Sign in →

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

616906

Useful For

Diagnosing hereditary angioedema

 

Monitoring response to C1 esterase inhibitor replacement therapy

Method Name

Enzyme Immunoassay (EIA)

Specimen Type

Serum Red

Specimen 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 days

Specimen Retention Time

14 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT 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