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.
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: For human genetic inheritable conditions and mutations. This test was developed and its performance characteristics determined by ARUP Laboratories. The U. S. Food and Drug Administration has not approved or cleared this test; however, FDA clearance or approval is not currently required for clinical use. The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions.

Counseling and informed consent are recommended for genetic testing. Consent forms are available online.

Note
Hotline History
N/A
CPT Codes

81363

Components
Component Test Code* Component Chart Name LOINC
2010114 Beta Globin (HBB) DelDup Specimen 31208-2
2010115 Beta Globin (HBB) DelDup Interp 50996-8
* 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
Beta Globin (HBB) Deletion/Duplication