Which features are associated with an increased risk of relapse of the ANCA vasculitis?
Patients with PR3-ANCA are more than 1.5 times as likely to relapse when compared to those with MPO-ANCA.
Additionally, pulmonary involvement has been associated with higher rates of relapse.
Upper airway involvement has also been implicated as a risk factor for relapse, which was linked to the nasal carriage of Staphylococcus aureus , which is also suggested as a risk factor for relapsing disease.
Although increases in PR3-ANCA or MPO-ANCA levels are generally associated with an increased likelihood of subsequent relapse, such relapses occur in a minority of patients within 12 months.
It is currently not recommended to increase or resume immunosuppressive therapy based on an increase in ANCA titer alone, in the absence of clinical signs or symptoms of active ANCA vasculitis.
