ANCA (c-ANCA and p-ANCA) Serum Test / c-ANCA and p-ANCA Test in Delhi

ANCA C + P Serum Combined Test at Home (cANCA and pANCA Blood Test)

The ANCA C + P Serum Combined test detects Anti-Neutrophil Cytoplasmic Antibodies in the blood, screening simultaneously for both the cytoplasmic (c-ANCA) and perinuclear (p-ANCA) patterns. These antibodies are directed against proteins inside the granules of neutrophils. When ANCA bind to these proteins, they abnormally activate neutrophils, triggering inflammation that damages the walls of small and medium-sized blood vessels across the body.

This group of conditions is known as ANCA-associated vasculitis (AAV), and it includes Granulomatosis with Polyangiitis (GPA), Microscopic Polyangiitis (MPA), and Eosinophilic Granulomatosis with Polyangiitis (EGPA). These conditions are uncommon but potentially life-threatening. Without early diagnosis and treatment, they can cause rapidly progressive kidney failure, severe pulmonary haemorrhage, and destruction of the upper respiratory tract.

MAX@Home brings this specialised blood test to your doorstep, allowing patients who may be experiencing vasculitis-related symptoms to avoid the burden of travel while ensuring their sample is handled with the care this type of autoimmune testing demands.

What the c-ANCA Pattern Detects

The cytoplasmic pattern (c-ANCA) appears as a diffuse granular staining of the cytoplasm of neutrophils on the immunofluorescence slide. This pattern is produced predominantly by antibodies against Proteinase 3 (PR3), a serine protease stored in the azurophil granules of neutrophils.

c-ANCA key facts

• c-ANCA is strongly and specifically associated with Granulomatosis with Polyangiitis (GPA), formerly Wegener's granulomatosis.
• PR3-ANCA is positive in approximately 80 to 90% of patients with active systemic GPA.
• A confirmed c-ANCA in a clinically compatible patient represents an urgent indication for specialist evaluation.
• PR3-ANCA titres sometimes correlate with disease activity in GPA, though this relationship is not consistent enough to drive management decisions alone.

PR3-ANCA and disease monitoring in GPA

In patients with established GPA who are in remission on immunosuppressive therapy, serial PR3-ANCA measurement is sometimes incorporated into monitoring protocols. A rising PR3 titre during otherwise stable disease may signal an impending relapse in some individuals, although the predictive value is not uniform across all patients. Because of this variability, ANCA titres are used as one element within a broader monitoring strategy that includes regular urinalysis, renal function testing, clinical review, and periodic imaging, rather than as a standalone decision-making tool.

What the p-ANCA Pattern Detects

The perinuclear pattern (p-ANCA) appears as a staining concentrated around the nucleus of the neutrophil. This pattern is primarily produced by antibodies against Myeloperoxidase (MPO), a lysosomal enzyme found in neutrophil granules.

p-ANCA key facts

• p-ANCA / MPO is most commonly associated with Microscopic Polyangiitis (MPA) and Eosinophilic Granulomatosis with Polyangiitis (EGPA).
• MPO-ANCA is positive in approximately 70% of MPA patients.
• p-ANCA can also appear in inflammatory bowel disease, autoimmune hepatitis, and rheumatoid arthritis, usually in an atypical pattern that does not carry the vasculitis association.
• A confirmed p-ANCA in the right clinical context warrants urgent investigation for small vessel vasculitis.

Why the Combined Test Screens for Both Patterns

GPA and MPA are distinct conditions with different clinical presentations, but they can overlap, and both may need to be excluded in the same patient. Screening for c-ANCA and p-ANCA in a single test ensures neither form of vasculitis is missed in one investigation request.

• A single combined test captures the full ANCA-associated vasculitis spectrum in one blood draw.
• Positive results from the combined serum screen are confirmed with specific antigen ELISA tests for PR3-ANCA and MPO-ANCA individually.
• The combined approach is more efficient than ordering the two patterns separately and reduces the risk of a missed result.

Conditions This Panel Evaluates

Granulomatosis with Polyangiitis (GPA)

GPA is a necrotising granulomatous vasculitis affecting the small blood vessels of the upper respiratory tract, lungs, and kidneys. It is one of the most serious autoimmune conditions because of its potential to cause life-threatening organ damage within weeks if untreated.

Characteristic features include:

• Persistent, severe sinusitis that does not respond to antibiotics.
• Nasal crusting, epistaxis (nosebleeds), and nasal septum perforation.
• Saddle-nose deformity from cartilage destruction.
• Subglottic stenosis causing breathlessness and stridor.
• Pulmonary infiltrates, nodules, or cavities on chest imaging.
• Rapidly progressive glomerulonephritis with haematuria and proteinuria.

Microscopic Polyangiitis (MPA)

MPA is a necrotising small vessel vasculitis without granuloma formation. It most commonly presents as a pulmonary-renal syndrome, combining rapidly progressive glomerulonephritis with pulmonary haemorrhage, which constitutes a medical emergency. Additional features include peripheral neuropathy and skin purpura. p-ANCA / MPO is the principal serological marker.

Eosinophilic Granulomatosis with Polyangiitis (EGPA)

EGPA is distinguished from GPA and MPA by prominent tissue and blood eosinophilia, adult-onset asthma, and features of systemic vasculitis. Cardiac involvement, including cardiomyopathy and pericarditis, is the leading cause of mortality in EGPA. p-ANCA is positive in approximately 40% of EGPA cases. ANCA-negative EGPA patients tend to have more prominent eosinophilic tissue damage and cardiac disease.

ANCA in Non-Vasculitic Conditions

p-ANCA in an atypical pattern can be positive in:

• Ulcerative colitis - present in 60 to 80% of UC patients; helps distinguish UC from Crohn's disease in ambiguous cases.
• Autoimmune hepatitis - may show a non-specific ANCA pattern.
• Rheumatoid arthritis - atypical patterns may appear without vasculitic significance.

These non-vasculitic associations underscore why positive ANCA results must always be interpreted in clinical context and confirmed with antigen-specific ELISA testing before attributing vasculitic significance.

Organ Involvement Spectrum in ANCA-Associated Vasculitis

ANCA-associated vasculitis is a multi-system disease, and the extent and pattern of organ involvement varies significantly across patients and disease subtypes. Kidney involvement, manifesting as rapidly progressive glomerulonephritis, is one of the most feared complications because it can lead to dialysis-dependent renal failure within days to weeks if untreated. Pulmonary involvement ranges from mild haemoptysis to life-threatening diffuse alveolar haemorrhage. Upper respiratory tract destruction in GPA can cause permanent structural damage to the nasal passages, orbits, and trachea. Peripheral neuropathy presenting as mononeuritis multiplex causes focal nerve damage across different parts of the body. Skin purpura and eye involvement, including scleritis and episcleritis, may also occur. Understanding this wide spectrum is why a positive ANCA in a symptomatic patient triggers a systematic multi-organ assessment rather than targeted single-organ investigation.

Who Should Get the ANCA C + P Serum Combined Test

• Anyone with unexplained haematuria or proteinuria on urinalysis.
• Patients with rapidly declining kidney function without an obvious cause.
• Those with recurrent or treatment-resistant sinusitis, especially with nasal crusting, epistaxis, or saddle-nose deformity.
• Individuals with persistent cough, breathlessness, or haemoptysis (coughing up blood) alongside renal abnormalities.
• Patients presenting with mononeuritis multiplex (nerve damage in different areas of the body).
• Those with systemic features such as unexplained weight loss, fever, arthralgia, and skin purpura.
• Adults with new-onset asthma, particularly when accompanied by blood or tissue eosinophilia.
• Patients with confirmed ANCA-associated vasculitis on treatment, where serial ANCA measurement is used as part of disease monitoring.

How to Prepare for Sample Collection

Before the test

• Fasting is not required.
• The test can be collected at any time of day.
• No specific dietary restrictions apply.
• Inform your doctor of all medications and any recent infections, as some can cause false-positive or atypical ANCA patterns.

Collection details

• Sample type: blood (serum).
• A certified MAX@Home phlebotomist visits your home at your scheduled time with sterile, single-use equipment.
• IIF serum screen report turnaround: 3 to 5 working days.
• Confirmatory PR3 and MPO ELISA, if required: 5 to 7 working days total.

What to inform your doctor before the test

• Recent infections, particularly respiratory or urinary tract infections, as these can transiently elevate inflammatory markers and occasionally affect ANCA patterns.
• Current immunosuppressive therapy, which may suppress ANCA titres even when the underlying vasculitis is active.
• Any medications associated with drug-induced ANCA positivity, including propylthiouracil, hydralazine, and minocycline.
• Recent blood transfusions, as alloantibodies can occasionally create artefactual patterns on the IIF slide.

Understanding Your ANCA C + P Serum Combined Results

Negative ANCA result

A negative ANCA result makes ANCA-associated vasculitis significantly less likely but does not exclude it entirely. Patients with limited or early disease may have ANCA titres below the detection threshold. When clinical suspicion remains high despite a negative screen, repeat testing or tissue biopsy may be needed.

Positive c-ANCA result

A positive c-ANCA confirmed by a positive PR3 ELISA is strongly suggestive of Granulomatosis with Polyangiitis in a clinically compatible patient. The result should prompt urgent nephrological or rheumatological review. Further investigations typically include urinalysis, kidney function tests, chest imaging, and often a kidney biopsy to confirm the diagnosis and assess the degree of organ damage.

Positive p-ANCA result

A positive p-ANCA confirmed by a positive MPO ELISA is associated with Microscopic Polyangiitis, EGPA, or certain forms of glomerulonephritis. Clinical correlation is essential because p-ANCA can also appear in non-vasculitic conditions. Confirmatory antigen-specific testing and specialist evaluation are always required before attributing significance to the result.

Important caveats

• ANCA titres do not reliably track disease activity in all patients. Some maintain high titres during remission.
• Management decisions must never be based on ANCA titres alone - always integrate the full clinical picture.
• Rising titres during treatment may precede relapse in some patients but should be interpreted alongside clinical and renal parameters.

How to Book Your ANCA C + P Serum Combined Test with MAX@Home

1.  Open the MAX@Home website or app and search for the ANCA C + P Serum Combined test.

2.  Select your preferred date and time. No fasting is required, so any convenient time works.

3.  A certified phlebotomist arrives with sterile equipment and collects your blood sample safely.

4.  The sample is transported to the accredited partner laboratory under proper conditions.

5.  Your digital report is delivered within 3 to 7 working days depending on whether confirmatory ELISAs are included.

Why Choose MAX@Home for This Test

• Vasculitis symptoms including fatigue, breathlessness, and joint pain make travel to a diagnostic centre genuinely difficult. Home collection removes this barrier.
• Validated transport protocols preserve serum integrity for accurate immunofluorescence-based ANCA testing.
• Accredited partner laboratories use IIF platforms that meet clinical-grade autoimmune testing standards.
• Digitally authenticated reports are suitable for direct use in specialist consultations, enabling faster clinical decisions.
• In a condition where speed of diagnosis directly impacts outcomes, removing the friction from the testing process has genuine medical value.