may evolve towards a rapidly progressive renal failure. C-ANCA-type antibodies are present in 90% of cases likely to disappear under the influence of treatment and reappear in case of relapse.
In the Churg-Strauss syndrome (CSS) – that characterize a late asthma, eosinophilia> 1000 / mL and fever with poor general condition – the antibodies are p-ANCA-type (70% of cases) .
ANCA are rapidly progressive glomerulonephritis specific focal necrosis with the tuft no deposit of immunoglobulin called pauci-immune.