Test Details
Methodology
Immunologic
Result 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.
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.
Custom 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.
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 Instructions
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.
Stability Requirements
Temperature | Period |
|---|---|
Room temperature | 2 days |
Refrigerated | 8 days |
Frozen | 3 months |
Freeze/thaw cycles | Stable x1 |
Reference Range
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 |
Storage Instructions
Maintain specimen at room temperature.
Causes for Rejection
Excessive lipemia (>250 mg/dL) and rheumatoid factors (>200 IU/mL) significantly increase the apparent C4 concentration.
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 |
| Order Code | 001834 | |||||
| Order Code Name | Complement C4, Serum | |||||
| Order Loinc | 4498-2 | |||||
| Result Code | 001833 | |||||
| Result Code Name | Complement C4, Serum | |||||
| UofM | mg/dL | |||||
| Result LOINC | 4498-2 |