Chronic Granulomatous Disease (CYBB Gene Scanning and NCF1 Exon 2 GT Deletion) with Reflex to CYBB Sequencing
2006356
 
Ordering Recommendation
Mnemonic
CGD PANEL
Methodology
High Resolution Melt Analysis
Performed
Mon, Thu
Reported
10-14 days
New York DOH Approval Status
Specimens from New York clients will be sent out to a New York DOH approved laboratory.
Specimen Required
Patient Preparation
 
Collect
Lavender (EDTA), pink (K2EDTA), or yellow (ACD Solution A or B).  
Specimen Preparation
Transport 3 mL whole blood. (Min: 1 mL)  
Storage/Transport Temperature
Refrigerated.  
Unacceptable Conditions
Frozen  
Remarks
 
Stability
Ambient: 72 hours; Refrigerated: 1 week; Frozen: Unacceptable  
Reference Interval
Interpretive Data
Background Information for Chronic Granulomatous Disease (CYBB Gene Scanning and NCF1 Exon 2 GT Deletion):
Characteristics of chronic granulomatous disease (CGD):

A primary immunodeficiency disorder characterized by recurrent, severe bacterial and fungal infections of the skin, lymph nodes, liver, lungs, bones, or visceral organs. Dysregulated inflammatory responses result in granulomas.
Incidence:
Approximately 1 in 250,000 births.
Inheritance:
X-linked recessive for CYBB; de novo mutations in 10-20 percent of affected males. Autosomal recessive for NCF1.
Cause:
Pathogenic mutations in the CYBB gene result in X-linked CGD that accounts for 60-70 percent of all CGD. Autosomal recessive CGD may result from mutations in NCF1 (25 percent), CYBA (<5 percent), NCF2 (<5 percent) and NCF4 (very rare).
Clinical Sensitivity:
86 percent for CGD.
Methodology:
PCR followed by high-resolution melting analysis to detect the common GT deletion in exon 2 of NCF1 and the entire coding region and intron/exon boundaries of the CYBB gene. Identified sequence variants are confirmed using targeted, bidirectional sequencing.
Analytical Sensitivity:
99 percent for CYBB and homozygous GT deletion, 90 percent for heterozygous GT deletion.
Analytical Specificity:
99 percent.
Limitations:
Diagnostic errors can occur due to rare sequence variations. Deep intronic mutations in CYBB, mutations in NCF1 other than the GT deletion in exon 2, and mutations in additional genes associated with CGD, are not evaluated in males or females. Large CYBB gene deletions/duplications will not be detected in females. Breakpoints of large deletions/duplications will not be determined in males. Because of potential recombination between NCF1 and its pseudogenes, the lack of detection of the GT deletion in exon 2 does not rule out carrier status for autosomal recessive CGD.



Counseling and informed consent are recommended for genetic testing. Consent forms are available online at www.aruplab.com.

See Compliance Statement C: www.aruplab.com/CS
Note
If pathogenic CYBB mutations are detected, then sequencing will be added. Additional charges apply.
CPT Code(s)
81479; If reflexed to Seq, add: 81479
Components
Component Test Code*Component Chart Name
2006357Chronic Granulomatous Disease, Specimen
2006358Chronic Granulomatous Disease
2006359Chronic Granulomatous Disease, Interpret
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, contact interface support at interface.support@aruplab.com.
Cross References