Long Chain Acyl-CoA Dehydrogenase Mutation

Test Code

11244

CPT Codes
81479

Physician Attestation of Informed Consent

This germline genetic test requires physician attestation that patient consent has been received if ordering medical facility is located in AK, DE, FL, GA, IA, MA, MN, NV, NJ, NY, OR, SD or VT or test is performed in MA.

Preferred Specimen

5 mL whole blood collected in an EDTA (lavender-top) tube

Minimum Volume

3 mL whole blood or bone marrow • 10 mL amniotic fluid • 10 mg tissue biopsy or chorionic villi

Other Acceptable Specimens

Whole blood collected in: EDTA (royal blue-top) tube, sodium heparin (green-top) tube, or ACD-B (yellow-top) tube • 10 mg tissue biopsy collected in a sterile container • 5 mL bone marrow collected in an EDTA (lavender-top) tube • 10 mL amniotic fluid collected in a sterile, plastic, leak-proof container • 10 mg chorionic villi collected in a sterile tube filled with sterile culture media • Cultured cells collected in each of two separate sterile T-25 flasks, 75% confluent

Instructions

Do not hold specimen; forward to laboratory when specimen arrives.

Whole blood: Specimen stability is crucial. Store and ship room temperature immediately. Do not freeze.

For fetal testing:
1) Please call 1-866-GENE-INFO (1-866-436-3463) prior to submission; 2) Documentation of parental carrier status must be provided; 3) It is required that Maternal Cell Contamination Study, STR Analysis be ordered in conjunction with fetal testing. A separate tube of maternal blood (EDTA) is required for this test.

Amniotic fluid (acceptable): Normal collection procedure. Specimen stability is crucial. Store and ship at room temperature immediately. Do not refrigerate or freeze; forward to laboratory when sample arrives.

Amniocyte or Chorionic Villus (CVS) culture (acceptable): Two sterile T25 flasks, 75% confluent, filled with culture medium. Specimen stability is crucial. Store and ship at room temperature immediately. Do not refrigerate or freeze; forward to laboratory when cells arrive.

Dissected Chorionic Villus (CVS) biopsy (acceptable): 10-20 mg dissected chorionic villi collected in sterile tube, filled with sterile culture medium. Specimen stability is crucial. Store and ship at room temperature immediately. Do not refrigerate or freeze; forward to laboratory when sample arrives.

Transport Temperature

Room temperature

Specimen Stability

Whole blood and bone marrow
Room temperature: 8 days
Refrigerated: 8 days
Frozen: Unacceptable

Tissue biopsy, amniotic fluid, chorionic villi, cultured cells
Room temperature: 48 hours
Refrigerated: Unacceptable
Frozen: Unacceptable

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)

Do not reject

Methodology
Polymerase Chain Reaction (PCR) • Single Nucleotide Primer Extension

FDA Status
This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by the U.S. Food and Drug Administration. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.

Setup Schedule

Set up: Wed, Sat; Report available: 6-10 days

Limitations

This analysis only evaluates the presence of the 1528G>C mutation and cannot detect other possible mutation in the HADHA gene, or other genes. DNA analysis can predict the occurrence of LCHAD deficiency, but not the severity of the condition.

Reference Range

See Laboratory Report

Clinical Significance

Long chain 3-hydroxyacyl-CoA dehydrogenase deficiency is an autosomal recessive inborn error of fatty acid metabolism that can cause recurrent episodes of hypoglycemia and metabolic decompensation. Studies have suggested that a percentage of patients with sudden infant death syndrome (SIDS) actually had undiagnosed LCHAD deficiency. Almost all patients with LCHAD deficiency are homozygous for a G>C transition at nucleotide position 1528 in the LCHAD gene.

Performing Laboratory

Quest Diagnostics Nichols Institute-San Juan Capistrano, CA

33608 Ortega Highway

San Juan Capistrano, CA 92675-2042

The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.