Page 16 - MRS Abstracts March 2023

An audit of ANCA testing at NUH
Tanya Deshmukh (University of Nottingham) Dr Peter Lanyon NUH
Dr Philip Courtney NUH
Introduction:
ANCA-associated vasculitis (AAV) is an autoimmune disease affecting small blood vessels in the body. It is caused by anti-neutrophilic cytoplasmic autoantibodies1. It includes three main diseases, which are granulomatosis with polyangiitis, eosinophilic granulomatosis with polyangiitis, and microscopic polyangiitis2. Treatment involves potent immunosuppressive agents, and full remission is often achieved. If left untreated, survival rates for AAV are low. It is predicted that at present, each year in the UK, there will be ∼700 new cases, of whom 95 will die within 12 months3.
Methods:
An analysis of positive ANCA results of an 18-month period between 2022 and 23 from the NUH immunology lab. We categorised these according to PR3 and MPO subtypes, identified the clinical service requesting the tests, recorded the final diagnoses from a review of medical records, and documented the timeframe from positive result to definitive treatment.
Results:
During the study period, 134 new positive MPO or PR3 ANCA results were identified. ANCA vasculitis was confirmed in 24 (18%) patients with 9 MPO and 15 PR3 subtypes.
65 results were attributed to other conditions. These include IBD, autoimmune thyroid disease, cancer, and cocaine use.
In 45 patients, no associated disease was identified based on clinical records. It is assumed they had no clinical features of ANCA vasculitis.
In terms of time to action for the 24 patients with confirmed ANCA vasculitis:
• Same-day action was present in 5 patients.
• 15 patients were diagnosed and treated while on the ward as inpatients.