Hyper-IgM Syndrome (HIGM): (CD40 [TNFRSF5] for HIGM3) (Full Gene Sequencing)

TEST: 252432
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CPT: 81479
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Test Includes

This test covers all coding nucleotides of gene CD40 (TNFRSF5), plus at least two and typically 20 flanking intronic nucleotides upstream and downstream of each coding exon, covering the conserved donor and acceptor splice sites, as well as typically 20 flanking nucleotides in the 5′ and 3′ UTR.

Special Instructions

In cases in which a known mutation can be documented, the physician may prefer to order test 252670.

Test orders must include an attestation that the provider has the patient's informed consent for genetic testing. See sample physician office consent form: Consent for Genetic Testing. In the case of family tests (ie, known mutations), please submit the result report of the first patient tested in the family (the index case), if not performed at a LabCorp facility. Other family members are subsequently tested for the specific mutation found in the first patient tested.

Expected Turnaround Time

28 - 35 days

Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.

Related Documents

For more information, please view the literature below.

Consent for Genetic Testing (Consentimiento para análisis genético)

Hyper-IgM Syndrome Genetic Testing

    Specimen Requirements

    Specimen

    Whole blood; DNA is accepted (Call 800-345-4363 for DNA collection information.)

    Volume

    2 mL

    Container

    Lavender-top (EDTA) tube

    Collection

    Samples may be stored for brief periods at 4°C. Ship overnight at room temperature.

    Storage Instructions

    Maintain specimen at room temperature.

    Causes for Rejection

    Container broken or leaking; container not labeled or label not legible; use of improper anticoagulant

    Test Details

    Use

    Confirm a clinical diagnosis of HIGM; detect carriers; allow early diagnosis in family members, guiding prophylactic measures

    Limitations

    This method does not reliably detect mosaic variants; large deletions; large duplications, inversions, or other rearrangements; or deep intronic variants. It may be affected by allele-dropout, it may not allow determination of the exact numbers of T/A or microsatellite repeats, and it does not allow any conclusion as to whether two heterozygous variants are present on the same or on different chromosome copies.

    Results of this test are for investigational purposes only. The performance characteristics of this assay have been determined by LabCorp. The result should not be used as a diagnostic procedure without confirmation of the diagnosis by another medically established diagnostic product or procedure.

    Methodology

    DNA sequencing

    Reference Interval

    Normal equals reference sequence or variants that are known or predicted to be benign; abnormal equals all other variants.

    Additional Information

    Hyper immunoglobulin M syndrome type 3 (HIM3) is a recessively inherited immune disorder characterized by lack of IgG, IgA, and IgE in the presence of excess IgM, leading to increased susceptibility to bacterial infections. In HIGM3, cellular immunity is also affected, resulting in additional susceptibility to opportunistic pathogens. Mutations in CD40 account for all of HIGM3 and <1% of HIGM overall. Genetic testing can confirm a clinical diagnosis of HIGM3 and detect mutation carriers within affected families.

    References

    Lougaris V, Badolato R, Ferrari S, Plebani A. Hyper immunoglobulin M syndrome due to CD40 deficiency: Clinical, molecular, and immunological features. Immunol Rev. 2005 Feb; 203:48-66. 15661021

    LOINC® Map

    Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
    252432 HIGM3:CD40 41103-3 252192 Routing 41103-3

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