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Complement component 4a deficiency(C4AD)

MedGen UID:
482272
Concept ID:
C3280642
Finding
Synonym: C4a deficiency
 
Gene (location): C4A (6p21.33)
 
Monarch Initiative: MONDO:0013721
OMIM®: 614380

Definition

Any classic complement early component deficiency in which the cause of the disease is a mutation in the C4A gene. [from MONDO]

Clinical features

From HPO
Vasculitis
MedGen UID:
12054
Concept ID:
C0042384
Disease or Syndrome
Inflammation of blood vessel.
Glomerulonephritis
MedGen UID:
6616
Concept ID:
C0017658
Disease or Syndrome
Inflammation of the renal glomeruli.
Systemic lupus erythematosus
MedGen UID:
6146
Concept ID:
C0024141
Disease or Syndrome
Systemic lupus erythematosus (SLE) is a complex autoimmune disease characterized by production of autoantibodies against nuclear, cytoplasmic, and cell surface molecules that transcend organ-specific boundaries. Tissue deposition of antibodies or immune complexes induces inflammation and subsequent injury of multiple organs and finally results in clinical manifestations of SLE, including glomerulonephritis, dermatitis, thrombosis, vasculitis, seizures, and arthritis. Evidence strongly suggests the involvement of genetic components in SLE susceptibility (summary by Oishi et al., 2008). Genetic Heterogeneity of Systemic Lupus Erythematosus An autosomal recessive form of systemic lupus erythematosus (SLEB16; 614420) is caused by mutation in the DNASE1L3 gene (602244) on chromosome 3p14.3. An X-linked dominant form of SLE (SLEB17; 301080) is caused by heterozygous mutation in the TLR7 gene (300365) on chromosome Xp22. See MAPPING and MOLECULAR GENETICS sections for a discussion of genetic heterogeneity of susceptibility to SLE.
Decreased circulating complement C4 concentration
MedGen UID:
893114
Concept ID:
C4073169
Finding
Concentration of the complement component C4 in the blood circulation below the lower limit of normal.
Reduced circulating CH50 activity
MedGen UID:
1380457
Concept ID:
C4476774
Finding
A diminished activity of the classical complement pathway as measured by the assay for 50% haemolytic complement (CH50) activity of serum.
Purpura
MedGen UID:
19584
Concept ID:
C0034150
Disease or Syndrome
Purpura (from Latin
Cutaneous photosensitivity
MedGen UID:
87601
Concept ID:
C0349506
Pathologic Function
An increased sensitivity of the skin to light. Photosensitivity may result in a rash upon exposure to the sun (which is known as photodermatosis). Photosensitivity can be diagnosed by phototests in which light is shone on small areas of skin.

Recent clinical studies

Etiology

Zhou D, King EH, Rothwell S, Krystufkova O, Notarnicola A, Coss S, Abdul-Aziz R, Miller KE, Dang A, Yu GR, Drew J, Lundström E, Pachman LM, Mamyrova G, Curiel RV, De Paepe B, De Bleecker JL, Payton A, Ollier W, O'Hanlon TP, Targoff IN, Flegel WA, Sivaraman V, Oberle E, Akoghlanian S, Driest K, Spencer CH, Wu YL, Nagaraja HN, Ardoin SP, Chinoy H, Rider LG, Miller FW, Lundberg IE, Padyukov L, Vencovský J, Lamb JA, Yu CY; for MYOGEN Investigators
Ann Rheum Dis 2023 Feb;82(2):235-245. Epub 2022 Sep 28 doi: 10.1136/ard-2022-222935. PMID: 36171069Free PMC Article
Chen JY, Wu YL, Mok MY, Wu YJ, Lintner KE, Wang CM, Chung EK, Yang Y, Zhou B, Wang H, Yu D, Alhomosh A, Jones K, Spencer CH, Nagaraja HN, Lau YL, Lau CS, Yu CY
Arthritis Rheumatol 2016 Jun;68(6):1442-1453. doi: 10.1002/art.39589. PMID: 26814708Free PMC Article
Lintner KE, Patwardhan A, Rider LG, Abdul-Aziz R, Wu YL, Lundström E, Padyukov L, Zhou B, Alhomosh A, Newsom D, White P, Jones KB, O'Hanlon TP, Miller FW, Spencer CH, Yu CY
Ann Rheum Dis 2016 Sep;75(9):1599-606. Epub 2015 Oct 22 doi: 10.1136/annrheumdis-2015-207762. PMID: 26493816Free PMC Article

Diagnosis

Tak AS, Satapathy J, Jana M, Sinha A, Jat KR, Bagri NK
Rheumatol Int 2022 Aug;42(8):1477-1482. Epub 2021 Jul 21 doi: 10.1007/s00296-021-04943-y. PMID: 34287686
Chen JY, Wu YL, Mok MY, Wu YJ, Lintner KE, Wang CM, Chung EK, Yang Y, Zhou B, Wang H, Yu D, Alhomosh A, Jones K, Spencer CH, Nagaraja HN, Lau YL, Lau CS, Yu CY
Arthritis Rheumatol 2016 Jun;68(6):1442-1453. doi: 10.1002/art.39589. PMID: 26814708Free PMC Article
Lintner KE, Patwardhan A, Rider LG, Abdul-Aziz R, Wu YL, Lundström E, Padyukov L, Zhou B, Alhomosh A, Newsom D, White P, Jones KB, O'Hanlon TP, Miller FW, Spencer CH, Yu CY
Ann Rheum Dis 2016 Sep;75(9):1599-606. Epub 2015 Oct 22 doi: 10.1136/annrheumdis-2015-207762. PMID: 26493816Free PMC Article

Clinical prediction guides

Lintner KE, Patwardhan A, Rider LG, Abdul-Aziz R, Wu YL, Lundström E, Padyukov L, Zhou B, Alhomosh A, Newsom D, White P, Jones KB, O'Hanlon TP, Miller FW, Spencer CH, Yu CY
Ann Rheum Dis 2016 Sep;75(9):1599-606. Epub 2015 Oct 22 doi: 10.1136/annrheumdis-2015-207762. PMID: 26493816Free PMC Article

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