Complement C4

TEST: 001834
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CPT: 86160
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Synonyms

  • C4
  • C4 (β1E Globulin)
  • C4 Complement
  • Fourth Complement Component

Expected Turnaround Time

1 - 2 days

Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.

Related Documents

For more information, please view the literature below.

Lupus Comprehensive Testing Brochure

Specimen Requirements

Specimen

Serum (preferred) or plasma

Volume

1 mL (adult), 0.5 mL (pediatric)

Container

Red-top tube, gel-barrier tube, green-top (lithium heparin) tube, or lavender-top (K3-EDTA) tube

Collection

Allow serum to clot at room temperature for 15 to 30 minutes. Remove serum or plasma after centrifugation and transfer to a plastic transport tube.

Storage Instructions

Maintain specimen at room temperature.

Stability Requirements

Temperature

Period

Room temperature

2 days

Refrigerated

8 days

Frozen

3 months

Freeze/thaw cycles

Stable x1

Causes for Rejection

Excessive lipemia (>250 mg/dL) and rheumatoid factors (>200 IU/mL) significantly increase the apparent C4 concentration.

Test Details

Use

Quantitation of C4 is used to detect individuals with inborn deficiency of this factor or those with immunologic disease in whom hypercatabolism of complement causes reduced levels. These diseases include lupus erythematosus, serum sickness, certain glomerulonephritides, chronic active hepatitis, and others.

Methodology

Immunologic

Reference Interval

See table.

Age

Male (mg/dL)

Female (mg/dL)

0 to 30 d

Not established

Not established

1 m to 17 y

10–34

10–34

>17 y

12–38

12–38

Additional Information

C4 is used only by the classical pathway, so that it is decreased only when this arm is activated. In diseases activating the alternate pathway alone, C4 levels will be normal. Total hemolytic activity (CH50), C3, and C4 are frequently decreased in a variety of conditions producing immune complexes. C4 levels are sensitive indicators of lupus disease activity. In hereditary angioedema, the lack of C1 esterase inhibitor allows unopposed lysis of C2 and C4 by C1 esterase, so C4 levels will be low. C4 deficiency has been described in association with a clinical SLE-like disease but with absence of LE cells and variable immunoglobulin or C3 deposits in the skin biopsy, and with Henoch-Schönlein purpura or glomerulonephritis. The condition is inherited as an autosomal recessive trait with close HLA linkage. Hereditary C4 deficiency has been associated with an increased incidence of pyogenic bacterial infections.

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
001834 Complement C4, Serum 4498-2 001833 Complement C4, Serum mg/dL 4498-2

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