Microscopic Polyangiitis Follow-up

Updated: Sep 24, 2021
  • Author: Mehran Farid-Moayer, MD; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Further Outpatient Care

Patients with microscopic polyangiitis (MPA) need to be monitored very closely at a rheumatology clinic. Patients need to take immunosuppressive medications for a long time, at least for a year. Clinical status and the erythrocyte sedimentation rate (ESR) should be monitored.

The level of ANCA may be used to monitor disease activity. However, ANCA levels do not correlate consistently with the disease activity. In one study, ANCA levels became undetectable in 83% of patients after treatment; however, ANCA levels increased in 57% of patients at a mean period of 7.8 weeks prior to relapse. Reappearance of anti-MPO antibodies has positive predictive value for relapse. [32, 33]



See the list below:

  • Complications of vasculitis depend on the particular organ system involvement (see Physical).

  • One of the most significant complications of treatment is bladder cancer. Among people who are treated with cyclophosphamide, 5% develop bladder cancer after 10 years and 16% develop bladder cancer after 15 years.

  • One study reviewed cardiovascular outcomes during long-term follow-up of patients with granulomatosis with polyangiitis and microscopic polyangiitis in the first 4 European Vasculitis Study Group trials. A model was developed and validated to predict those at risk for a cardiovascular event. Older age, diastolic hypertension, and positive PR3-ANCA status were found to be independent determinants of cardiovascular outcomes. Within 5 years of diagnosis, 14% of patients experienced a cardiovascular event. [34]


Patient Education

See the list below:

  • Patients with MPA should be aware of the severity of the disease and the risk of recurrence.

  • Compliance with medications and follow-up visits is critical.