Hereditary Paraganglioma-Pheochromocytoma (SDHA) Sequencing

Background Information for Hereditary Paraganglioma-Pheochromocytoma (SDHA)Sequencing:
Characteristics: Hereditary paraganglioma-pheochromocytoma (PGL/PCC) syndrome is characterized by paragangliomas (neuroendocrine tumors of the autonomic nervous system) and pheochromocytomas (paragangliomas of the adrenal medulla). Pathogenic germline mutations in a number of genes, including SDHA, predispose to paraganglioma and pheochromocytoma with risk of malignant transformation.
Incidence: About 1 in 300,000 per year.
Inheritance: Autosomal dominant.
Cause: Pathogenic succinate dehydrogenase, subunits A, B, C, and D (SDHA, SDHB, SDHC, and SDHD) gene mutations. Mutations in other genes, including TMEM127, EGLN1, MAX, and SDHAF2, may also be causative.
Clinical Sensitivity: Less than 3 percent.
Methodology: Bidirectional sequencing of all coding regions and intron-exon boundaries of the SDHA gene. Sequencing primers are specifically selected to target the functional SDHA gene.
Analytical Sensitivity and Specificity: 96 percent.
Limitations: Diagnostic errors can occur due to rare sequence variations. Regulatory region mutations, deep intronic mutations, and large deletions/duplications in SDHA are not detected. In some cases, results may be uninterpretable due to technical limitations in the presence of pseudogenes. This assay is not designed to detect somatic variants associated with malignancy. Interpretation of this test result may be impacted if the patient has had an allogeneic stem cell transplantation.

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