<s>[INST] Hello doctor, My c-ANCA levels are 5.6 U/ml (borderline positive). I have hypertension and proteinuria (3g), high serum creatinine (2.4) and UTI. My other autoimmune tests and serum electrophoresis results are negative. What should I do and what is the general prognosis? [/INST] Hi. Based on your query, my opinion is as follows: C-ANCA (Antineutrophil cytoplasmic antibodies) positivity indicates Wegener's Granulomatosis. In this condition, there is involvement of upper and lower respiratory tract and kidneys. Most common diagnosis, while kidneys are effected, is Lupus. But I suppose your ANA and anti-Ds DNA are negative.  I would like to see all your reports, and I also recommend you to get an x-ray of paranasal sinuses to see for any polyps that are associated with Wegener's Granulomatosis. A chest x-ray may show a cavitary lesion. You need a kidney biopsy, first of all, followed by which you will be started on immunosuppressive therapy. Steroids and other immunosuppressive agents like Cyclophosphamide, Azathioprine are used. Prognosis and life expectancy can be commented after the report of kidney biopsy, as most of the times fatality occur due to renal failure. I hope it helps. </s>