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Beta Globin (HBB) Deletion/Duplication
2010113
Ordering Recommendation

This is a second tier test and REQUIRES PERMISSION from ARUP's Genetic Counselor (800-242-2787, x2141) before ordering. Preferred initial test is the combined sequencing and deletion/duplication test.

Mnemonic
BG DD
Methodology
Multiplex Ligation-dependent Probe Amplification
Performed
Varies
Reported
Within 14 days
New York DOH Approval Status
This test is New York DOH approved.
ARUP Consult®
Disease Topics
Specimen Required
Patient Preparation
 
Collect
Lavender (EDTA), pink (K2EDTA), or yellow (ACD Solution A or B). 
Specimen Preparation
Transport 3 mL whole blood. (Min: 2 mL) 
Storage/Transport Temperature
Refrigerated. 
Unacceptable Conditions
 
Remarks
 
Stability
Ambient: 72 hours; Refrigerated: 1 week; Frozen: Unacceptable 
Reference Interval
Interpretive Data
Background Information: Beta Globin (HBB) Deletion/Duplication
Characteristics:
Beta thalassemia is caused by decreased or absent synthesis of the hemoglobin beta-chain resulting in variable clinical presentations ranging from mild anemia to transfusion dependence. Hereditary persistence of fetal hemoglobin (HPFH) is a clinically benign condition caused by variants within the beta globin gene cluster that alter normal hemoglobin switching and result in persistent fetal hemoglobin (Hb F) production.
Incidence:
Varies by ethnicity.
Inheritance:
Usually autosomal recessive, infrequently autosomal dominant.
Cause:
Pathogenic variants within the HBB gene or variants involving the beta globin gene cluster and its regulatory elements.
Clinical Sensitivity:
Varies by ethnicity.
Methodology:
Multiplex ligation-dependent probe amplification (MLPA) of the beta globin gene cluster (HBB, HBD, HBG1, HBG2, HBE1) and its locus control region.
Analytical Sensitivity and Specificity:
99 percent.
Limitations:
Diagnostic errors can occur due to rare sequence variations. HBB single base pair substitutions, small deletions/duplications, deep intronic and promoter variants will not be detected. Breakpoints of large deletions/duplications will not be determined; therefore, the precise clinical phenotype associated with a particular deletion (e.g., HPFH vs. delta-beta thalassemia) may not be known. Intragenic deletions in the beta globin cluster genes, other than HBB, may not be detected. This assay does not assess for sequence variants within the coding or regulatory regions of HBB, HBD, HBG1, HBG2 or HBE1. Apparent copy number changes detected solely in the HBG1-HBG2 region will not be reported as they can result from benign sequence variants or gene conversion events.

Compliance Statement C: The performance characteristics of this test were validated by ARUP Laboratories. The U.S. Food and Drug Administration (FDA) has not approved or cleared this test. However, FDA approval or clearance is currently not required for clinical use of this test. The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions. ARUP is authorized under Clinical Laboratory Improvement Amendments (CLIA) and by all states to perform high-complexity testing. Counseling and informed consent are recommended for genetic testing. Consent forms are available online.

Note
CPT Code(s)
81403
Components
Component Test Code*Component Chart NameLOINC
2010114Beta Globin (HBB) DelDup Specimen31208-2
2010115Beta Globin (HBB) DelDup Interp50996-8
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.
Aliases