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Table 2 Plasma concentration of C3, C4, CFH, CFI and CFB and expression of MCP in the various subgroups of atypical hemolytic uremic syndrome

From: Atypical hemolytic uremic syndrome

 

Protein level or expression

 

C4

C3

CFH

CFI

CFB

MCP

CFH mutation

N

Normal

(decreased)

Normal

(decreased)

Normal

Normal

(decreased)

Normal

CFI mutation

N

Normal

(decreased)

Normal

Normal

(decreased)

Normal

(decreased)

Normal

MCP mutation

N

Normal

(decreased)

Normal

Normal

Normal

Decreased

(normal)

CFB mutation

N

Decreased

Normal

Normal

Normal

(decreased)

Normal

C3 mutation

N

Decreased

Normal

Normal

Normal

(decreased)

Normal

THBD mutation

N

Normal

or decreased

ND

ND

ND

Normal

Anti-CFH Ab

N

Decreased

(normal)

Normal

(decreased)

Normal

Normal

(decreased)

Normal

  1. Very low C3 levels are observed in patients with homozygous CFH mutation (complete CFH deficiency) or compound heterozygous CFH mutation, and in patients with CFB or C3 gain-of-function mutations. In most of the other patients, C3 concentration is mildly decreased or normal. Undetectable CFH concentrations are observed only in patients with homozygous CFH mutation. Decreased CFH concentration can be observed in patients with heterozygous type 1 CFH mutation, and during flares of anti-CFH antibodies-HUS. Decreased C4 plasma levels have been reported in zero to a few % of patients of the various subgroups [18].
  2. "Normal" and "decreased" without brackets means most frequently normal or decreased, within brackets means possible but not frequent. "Normal or decreased" without brackets means normal or decreased is equally frequent. CFH: factor H; CFI: factor I; MCP: membrane cofactor protein; CFB: factor B; THBD: thrombomodulin; Ab, antibodies. ND: not documented.