ANCA comes of age-but with caveats.

Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis are predominantly diseases of older patients, frequently involving the kidney. Bomback and colleagues studied disease outcome in very elderly patients (>80 years old) with ANCA-associated renal disease. Immunosuppression resulted in lower rates of end-stage renal disease at 1 year and lower mortality at 2 years. Although these data suggest we should treat these elderly patients with immunosuppression, the criteria for patient selection and the dosage and duration of the treatment regimen need to be established.