Symptoms are often subtle and non-specific and the diagnosis easily missed. Features of an active ANCA vasculitis can include:
- Blood and Protein on urine dipstick
- Malaise, Flu-like symptoms, myalgia
- Weight Loss
- ENT symptoms – Sinusitis, epistaxis, otitis media
- Respiratory involvement – cough, dyspnoea, asthma, haemoptysis (pulmonary haemorrhage is seen as diffuse pulmonary shadowing on chest X-ray often associated with reduced haemoglobin concentration; this can be life threatening)
- Ocular involvement – conjunctivitis, scleritis, uveitis
- Skin involvement – palpable purpura, ulcers in up to 50% of patients
- The heart, nervous system and GI tract may also be involved.
The only typical findings in a patient with renal ANCA vasculitis is evidence of blood and protein in the urine dip and AKI. The remainder of symptoms are often vague and overlooked.
