This test analyzes the CYP21A2 gene, which is associated with 21-hydroxylase deficiency.
| Test Code | D5019 |
|---|---|
| Test Summary |
This test analyzes the CYP21A2 gene, which is associated with 21-hydroxylase deficiency. |
| Turn Around Time | 3 - 5 weeks |
| Acceptable Sample Types | DNA, Isolated , Dried Blood Spots , Saliva , Whole Blood (EDTA) |
| Acceptable Billing Types | Institutional Billing , Self (patient) Payment |
| NY Approved | No |
| CPT Codes** | 81405(x1), 81479(x1) |
| Self (patient) Price | $935.00 |
|---|---|
| Institutional Price | $935.00 |
This gene sequencing panel includes both sequencing and deletion/duplication (CNV) analysis for all coding regions of the CYP21A2 gene. Analysis is performed utilizing either LR-PCR followed by NGS sequencing or MLPA. All variants are classified according to American College of Genetics and Genomics (ACMG) guidelines.
21-hydroxylase deficiency is a disease that causes excessive androgen production in the adrenal glands. There are three distinct types of 21-hydroxylase deficiency: salt wasting, simple virilizing, and non-classic. The salt wasting form of the disease is the most severe with an age of onset typically in the fetal or neonatal periods and have symptoms of excessive loss of sodium in the urine, poor feeding, weight loss, dehydration, vomiting, ambiguous genitalia in females, small testses in males, an early growth spurt, shorter adult height, decreased ferility, hirsutism in females, irregular menstruation, and male pattern baldness. The simple virilizing form has an age of onset in the fetal or neonatal period, with symptoms of anbiguous genitalia in females, small testes in males, an early growth spurt, shorter adult height, decreased ferility, hirsutism in females, irregular menstruation, and male pattern baldness. The non-classic form has an age of onset in adolesence or adulthood with symptoms of hirsuitism in females, male pattern baldness, irregular menstruation, decreased fertility, early beard growth and small testes in males. The incidence of the salt wasting and simple virilizing forms for 21-hydroxylase deficiency is estimated to be ~ 1 in 15,000. The incidence of the non-classic form of 21-hydroxylase deficiency is estimated to be ~ 1 in 1000.
Long-range PCR was performed to specifically amplify the genomic sequence of the gene of interest from the individual's genomic DNA; sequences from associated pseudogene regions are excluded. Sequencing of the long-range PCR product was performed using short-read next-generation sequencing (NGS). Indel and single-nucleotide variants (SNVs) may be confirmed by Sanger sequencing analysis before reporting, based on laboratory requirements. This analysis cannot detect variants in regions that are not analyzed, such as promoters, deep intronic, or long repetitive regions. This assay is not designed to detect mosaicism; however, possible cases of mosaicism may be detected and reported if laboratory requirements are met.
Copy number variation (CNV) analysis was performed using MLPA (Multiplex Ligation-dependent Probe Amplification). This analysis cannot determine the location or orientation of a duplication. Copy-neutral gene conversion or fusion, complex rearrangements, or large deletions including the entire gene with breakpoint(s) outside the targeted region may not be detected by this assay.
| Collection |
Required DNA Quantity by Test Type*:
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|---|---|
| Sample Condition |
* Required DNA Quality: High molecular weight DNA (>12kb). A260/A280 reading should be ≥ 1.8. A260/230 a ratio range of 1.8 to 2.2. Contact the laboratory for specific amounts if total ng cannot be met. |
| Shipping |
Ship overnight at ambient temperature. |
| SPECIAL SAMPLE INSTRUCTIONS |
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| Collection Container(s) |
EDTA (purple top) |
|---|---|
| Collection |
Infants (< 2-years): 2 to 3 mL; Children (>2-years): 3 to 5 mL; Older children and adults: Minimum 5mL. The blood tube should be inverted several times immediately after blood collection to prevent coagulation. |
| Sample Condition |
Store at ambient temperature. Do not refrigerate or freeze. |
| Shipping |
Ship overnight at ambient temperature ensuring receipt within 5-days of collection. |
| SPECIAL SAMPLE INSTRUCTIONS |
Clotted or hemolyzed samples are not accepted. |
| Collection Container(s) |
Oragene™ Saliva Collection Kit or ORAcollect-Dx kit |
|---|---|
| Collection |
Collect saliva on an Oragene™ Saliva Collection Kit ORAcollect-Dx kit according to the manufacturer's instructions. |
| Sample Condition |
Store at ambient temperature. Do not refrigerate or freeze. |
| Shipping |
Ship overnight at ambient temperature. |
| SPECIAL SAMPLE INSTRUCTIONS |
Please contact Revvity Omics to request the saliva collection kit for patients who cannot provide a blood sample as whole blood is the preferred sample. Testing using Saliva swabs is currently not available for customers in India. Contact the Revvity Omics laboratory for more information. |
| Collection Container(s) |
Dried blood spot card |
|---|---|
| Collection |
Follow kit instructions. Briefly, allow blood to saturate the card until indicated areas are filled and blood has soaked through the card. Air dry the card at ambient temperature for at least 3 hours.
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| Sample Condition |
Follow the instructions provided with the collection set. Store the dried blood at ambient temperature for up to two days. If the specimen cannot be sent as soon as it is dry, the filter paper should be placed in a sealable plastic bag and stored in a refrigerator (≤ 8°C) or preferably in a freezer. |
| Shipping |
Follow kit instructions. Double bag and ship overnight at ambient temperature. |
Select the correct test for your patient, and download and fill out the Clinical Genomics test requisition form.
Obtain a sample for testing from the patient using one of the provided Revvity Omics test packs.
Send samples and all required forms back to Revvity for processing using pre-paid shipping label.
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