Assessing disease activity in systemic lupus erythematosus
Investigating an undetectable total complement (CH50) level
Nephelometry
C3 (3rd Component of Complement), Serum
C3 (Third Component of Complement), Serum
C3 COMP, S
C3, Serum
Complement C3, Serum
Serum
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
If not ordering electronically, complete, print, and send a Renal Diagnostics Test Request (T830) with the specimen.
0.5 mL
Gross hemolysis | OK |
Gross lipemia | Reject |
Gross icterus | OK |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum | Refrigerated (preferred) | 7 days | |
Frozen | 28 days | ||
Ambient | 72 hours |
Assessing disease activity in systemic lupus erythematosus
Investigating an undetectable total complement (CH50) level
The complement system is an integral part of the body's immune defenses. It can be activated via immune complexes (classic pathway) or by bacterial polysaccharides (alternative pathway).The primary complement pathway consists of recognition (Clq, Clr, Cls), activation (C4, C2, C3), and attack (C5, C6, C7, C8, C9) mechanisms with respect to their role in antibody-mediated cytolysis.
C3 activation involves cleavage by C3 convertase into C3a and C3b. When immune complexes are not involved, the alternate method of complement activation initiates the reactant sequence at C3, bypassing C1, C4, and C2.
Severe recurrent bacterial infections occur in patients with homozygous C3 deficiency and in those patients with low levels of C3 secondary to the absence of C3b activator.
Decreased C3 may be associated with acute glomerulonephritis, membranoproliferative glomerulonephritis, immune complex disease, active systemic lupus erythematosus, septic shock, and end-stage liver disease.
75-175 mg/dL
A decrease in C3 levels to the abnormal range is consistent with disease activation in systemic lupus erythematosus.
The results are dependent on appropriate specimen transport and
1. Willrich MAV, Braun KMP, Moyer AM, Jeffrey DH, Frazer-Abel A: Complement testing in the clinical laboratory. Crit Rev Clin Lab Sci. 2021 Nov;58(7):447-478. doi: 10.1080/10408363.2021.19072972
2. Wong EKS, Kavanagh D: Diseases of complement dysregulation-an overview. Semin Immunopathol. 2018 Jan;40(1):49-64. doi: 10.1007/s00281-017-0663-8
3. Prohaszka Z, Kirschfink M, Frazer-Abel A: Complement analysis in the era of targeted therapeutics. Mol Immunol. 2018 Oct;102:84-88. doi: 10.1016/j.molimm.2018.06.001
4. Brodszki N, Frazer-Abel A, Grumach AS, et al: European Society for Immunodeficiencies (ESID) and European Reference Network on Rare Primary Immunodeficiency, Autoinflammatory and Autoimmune Diseases (ERN RITA) Complement Guideline: Deficiencies, Diagnosis, and Management. J Clin Immunol. 2020 May;40(4):576-591. doi: 10.1007/s10875-020-00754-1
C3 is measured by immunonephelometry. Antiserum to C3 is mixed with patient serum, the light scatter resulting from the antibody interaction with C3 is measured, and the signal is compared to standard concentrations of C3.(Instruction manual: Siemens Nephelometer II Operations. Siemens, Inc; Version 2.4, 07/2019; Addendum to the Instruction Manual 2.3, 08/2017)
Monday through Friday
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.
86160
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
C3 | Complement C3, S | 4485-9 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
C3 | Complement C3, S | 4485-9 |