Indication
Suspected Hypocomplementemic urticarial vasculitis syndrome or SLE with renal involvement.
Method
ELISA
Answer
The result is given as negative or positive.
Reference range
<26 E/mL
Interpretation
C1q antibodies have primary been studied in systemic lupus erythematosus (SLE) and Hypocomplementemic urticarial vasculitis syndrome (HUVS), a SLE-like disease. The presence of C1q antibodies in SLE is associated with severe illness, often with renal involvement. The highest concentrations are associated with disease relapse, when the level of C1q simultaneously is low. High concentration of antibodies usually decreases rapidly in response to treatment.
Almost 100% of all SLE patients with renal involvement have C1q antibodies. The prevalence is about 50% for severe SLE without renal involvement. C1q antibodies are rarely detected in mild SLE. Close to 100% of patients with Hypocomplementemic urticarial vasculitis syndrome have C1q antibodies. Hypocomplementemic urticarial vasculitis syndrome is almost always characterized by persistence of the C1q antibodies as well as low C1q levels for a long time. C1q antibodies have also been reported in, among other things, membrane proliferative glomerulonephritis and rheumatoid arthritis with vasculitis, conditions with normal C1q content. In SLE, C1q antibodies usually occur in combination with antibodies against native DNA.
Autoantibodies against C1q have also been detected in patients with Felty's syndrome, Morbus Bechterew, Mixed connective tissue disease (MCTD), Polyarteritis nodosa (PAN), Essential mixed cryoglobulinemia, and Goodpasture's syndrome.
In SLE there is no correlation with disease activity, but the presence of antibodies correlates positively with lupus nephritis, skin lesions, hypocomplementemia and dsDNA antibodies. The presence of autoantibodies in healthy individuals increases with age.
Indikation
Misstanke om hypokomplementemiskt urtikariavaskulit-syndrom (HUVS) eller SLE med njurengagemang.
Metod
ELISA
Svar
Anges som positivt eller negativt.
Referensintervall
<26 E/mL
Tolkning
C1q-antikropparna har framför allt studerats vid systemisk lupus erythematosus (SLE) och vid det s k hypokomplementemiskt urtikariavaskulit-syndrom (HUVS), en delvis SLE-liknande sjukdom. Vid SLE är förekomst av C1q-antikroppar förenad med svår sjukdom och fr a med njurengagemang. De högsta halterna påträffas i samband med sjukdomsskov, då halten av C1q samtidigt är låg. Antikropparna minskar vanligen snabbt i koncentration som svar på behandling.
Nära 100% av alla SLE-patienter med njurengagemang har C1q-antikroppar. Frekvensen är ca 50% vid svår SLE utan njurengagemang. C1q-antikroppar är ett ovanligt fynd vid lindrig SLE. Vid HUVS finner man C1q-antikroppar hos nära 100% av patienterna. Förloppet utmärks nästan alltid av att C1q-antikroppar och låg C1q-halt kvarstår under lång tid.
C1q-antikroppar har också rapporterats vid bl a membranproliferativ glomerulonefrit och reumatoid artrit med vaskulit, tillstånd med normal C1q-halt.
Vid SLE uppträder C1q-antikroppar oftast i kombination med antikroppar mot nativt DNA.