Ordering Recommendation

Carrier screening or diagnostic testing for lipoamide dehydrogenase deficiency for individuals of Ashkenazi Jewish descent.

Mnemonic
DLD
Methodology

Polymerase Chain Reaction/Fluorescence Monitoring

Performed

Tue, Fri

Reported

5-10 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: 1 mL)

Storage/Transport Temperature

Refrigerated.

Unacceptable Conditions

Plasma or serum. Specimens collected in sodium heparin or lithium heparin tubes.

Remarks
Stability

Ambient: 72 hours; Refrigerated: 2 weeks; Frozen: 1 month

Reference Interval

By report

Interpretive Data

Background Information for Lipoamide Dehydrogenase Deficiency (DLD), 2 Variants:
Characteristics: Lipoamide dehydrogenase deficiency has a variable presentation that ranges from early-onset neurologic disease to adult-onset disease which is primarily hepatic. Early-onset neurologic disease presents in infancy with hypotonia, lethargy, vomiting and progressive encephalopathy resulting in death within the first or second year of life. Adult-onset primarily hepatic disease has a variable onset from infancy to the fourth decade and presents with liver injury or failure that is usually preceded by nausea and vomiting.
Incidence: 1 in 35,000 in Ashkenazi Jewish individuals.
Inheritance: Autosomal recessive.
Cause: DLD pathogenic variants.
Variants Tested: p.Y35X (c.104dupA), p.G229C (c.685G>T).
Clinical Sensitivity: 99 percent in Ashkenazi Jewish individuals; unknown in other ethnicities.
Methodology: Polymerase chain reaction (PCR) and fluorescence monitoring.
Analytical Sensitivity and Specificity: Greater than 99 percent.
Limitations: Variants other than those tested will not be detected. Diagnostic errors can occur due to rare sequence variations.

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

81479

Components
Component Test Code* Component Chart Name LOINC
2013736 Lipoamide Dehydrogenase Def, Specimen
2013737 Lipoamide Dehydrogenase Def, Allele 1
2013738 Lipoamide Dehydrogenase Def, Allele 2
2013739 Lipoamide Dehydrogenase Def, Interp
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Aliases
  • Dihydrolipoamide dehydrogenase deficiency
Lipoamide Dehydrogenase Deficiency (DLD), 2 Variants