29th January 2024

Common blood tests used in the diagnosis and management of vasculitis

Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) – these inflammatory markers are frequently raised at presentation. They are also useful to monitor disease activity in response to treatment.
Antineutrophil Cytoplasmic Antibodies (ANCA) – are antibodies raised against antigens in the cytoplasm of neutrophil granulocytes. Antigens for p ANCA include myeloperoxidase (MPO) and bacterial permeability-increasing factor. The c-ANCA antigen is specially proteinase 3 (PR3). The presence of PR3 and MPO antibodies are highly important in the diagnosis of ANCA-associated vasculitis.
Antinuclear antibody (ANA) – this is an antibody which targets the nuclear components of the cell. It is non-specific and, therefore, not often used for diagnosis of vasculitides but can be an indicator of underlying autoimmune processes.
Complement levels – the complement cascade is part of the immune system that allows antibodies and phagocytic cells to clear microbes and damaged cells from an organism. In immune-mediated vasculitis, the complement cascade enhances the ability of autoantibodies and phagocytic cells to clear damaged cells. In acute vasculitis, complement C3 and C4 levels are often reduced and normalised as a response to treatment.

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