Anti Neutrophilic Cytoplasmic Antibody (ANCA) - IFA

If an ANCA test is positive, it indicates antibodies that can point to small‑vessel autoimmune vasculitis (eg, granulomatosis with polyangiitis, microscopic polyangiitis). Clinicians will correlate results with symptoms, repeat or subtype the test (c‑ANCA/PR3 or p‑ANCA/MPO), order urine, blood tests, imaging and often a tissue biopsy, and refer to a specialist. False positives occur, so diagnosis requires clinical confirmation and may lead to immunosuppressive treatment.

ANCA IFA (indirect immunofluorescence assay) detects antineutrophil cytoplasmic antibodies in patient serum by incubating it with fixed neutrophils and visualizing binding with fluorescent anti‑human antibodies. It identifies staining patterns—cytoplasmic (c‑ANCA) or perinuclear (p‑ANCA)—used to screen for small‑vessel vasculitis (e.g., granulomatosis with polyangiitis, microscopic polyangiitis). Positive results need confirmatory antigen‑specific testing (PR3, MPO) and clinical correlation.

ANCAs are classically positive in small-vessel vasculitides such as granulomatosis with polyangiitis, microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis. They occur in renal-limited vasculitis and rapidly progressive (pauci-immune) glomerulonephritis, and can be seen with certain infections, drug-induced vasculitis (e.g., hydralazine, propylthiouracil), and occasionally in IBD, rheumatoid arthritis, or lupus.

ANCA (antineutrophil cytoplasmic antibodies) can signal potentially serious autoimmune vasculitis. ANCA‑associated vasculitis may cause rapid organ damage—particularly to kidneys and lungs—and can be life‑threatening if untreated. Early specialist assessment and immunosuppressive treatment often induce remission, but relapses occur and long‑term monitoring is needed. Prognosis varies depending on organ involvement and promptness of treatment.

ANCA-positive disease (ANCA‑associated vasculitis) is treated with rapid induction therapy—high‑dose corticosteroids plus either cyclophosphamide or rituximab—to control inflammation. Severe organ‑threatening cases may require plasma exchange and intensive care. After remission, maintenance uses lower‑dose steroids with azathioprine, methotrexate or periodic rituximab. Care includes infection prophylaxis, relapse monitoring and organ support as needed.

Yes. Various infections—particularly chronic bacterial (e.g., infective endocarditis, tuberculosis), some viral infections and other systemic infections—can cause transient or low‑titer ANCA positivity. Infection‑associated ANCAs may mimic ANCA‑associated vasculitis, so clinicians correlate titers with clinical features, repeat testing and, when needed, tissue biopsy. Treating the underlying infection often resolves antibodies; persistent high titers suggest true vasculitis.