Test Code LAB1926 Wilson Disease Sequencing
Clinical System Name
Wilson Disease (ATP7B) Sequencing
Description
Wilson disease is an autosomal recessive disorder of copper metabolism. Sequencing of the ATP7B gene can identify greater than 98% of mutations in affected individuals.
ATP7B full gene sequencing is appropriate for individuals with:
- Liver disease
- Neurologic presentations
- Psychiatric disturbance
- Low serum copper & ceruloplasmin levels
- Increased urine copper
- Kayser-Fleisher rings in the cornea
- Increased hepatic copper levels
Also available: Targeted Gene Variant Sequencing (LAB1915) - For targeted analysis of variants previously identified through clinical testing of a family member or research testing of the individual. Please review requirements and restrictions for testing.
Sample Requirements
Note: For patients who have had a whole blood transfusion, wait 10 days post transfusion to draw for genetic testing. No wait time is necessary for blood or saliva collection if the patient received leuko-reduced red cells or plasma.
Specimen: Whole blood, cord blood
Container(s): Lavender/EDTA, Yellow/ACD A or B
Preferred Vol: 3 mL
Minimum Vol: 1 mL
Note: Heparin samples (Green tops) are unacceptable.
Specimen: Extracted DNA from EDTA blood
Minimum: 10µg
Note: Isolation of nucleic acids for clinical testing must be performed in a CLIA-certified
laboratory or a laboratory meeting equivalent requirements as determined by the CAP
and/or the CMS. DNA concentration minimum 50 µg/mL; 260/280 ratio 1.70-2.00.
Specimen: Cultured cells
Acceptable: Fibroblasts
Container(s): T-25 flasks
Preferred Vol: 2 flasks
Specimen: Saliva collected using Oragene Dx OGD-575/675 collection kit.
Container: Oragene Dx OGD-575/675 collection kit
IMPORTANT NOTE: Manufacturer instructions must be followed. The Oragene Dx OGD575/675 kit is not for children under 6 months. Contact Lab Client Services for more information or to obtain a kit 206-987-2617, labclientservices@seattlechildrens.org
Processing Instructions
Reject due to: Heparin
Spin: No
Aliquot: No
Temp: Refrigerate
Storage location: Molecular Genetics box in CPA refrigerator #2
Off-site collection: Refrigerate blood samples until ready to ship. Transport all sample types at room temperature via overnight shipping.
Stability
Specimen Type | Temperature | Time |
---|---|---|
Cultured cells | Room temp | 3 days |
Whole blood, extracted DNA | Room temp | 3-5 days |
Whole blood, extracted DNA | Refrigerated | 7 days |
Extracted DNA | Frozen | ok |
Saliva, ORAgene Dx OGD-575/675 | Room Temp | 2 weeks |
Note: Whole blood samples > 7days may be submitted to be assessed by our lab for acceptability for testing.
Availability
STAT | Performed | TAT |
---|---|---|
Contact lab | Monday - Friday | 2-3 weeks |
Performing Laboratory
Seattle Children's Laboratory
Department
Department: Molecular Genetics Laboratory
Phone: 206-987-3872
Lab Client Services: 206-987-2617
Lab Genetic Counselor: LabGC@seattlechildrens.org
CPT Codes
81406 (updated 2/2/16 by jconta)
Methodology
Method: Bi-directional sequencing of all exons and exon-intron boundaries
Limitations: Mutations in the promoter region, large deletions, large duplications, or rare recombinant mutations may not be detected by this method.
Reference Range
Interpretive report will be provided
Requisition
Special Instructions
Links to: Wilson Disease GeneReviews
Clinical Utility
Wilson disease is an autosomal recessive disorder of copper metabolism. Copper accumulation in tissues and organs can lead to liver disease, neurological symptoms including movement disorders, dysarthria, dystonia, migraines and seizures; and psychiatric symptoms including depression, personality changes and psychoses. Many individuals will have characteristic changes to their cornea called Kayser-Fleischer rings.
The age of onset can be from childhood to adulthood; signs and symptoms are rarely observed in children under 3 years of age. Children tend to present with liver disease as their primary symptom, whereas most neurological and psychiatric symptoms tend to arise in adulthood.
Full gene sequencing will identify greater than 98% of mutations in affected individuals.
Carrier testing for biological family members is available once mutations are known.