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Test Code LAB0255232 C1 Esterase Inhibitor, Functional, Serum

Additional Codes

Mayo Test ID
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.


Useful For

Diagnosing hereditary angioedema

 

Monitoring response to C1 esterase inhibitor replacement therapy

Method Name

Enzyme Immunoassay (EIA)

Reporting Name

C1 Esterase Inhib, Functional, S

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

Day(s) Performed

Varies

Report Available

3 to 5 days

Specimen Retention Time

14 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

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.

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