A 50-year-old man diagnosed with polyangiitis with granulomatosis 10 years earlier and untreated for the past 5 years is asymptomatic at a scheduled check-up. Chest X-ray, blood tests and urine sediment are normal except for positive anti-neutrophil cytoplasmic antibodies (ANCA) at titer 1/320, with anti-proteinase 3 specificity, which had previously been negative. What is the most advisable therapeutic approach?
In ANCA vasculitis, whatever it is, these antibodies have been shown to be related to the activity of the disease, but at no time are changes in treatment obligatory due to their levels. In this case, with the patient being asymptomatic and with objective evidence of lack of activity, close follow-up should be performed without restarting or modifying treatment.
Start treatment with corticosteroids.
Initiate treatment with cyclophosphamide.
Initiate treatment with mycophenolate mofetil.
Watchful waiting.
In ANCA vasculitis, whatever it is, these antibodies have been shown to be related to the activity of the disease, but at no time are changes in treatment obligatory due to their levels.
In ANCA vasculitis, whatever it is, these antibodies have been shown to be related to the activity of the disease, but at no time are changes in treatment obligatory due to their levels.
In ANCA vasculitis, whatever it is, these antibodies have been shown to be related to the activity of the disease, but at no time are changes in treatment obligatory due to their levels.
with the patient being asymptomatic and with objective evidence of lack of activity, close follow-up should be performed without restarting or modifying treatment.