ARUP's Laboratory Test Directory

Hereditary Persistence of Fetal Hemoglobin (HPFH) 8 Mutations : 2005408
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Patient History for Hemoglobinopathy/Thalassemia Testing
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Additional Technical Information


Mnemonic: HPFH

Ordering Recommendation: Aids in determining the cause of elevated HbF. Test confirms suspected deletional hereditary persistence of fetal hemoglobin (HPFH).
Methodology: Polymerase Chain Reaction/Electrophoresis
Performed: Tue, Fri
Reported: 7-10 days
Specimen Required: Collect: Lavender (EDTA) or pink (K2EDTA). Also acceptable: Yellow (ACD Solution A or B), lt. blue (sodium citrate), or green (sodium or lithium heparin).

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 Hereditary Persistence of Fetal Hemoglobin (HPFH) 8 Mutations:
Characteristics:
HPFH is a clinically benign condition resulting from mutations within the beta globin gene cluster that alter normal hemoglobin switching and result in persistent production of hemoglobin F (Hb F). Individuals heterozygous for an HPFH deletion typically have elevated levels of Hb F with normal red blood cell indices, while homozygotes typically have Hb F levels approaching 100 percent and mild erythrocytosis. When an HPFH deletion is paired with another beta globin gene mutation, variable phenotypes can result.
Incidence:
Varies depending on the population.
Cause
: Beta globin gene cluster deletions and point mutations within the promoter of the gamma globin genes.
Mutations Tested:
HPFH-1 (g.5174452_5259368del84917), HPFH-2 (g.5180404_5263982del83579), HPFH-3 (g.5215683_5265453del49771), HPFH-4 (g.5217940_5260078del42139), HPFH-5 (g.5246023_5258951del12929), HPFH-6 (g.5193975_5273259del79278), HPFH-7 (g.5247860_5270651del22792), and SEA-HPFH (g.5222878_5250288del27411).
Clinical Sensitivity:
Unknown.
Methodology:
Multiplex PCR and gel electrophoresis.
Analytic Sensitivity:
Greater than 95 percent for the 8 targeted HPFH deletions.
Limitations:
Only the 8 targeted deletions associated with HPFH will be interrogated. Point mutations or rare deletions that cause HPFH or delta/beta thalassemia will not be identified. Other genetic modifiers of Hb F levels will not be assessed. This test will not differentiate homozygosity for an HPFH deletion from an HPFH deletion paired with a rare globin gene cluster deletion. Rare diagnostic errors can occur due to primer-site mutations.



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