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C4a test results

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Posted 3/26/2015 5:22 PM (GMT 0)
Hi all,

I'm in a slight Lyme limbo (as I know many people are). My doctor clinically diagnosed me with Lyme and bartonella based on having tested positive and having been treated for Lyme (for only 14 days w/ 200mg of doxy) back in 1997, the constellation of symptoms, and my bartonella-specific "stretch mark" rashes (which I always thought were stretch marks--but that's another thread on this forum).

My Bb, bartonella and babesia tests all came back negative a couple of weeks ago. I've had ELISA (LabCorp) and Western Blot (Quest Diagnostics) Lyme tests. However, my doctor sent me my C4a test result this morning, and it is very high: the normal range is 0-2,830 and my result is 19,647. My doctor said "the elevated number doesn't mean anything 'bad.'" (I'm not sure what the doc means by that, but I am interpreting it as 'don't panic.') She said that the test indicates I had a very high level of inflammation present in my blood when the blood samples were drawn, and that it's not due to environmental allergens, but that it's not specific to Lyme.

I've (of course) Googled "elevated C4a" and a lot of the links (see below) relate a high C4a result with Lyme; however, I understand it could also be due to anything from lupus to rheumatoid arthritis to mold or HIV infection. (I've had tests to rule out all of those, except mold.)

So does anyone know anything more about C4a? If not, maybe this info can be useful to take to your doctor and have them check your count. If so, I'd love to know more, hear about how this has/hasn't factored into your diagnosis and/or treatment.

http://www.publichealthalert.org/role-of-c3a-and-c4a-complement-proteins-in-chronic-lyme-disease.html
Posted 3/26/2015 5:57 PM (GMT 0)
My doctor tested my C4A and took my "normal" test as a good sign.

But we later discovered I do have Lyme, and very high levels of inflammation, so I don't put too much stock in it.
Posted 3/26/2015 6:05 PM (GMT 0)
You pretty much know most of all there is about the C4a test, its simple. Its mosltly triggered by lyme and mold. And when people are treated for those, the c4a usually recedes to normal levels. Its more of a treatment monitoring tool than a diagnostic. It is now said to be more reliable than the cd-57 test.
Posted 3/26/2015 7:44 PM (GMT 0)
C4a is a highly non-specific immune marker. All it is telling you is that your innate immune system is being activated. Almost all pathogens invoke a response from the innate immune system and will cause a complement cascade (i.e cleavage of other complement proteins and stimulation of pro-inflammatory cytokines).

Not sure what your doctor means by saying "it doesn't mean anything bad". Those values in and of themselves are not evidence of a life threatening situation, but clearly show you have some kind of infection/possible autoimmune reaction going on. That's definitely one of the higher numbers I have seen. FWIW, I saw an infectious disease specialist once when my C4a was at 8000 and she didn't know how to interpret the results because she didn't know what C4a was. In her words it didn't mean anything and wasn't important. Months later I found out I had 5 co-infections and Lyme. Any number that far outside of an established range should be of some concern.
Posted 3/26/2015 8:34 PM (GMT 0)
I'm chiming in - CD57 is a common test, but again, very unreliable. My CD57 was lower after I recovered from lyme - figure that one out!

But the Compliment C4a is an excellent reference. americanlyme - that is a major concern - 19k?? wow. mine was 850 when I was sick with lyme and then went back down to 188 while I was treating. C4a measures the level of inflammation in the body - so the more bacteria, the higher the inflammation. My Dr used this as a guide more than any other test I took.

They have reference ranges for a reason and as bmoberg337 said - "Any number that far outside of an established range should be of some concern."
Posted 3/26/2015 11:10 PM (GMT 0)

Chapelle said...

But the Compliment C4a is an excellent reference. americanlyme - that is a major concern - 19k?? wow. mine was 850 when I was sick with lyme and then went back down to 188 while I was treating. C4a measures the level of inflammation in the body - so the more bacteria, the higher the inflammation. My Dr used this as a guide more than any other test I took.
"

I agree I think the C4a is an excellent marker of progression. I test mine every other month to ensure the treatment I am on is working. What I have found interesting is that even though I have eliminated 2 co-infections the C4a hasn't dropped much, which leads me to believe the Lyme has more influence on this number and overall symptom severity.
Posted 3/27/2015 12:19 AM (GMT 0)
Very interesting! And I think that Candida can also play a role, because I ended up having yeast issues when I stopped the antifungals, and then my C4a went up to 500 (but it was still within the normal range)
Posted 4/9/2015 10:12 PM (GMT 0)
Thank you, everyone. Your responses are very useful for me and I'm sure for a lot of other people...for some reason I didn't get an email notification that people had replied. :-/

Anyway, I'll definitely keep an eye on my C4a complement and discuss further with my doctor.
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