P-ANCA and Other Test Results

[Reflection]

Hi all,
Hoping someone can help me out. I should first point out that when my GP ordered these set of blood work CD was not even on the radar. So I am sure there will be more test ordered that are in line with diagnosing CD.

I was going over some I had done in March when I was having horrible hip pain and electrically stabbing pains in my legs and arms (only way I know to describe them). My GP ran a PAN-ANCA evaluation. At the time he was looking for arthritis of some sort. Anywho, it came back positive, but just elevated. The ANCA Total ABS 1:40 (normal < 1:20), also shows P-ANCA Granulocyte ANA specific pattern detected. The Myeloperox.ABS and Proteniase-3AB where both normal. I also had low Folic Acid and am now on supplement for that. Doc said since neither the Mye or Pro where high that he didn't know what it meant. He had ordered an MRI but unfortunately there was a big mess up in his office and authorization didn't get submitted till they submitted the request for my CT a couple of weeks ago.

My current blood work shows an elevated WBC count, platelet count and ALK phos. None are extraordinarily high but they are elevated. The differential of the CBC shows my Neut# and Lymph# high. Granted this was taken three weeks ago just a day after I started to experience the severe pain. Doc had said that they will draw when I go in Friday and rerun tests. Last time I got sick like this they said it was my gallbladder (frankly it wasn't working 6% ejection rate on the HIDA scan). But my blood work started similar to this but about 4 weeks into getting sicker and sicker, my pee turned brown and all my liver enzymes skyrocketed and my neutrophils plummeted. Since everything got back to normal (well except for the flash runs to the bathroom and intermittent abdominal pain) they blamed it all on an intestinal infection and my gallbladder.

I not really sure what my questions are except for has anyone had P-ANCA tests done? And did they have similar results. Not sure how CD shows up in "regular" blood work either. Any information is appreciated.

Thanks,
Reflection

 

[araceli]

Hi. I don't believe any blood test will tell you that you have CD. I may be wrong. It can show signs of problems but not exactly CD, like elevated SedR or CRP . IBD panel may help with a diagnosis but it is not 100% accurate. My son has intestinal granulomas consistent with Crohn's, his IBD panel showed elevated P-Anca but results on panel are that he does not have any signs of IBD. My son also suffers from joint pain but the Rheumy did not think anything about the panel results. Go figure. I think the best way to diagnose CD will be with colo/endo and or the pill cam. We are at the point now to believe his joint pain is IBD-associated spondyloarthrophaty. I am no expert, it is just my opinion. I hope someone with more acknowledge answers your question.












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[Patricia56]

Sounds like some kind of intestinal illness needs to be ruled out if you have Diarrhea and abdominal pain. But there are number of things that need to be ruled out.

The P-ANCA testing for CD is of limited utility and the version you describe doesn't seem to be typically associated with a Crohn's diagnosis. Here's a link to more info on ASCA testing for Crohn's.

http://www.moavenandpartners.com/doctors/information_form/asca-testing-for-crohns-disease.shtml

All that said, Crohn's can present in strange ways (As can Ulcerative Colitis) with extra-intestinal manifestations the first sign of something wrong. This could explain the liver (especially if it were UC) symptoms. Don't know what to make the strange pains.

The other thing you might ask your doctors about is pancreatitis. It usually presents with severe abdominal pain but not always.

It sounds like your doctor is doing a comprehensive assessment which is good and I would look to him for a diagnosis. It's not always a good thing to go fishing for a diagnosis on your own - anxiety provoking and may be totally wrong.

I hope they figure it out soon.

Best wishes,

 

[Reflection]

Patricia,
Thank you for your reply. However, I just want to clear a few things up. I wasn't and am not trying to diagnose myself. I was just looking at old lab work and seeing if there was a correlation to a time a few years back when I got really really sick. Also, I wrote about my other blood work as I was curious to see if anyone else had similar results, or if there is any pattern to Crohn's and how it affects certain blood levels. I know that the P-ANCA is not a test ran for Crohn's. My doctor did not run it looking for that, but for another condition trying to figure out the stabbing pains. I again, I was just curious if anyone else had this test and had similar results. Since Crohn's seems to affect everyone differently. I do know that this positive results has been seen in IBD (but is NOT used for diagnoses). As for pancreatitis, Yes, that was his first initial thought. But the enzymes that would be elevated in pancreatitis attack were not.

My doctor actually appreciates it when I see a pattern in my lab results that he has not. They are human and over worked. He always gives me copies of my results and discusses them with me. As he says, we know our bodies better than anyone else. We are only looking at our tests and not 100 other patients. I do not go looking for diagnoses. That is his job, but if I can help him get a clearer picture of what is going on with me than he is grateful. Sometimes what I come back to him with goes nowhere. Sometimes it sends him on a path that helps. I will always be active in my health care and participate in it and not just be a bystander while the doctors pic and prod me.

Again, I do thank you for your response. I appreciate your concern over someone playing "Dr. Google". I know that only thing it does is send you down a path of worry and dying next week.

Best regards,
Reflection

 

[Patricia56]

Sounds like you have a great doctor and a good relationship.

Hopefully the two of you will figure it out soon. Or, even better, it will all just go away!

 

[fozheart]

Hi Reflection,
I am tested a few times a year for vasculitis, which stems from me having mixed connective tissue disease. In that case, the P-ANCA test has to do with detecting narrowing of the blood vessels. That probably does not help you, but it sounds like you do have a doctor that is trying to cover all of the bases, which is great! Best of luck to you!