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Soluble Complement 5b-9 (sC5b-9)

Justification

Elevations in soluble Complement 5b-9 (sC5b-9) have been associated with increased activation of the alternative complement pathway. Increased complement activation may be seen with aHUS and other TMAs, and may be a sensitive early predictor of the development of transplant associated TMA. In a cohort of 67 pediatric patients who had an allogeneic HSCT, an increase in sC5b-9 concentration from baseline had 100% sensitivity and 53% specificity for TA-TMA.

STAT: < 24 hours (7 days a week)

ELISA

Draw Tube: Purple Top

Sample Type: EDTA Plasma

Specimen Requirements

Sample Type Volume Required Minimum Volume Stability
PREFERRED EDTA Plasma 1mL 0.5mL Frozen (-20C): 2 weeks
Frozen (-80C): 6 months
ALTERNATIVE - - - -
REJECTION CRITERIA Thawed in transit if shipped frozen, refrozen, clotted sample
SPECIAL INSTRUCTIONS Process and freeze samples within one hour of collection.

General Information

METHODOLOGY ELISA
STAT TAT < 24 hours (7 days a week)
STAT TAT Performance > 90% of results released in 21.2 hours 7 days a week
ROUTINE TAT < 1 week
ALTERNATIVE NAMES soluble C5b-9, sC5b-9, soluble MAC, sMAC, membrane attack complex, TCC, terminal complement, complement activation
DESCRIPTION Chromogenic ELISA for the quantitative detection of soluble complement 5b-9, also known as the soluble membrane attack complex (sMAC).
LIMITATIONS -
NORMAL RANGE < 250 ng/mL
ASSOCIATED TESTING -
REFERENCES

Bomback AS et al. Clin J Am Soc Nephrol. 2012 May;7(5):748-56. Nicolas C et al. Pediatr Nephrol. 2014;29(1):85.

Mezö B, Horváth O, et al. Validation of Early Increase in Complement Activation Marker sC5b-9 as a Predictive Biomarker for the Development of Thrombotic Microangiopathy After Stem Cell Transplantation. Front. Med. 2020 Oct 6; 7:569291. doi: 10.3389/fmed.2020.569291

Horváth O, Kállay K, et al. Early Increase in Complement Terminal Pathway Activation Marker sC5b-9 Is Predictive for the Development of Thrombotic Microangiopathy after Stem Cell Transplantation. Biol Blood Marrow Transplant 2018 May; 24(5):989-996.
SAMPLE REPORT Upon request
NEW YORK STATE APPROVED No

Test Codes

ORDER CODE P3364
CPT CODE 86160
LOINC CODE 93244-2