Hello doctor, I am a 47-year-old female. I started to have severe joint pains and inflammation around three weeks back. Then one day as I was giving a presentation, my team members noticed that I was bleeding profusely from my nose. The in-house nurse was called and I was found with high pressure of 210/120 mmHg and was subsequently hospitalized for a day. After extensive blood tests, I was found that my ANCA-MPO (p-ANCA) is 202.55 U/ml and ANCA-Pr3 (c-ANCA) is 40.74 U/ml. What does this mean? I was prescribed Imuran 50 mg once a day.
Hi. I have gone through your query. I need to clear a few doubts before giving you the final answer. I understand you had some problem which started three weeks back with joint pains followed by high blood pressure causing a nose bleed. I would like to investigate why you had sudden blood pressure rise? Is it due to inflammation in the kidneys or some other reason if previously things were normal? Do you have any history of fever, recurrent nose blocks or hearing loss? Were the other blood tests done like CRP (C-reactive protein), urine routine, chest x-ray, ESR (erythrocyte sedimentation rate)? As per the results, these are the markers for vasculitis. So we need to be sure these are the ones that are causing your joint pains or high blood pressure. Because the management will change if there is renal involvement and Imuran alone would not be enough. 1. CRP. 2. ESR. 3. Urine routine. 4. X-ray chest PA (postero-anterior) view. 5. CBC (complete blood count), LFT (liver function test) and serum creatinine.