Test Code LAB769 C1 Esterase Inhibitor, Functional, Serum
Additional Codes
C1INF
Specimen Required
Patient Preparation: Fasting, preferred but not required
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube:
Preferred: Red top
Acceptable: Serum gel
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions:
1. Immediately after specimen collection, place the tube on wet ice.
2. After sample has clotted on wet ice, centrifuge at 4° C and aliquot serum into a plastic vial.
3. Freeze specimen within 30 minutes of centrifugation. Sample must be placed on dry ice if not frozen immediately.
NOTE: If a refrigerated centrifuge is not available, it is acceptable to use a room temperature centrifuge, provided the specimen is kept on ice before centrifugation and immediately afterward, the serum aliquoted and frozen.
Secondary ID
616906Useful For
Diagnosing hereditary angioedema
Monitoring response to C1 esterase inhibitor replacement therapy
Method Name
Enzyme Immunoassay (EIA)
Specimen Type
Serum RedSpecimen Minimum Volume
0.4 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum Red | Frozen | 28 days |
Reject Due To
Gross hemolysis | OK |
Gross lipemia | OK |
Gross icterus | Reject |
Heat-inactivated samples | Reject |
Reference Values
>67% normal (normal)
41-67% normal (equivocal)
<41% normal (abnormal)
Interpretation
The C1 esterase inhibitor (C1-INH) concentration assay can be used to distinguish type I hereditary angioedema (HAE), with low C1-INH concentration, from type II HAE characterized by normal or elevated concentration. Furthermore, serum C1q concentrations can be used to differentiate HAE from acquired angioedema (AAE) forms of angioedema as the latter is characterized by decreased C1q antigen concentration and autoantibodies against C1-INH. Genetic analysis for SERPING1 variants status may also help exclude HAE.
-Nonfunctional C1-INH results are consistent with HAE
-Patients with current attacks may also have low C2 and C4 concentrations due to C1 activation and complement activation of the classical pathway (consumption).
-Patients with acquired C1-INH deficiency have a low C1q concentration and/or function in addition to low C1-INH.
Table. Laboratory Features Consistent with Hereditary and Acquired Angioedema Subtypes
|
Type I hereditary angioedema |
Type II hereditary angioedema |
Acquired angioedema |
C1 esterase inhibitor (C1-INH) concentration |
Low |
Normal/high |
Low |
C1-INH function |
Low |
Low |
Low/normal |
C4 concentration |
Low |
Low |
Low |
C1q concentration |
Normal |
Normal |
Low |
Anti-C1-INH antibodies |
Absent |
Absent |
Present |
C3 concentration |
Normal |
Normal |
Normal |
Family history |
Yes |
Yes |
No |
Method Description
The Quidel C1 inhibitor enzyme immunoassay for the quantitation of functional C1 inhibitor protein in human serum or plasma is a four-step procedure. In the first step, standards, controls, and test specimens are incubated with C1 esterase inhibitor (C1-INH) reactant (biotinylated, activated C1s). During this incubation, functionally active C1-INH present in the standards, controls, and test samples will bind to the biotinylated C1-INH reactant to form complexes. In the second step, an aliquot of the incubation mixtures containing biotinylated C1-INH reactant is added to microtiter wells pre-coated with avidin. C1-INH reactant: C1-INH complexes present in the standards, controls, or specimens will bind to the avidin-coated microassay wells. After incubation, a wash cycle removes unbound material. In the third step, horseradish peroxidase (HRP)-conjugated goat anti-C1-INH is added to each test well. During this step, the HRP-conjugated anti-C1-INH binds to the C1-INH reactant: C1-INH complexes, which were captured on the surface of the avidin-coated microassay wells. After incubation, a wash cycle removes excess conjugate. In the fourth step, a chromogenic enzyme substrate is added to each microassay well. The bound HRP-conjugate reacts with the substrate forming a blue color. After incubation, the enzyme reaction is stopped chemically, forming a yellow color and the color intensity is measured spectrophotometrically at 450 nm. The color intensity of the reaction mixture is proportional to the concentration of functional C1-INH protein present in the test specimens, standards, and controls.(Package insert: C1-Inhibitor Enzyme Immunoassay. Quidel; 09/2021)
Day(s) Performed
Varies
Report Available
3 to 5 daysSpecimen Retention Time
14 daysPerforming Laboratory
Mayo Clinic Laboratories in RochesterCPT Code Information
83520
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
C1INF | C1 Esterase Inhib, Functional, S | 48494-9 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
C1INF | C1 Esterase Inhib, Functional, S | 48494-9 |