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26114 Complement, Total, Serum (COM)

Complement, Total, Serum (COM)
Test Code: COMSO
Synonyms/Keywords
C'H(100)
C'H(50)
CH50
COMPLEMENT, TOTAL (C'H50)
Complement, Total Hemolytic
Connective Tissue Disease Activity Assessment (2 tests)
Immunology Profile (CH50)
Total Complement, Serum
Total Hemolytic Complement-routine
Useful For

Detection of individuals with an ongoing immune process

First-tier screening test for congenital complement deficiencies

Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Yes-preferred ​Serum ​Red Top Tube (RTT) ​1 mL ​0.5 mL
Collection Processing Instructions

1. Immediately after specimen collection, place the tube on wet ice.

2. Centrifuge and separate serum from clot; transferring the serum into a plastic vial.

3. Immediately freeze specimen.

Specimen Stability Information
Specimen Type Temperature Time
​Serum ​Frozen ​28 days
Rejection Criteria
Serum Gel Tube (SST) collected sample
Interference
Because this is a functional assay, the results are dependent on appropriate specimen transport and storage.
Performing Laboratory Information
Performing Location Day(s) Test Performed Report Available Methodology/Instrumentation
​Mayo Clinic Laboratories ​Monday through Friday ​1 to 2 days ​Automated Liposome Lysis Assay
Reference Lab
Test Information

Complement proteins are components of the innate immune system. There are 3 pathways to complement activation: (1) the classic pathway, (2) the alternative (or properdin) pathway, and (3) the lectin activation (or mannan-binding protein) pathway. The classic pathway of the complement system is composed of a series of proteins that are activated in response to the presence of immune complexes. The activation process results in the generation of peptides that are chemotactic for neutrophils and that bind to immune complexes and complement receptors. The end result of the complement activation cascade is the formation of the lytic membrane attack complex (MAC).

The absence of early components (C1, C2, C3, C4) of the complement cascade results in the inability of immune complexes to activate the cascade. Patients with deficiencies of the early complement proteins are unable to generate the peptides that are necessary to clear immune complexes and to attract neutrophils or to generate lytic activity. These patients have increased susceptibility to infections with encapsulated microorganisms. They may also have symptoms that suggest autoimmune disease, and complement deficiency may be an etiologic factor in the development of autoimmune disease.

Patients with deficiencies of the late complement proteins (C5, C6, C7, C8, and C9) are unable to form the MAC, and may have increased susceptibility to neisserial infections.

Undetectable complement levels are found in patients with specific component deficiencies. Decreased complement levels are found in infectious and autoimmune diseases due to fixation and consumption of complement.

Reference Range Information
Performing Location Reference Range
​Mayo Clinic Laboratories 30-75 U/mL
Interpretation

Low levels of total complement (total hemolytic complement: CH50) may occur during infections, disease exacerbation in patients with systemic lupus erythematosus, and in patients with immune complex diseases such as glomerulonephritis.

Undetectable levels suggest the possibility of a complement component deficiency. Individual complement component assays are useful to identify the specific deficiency.

Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
​86162 ​1
Synonyms/Keywords
C'H(100)
C'H(50)
CH50
COMPLEMENT, TOTAL (C'H50)
Complement, Total Hemolytic
Connective Tissue Disease Activity Assessment (2 tests)
Immunology Profile (CH50)
Total Complement, Serum
Total Hemolytic Complement-routine
Ordering Applications
Ordering Application Description
​Centricity ​Complement, Total, S (COM)
​Cerner ​Complement, Total, S (COM)
​COM ​Complement, Total, S
​Portal​Complement, Total (COM)
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
Pediatric Minimum Volume
(no repeat)
​Yes-preferred ​Serum ​Red Top Tube (RTT) ​1 mL ​0.5 mL
Collection Processing

1. Immediately after specimen collection, place the tube on wet ice.

2. Centrifuge and separate serum from clot; transferring the serum into a plastic vial.

3. Immediately freeze specimen.

Specimen Stability Information
Specimen Type Temperature Time
​Serum ​Frozen ​28 days
Rejection Criteria
Serum Gel Tube (SST) collected sample
Interference
Because this is a functional assay, the results are dependent on appropriate specimen transport and storage.
Useful For

Detection of individuals with an ongoing immune process

First-tier screening test for congenital complement deficiencies

Reference Range Information
Performing Location Reference Range
​Mayo Clinic Laboratories 30-75 U/mL
Interpretation

Low levels of total complement (total hemolytic complement: CH50) may occur during infections, disease exacerbation in patients with systemic lupus erythematosus, and in patients with immune complex diseases such as glomerulonephritis.

Undetectable levels suggest the possibility of a complement component deficiency. Individual complement component assays are useful to identify the specific deficiency.

For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Report Available Methodology/Instrumentation
​Mayo Clinic Laboratories ​Monday through Friday ​1 to 2 days ​Automated Liposome Lysis Assay
Reference Lab
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)
Quantity Description Comments
​86162 ​1
For most current information refer to the Marshfield Laboratory online reference manual.