C4A and lobular neoplasia: In a more recent study, individual ELISA measurements of urinary protein biomarkers L-PGDS, ICAM-1, VCAM-1, along with conventional biomarkers anti-dsDNA, C3, and C4, were used to develop a biomarker panel that showed excellent ability to identify renal flare (AUC = 0.98) in a small cohort of LN patients with flare (N = 8) (58).