ARUP's Laboratory Test Directory

Juvenile Polyposis (SMAD4) Deletion/Duplication : 2001976
[ image for: Patient History for Juvenile Polyposis (JPS)/Hereditary Hemorrhagic Telangiectasia (HHT)]
Patient History for Juvenile Polyposis (JPS)/Hereditary Hemorrhagic Telangiectasia (HHT)
  


Mnemonic: SMAD4 DD

Methodology: Polymerase Chain Reaction/Multiplex Ligation-dependent Probe Amplification
Performed: Varies
Reported: Within 14 Days
Specimen Required: 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.

Stability (collection to initiation of testing): Ambient: 72 hours; Refrigerated: 1 week; Frozen: Unacceptable

Reference Interval:
By report
Interpretive Data: Background Information for Juvenile Polyposis (SMAD4) Deletion/Duplication:
Characteristics of Juvenile Polyposis Syndrome (JPS):
Gastrointestinal (GI) bleeding, multiple hamartomatous polyps in the GI tract, increased risk for GI carcinoma.
Characteristics of JP/Hereditary Hemorrhagic Telangiectasia (HHT):
Recurrent nosebleeds, telangiectases (mouth, face, hands, GI tract), arteriovenous malformations (lung, brain, liver, spine) and hamartomatous polyps in the GI tract.
Incidence
: 1 in 16,000 to 1 in 100,000 for JPS; unknown for JP/HHT.
Inheritance:
Autosomal dominant; de novo mutations occur in 25 percent of JPS.
Penetrance:
Suspected to be greater than 90 percent for JPS.
Cause for JPS:
Mutations in SMAD4, BMPR1A and other unknown genes.
Cause for JP/HHT:
Mutations in SMAD4.
Clinical Sensitivity
: Approximately 10 percent for JPS; unknown for JP/HHT.
Methodology
: Multiplex ligation-dependent probe amplification (MLPA) to detect large SMAD4 coding region deletions/duplications.
Analytical Sensitivity and Specificity:
90 and 99 percent, respectively.
Limitations:
Rare diagnostic errors can occur due to probe site mutations. Breakpoints for large deletions/duplications will not be determined. SMAD4 base pair substitutions, small deletions/duplications, deep intronic, and regulatory region mutations will not be detected.



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

Refer to Statement C under Testing Information at http://www.aruplab.com.
CPT Code(s): 83891 Isolation; 83896 Nucleic acid probes; 83898 Amplification; 83914 Extension; 83909 Capillary electrophoresis; 83912 Interpretation and report - Additional CPT code modifiers may be required for procedures performed to test for oncologic or inherited disorders.
Cross References: SMAD4 (Juvenile Polyposis (SMAD4) Deletion/Duplication)
 
 

 

 

 
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