So, on its own, a positive ANCA actually means very little. There are a fairly wide range of conditions that can lead to a positive (or false positive) result, including most autoimmune conditions such as rheumatoid arthritis, lupus (SLE), and forms of inflammatory bowel disease such as ulcerative colitis and Crohns. It’s recognised now that the level of ANCA detected is actually almost as important as the presence of it to help distinguish between patients likely to have vasculitis, and why vasculitis is still a clinical diagnosis based on tests and symptoms in combination rather than purely a positive ANCA result. A small percentage of people have a positive test without any underlying disease being found at all. I read up on it when we were looking to see if the child potentially had lupus or mastocytosis and they ran both ANCA and ANA as part of that: interestingly, I do recall there was at least one paper stating that a small percentage of IPF patients also had a positive ANCA either at diagnosis or slightly further down the line that didn’t develop into anything else. I’ll see if I can find it again if you’re interested, but a google for IPF and positive ANCA might turn it up? Bottom line, though, is wait and see what if anything else turns up: the first step with any positive autoantibody test is usually to break the test down further and look for other specific markers. It’s a clue in the puzzle, rather than being definitive for anything, and can occasionally turn out to be nothing at all.
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