ARUP's Laboratory Test Directory

Juvenile Polyposis (SMAD4) Sequencing : 0051510
[ image for: Patient History for Juvenile Polyposis (JPS)/Hereditary Hemorrhagic Telangiectasia (HHT)]
Patient History for Juvenile Polyposis (JPS)/Hereditary Hemorrhagic Telangiectasia (HHT)
  


Mnemonic: SMAD4 SEQ

Ordering Recommendation: Diagnostic testing for juvenile polyposis syndrome/ hereditary hemorrhagic telangiectasia. Predictive testing for juvenile polyposis syndrome/ hereditary hemorrhagic telangiectasia.
Methodology: Polymerase Chain Reaction/ Sequencing
Performed: Varies
Reported: 14-21 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

Interpretive Data: Background Information for Juvenile Polyposis (SMAD4) Sequencing
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 20 percent for JPS; unknown for JP/HHT.
Methodology:
Bidirectional sequencing of the entire coding region and intron/exon boundaries of the SMAD4 gene.
Analytical Sensitivity and Specificity:
99 percent.
Limitations:
Rare diagnostic errors can occur due to primer site mutations. Regulatory region mutations, deep intronic mutations, and large deletion/duplications will not be detected. Mutations in genes other than SMAD4 will not be detected.



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

See Compliance Statement C: www.aruplab.com/CS
CPT Code(s): 81479
Cross References: SMAD4 (Juvenile Polyposis (SMAD4) Sequencing)