Test Code Billings Clinic: 8026 Chromosome Analysis, Fragile X, Blood
Performing Laboratory
Shodair Children's Hospital, Helena, Montana
Useful For
- Confirmation of diagnosis in a patient with consistent signs and symptoms, especially males with a positive family history of mental retardation.
- Testing is often used in a “screening” fashion since physical signs are subtle, and are difficult to recognize in affected females. Pregnant women with a family history of mental retardation in males may be suitable candidates for carrier testing.
Methodology
- Patient DNA is amplified by PCR and CGG allele sizes determined by a high resolution laserinduced capillary fluorescence electrophoresis system.
- Southern hybridization of probe StB12.3 to an EcoRI / EagI digest of genomic DNA detects larger expansions and assesses FMR-1 methylation.
- Results are reported within 3 weeks or less of receipt of sample; expedited on request.
- Based on Guidelines from the American College of Medical Genetics (ACMG, 1994), a comprehensive genetic evaluation of patients with mental retardation of unknown cause should include routine cytogenetic analysis as well as DNA analysis for Fragile X syndrome. Chromosome abnormalities have been identified as often as or more frequently than FMR-1 mutations in mentally retarded individuals referred for Fragile X testing.
Specimen Requirements
Specimen must arrive at Shodair Children’s Hospital within 24 hours of draw. Contact Billings Clinic Laboratory at 866-232-2522 to discuss the best specimen transport.
EDTA whole blood and sodium heparin whole blood are required for this test.
EDTA Whole Blood for Molecular Analysis
- Draw a full, lavender-top (EDTA) tube, and send 10 mL of unprocessed EDTA whole blood.
- Invert several times to mix blood.
- Forward unprocessed whole blood promptly at ambient temperature only.
- Specimen cannot be frozen.
- Protect specimen from extreme temperatures.
- When shipping, try to keep specimen as close to room temperature as possible.
- Reason for referral plus relevant clinical and family information, date of birth, sex, and diagnosis are required on request form for processing and to provide correct interpretation of test results.
- Label specimen appropriately (EDTA whole blood for molecular analysis).
Sodium Heparin Whole Blood for Cytogenetic Analysis
- Draw a full, green-top (sodium heparin) tube, and send 5 mL of sodium heparin whole blood.
- Invert several times to mix blood.
- Forward unprocessed whole blood promptly at ambient temperature only.
- Specimen cannot be frozen.
- Protect specimen from extreme temperatures.
- When shipping, try to keep specimen as close to room temperature as possible.
- Reason for referral plus relevant clinical and family information, date of birth, sex, and diagnosis are required on request form for processing and to provide correct interpretation of test results.
- Label specimen appropriately (sodium heparin whole blood for cytogenetic analysis).
Reject Due To
- Clotted specimens
- Frozen specimens
Reference Values
Reference values are included with patient’s report.
Day(s) Test Set Up
Daily
Test Classification and CPT Coding
83891 - Molecular diagnostics; isolation or extraction of highly
purified nucleic acid, each nucleic acid type (ie, DNA or RNA)
83892 - Molecular diagnostics; enzymatic digestion, each enzyme
treatment
83894 - Molecular diagnostics; separation by gel electrophoresis
(eg, agarose, polyacrylamide), each nucleic acid preparation
83896 - Molecular diagnostics; nucleic acid probe, each
83897 - Molecular diagnostics; nucleic acid transfer (eg, Southern,
Northern), each nucleic acid preparation
83898 - Molecular diagnostics; amplification, target, each nucleic
acid sequence
83912 - Molecular diagnostics; interpretation and report