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  • CYP21A2 Gene Test

CYP21A2 Gene Test

CYP21A2 Gene Test
Test code: D5019
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Test code: D5019
Order Tests

CYP21A2 Gene Test

This test analyzes the CYP21A2 gene, which is associated with 21-hydroxylase deficiency.

View test information
Test Code D5019
Test Summary

This test analyzes the CYP21A2 gene, which is associated with 21-hydroxylase deficiency.

Turn Around Time 3 - 5 weeks
Acceptable Sample Types DNA, Isolated , Dried Blood Spots , Saliva , Whole Blood (EDTA)
Acceptable Billing Types Institutional Billing , Self (patient) Payment
NY Approved No
CPT Codes** 81405(x1), 81479(x1)
Self (patient) Price $935.00
Institutional Price $935.00
*TAT starts after the sample and all required sample information is received at the processing laboratory.

**The CPT codes listed are in accordance with Current Procedural Terminology, a publication of the American Medical Association, and are provided for informational purposes only. CPT coding is the sole responsibility of the billing party.

This testing service has not been cleared or approved by the U.S. Food and Drug Administration. Testing services may not be licensed in accordance with the laws in all countries. The availability of specific test offerings is dependent upon laboratory location.
Test code: D5019
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Download PDF Version
This test is not available in your region Japan, please select your nearest laboratory to request more information.
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Test information

  • Test description
  • Condition description
  • Genes
  • Test methods and limitations
  • Detailed sample requirements

Test description

This gene sequencing panel includes both sequencing and deletion/duplication (CNV) analysis for all coding regions of the CYP21A2 gene. Analysis is performed utilizing either LR-PCR followed by NGS sequencing or MLPA. All variants are classified according to American College of Genetics and Genomics (ACMG) guidelines.

Condition description

21-hydroxylase deficiency is a disease that causes excessive androgen production in the adrenal glands. There are three distinct types of 21-hydroxylase deficiency: salt wasting, simple virilizing, and non-classic. The salt wasting form of the disease is the most severe with an age of onset typically in the fetal or neonatal periods and have symptoms of excessive loss of sodium in the urine, poor feeding, weight loss, dehydration, vomiting, ambiguous genitalia in females, small testses in males, an early growth spurt, shorter adult height, decreased ferility, hirsutism in females, irregular menstruation, and male pattern baldness. The simple virilizing form has an age of onset in the fetal or neonatal period, with symptoms of anbiguous genitalia in females, small testes in males, an early growth spurt, shorter adult height, decreased ferility, hirsutism in females, irregular menstruation, and male pattern baldness. The non-classic form has an age of onset in adolesence or adulthood with symptoms of hirsuitism in females, male pattern baldness, irregular menstruation, decreased fertility, early beard growth and small testes in males. The incidence of the salt wasting and simple virilizing forms for 21-hydroxylase deficiency is estimated to be ~ 1 in 15,000. The incidence of the non-classic form of 21-hydroxylase deficiency is estimated to be ~ 1 in 1000.

Genes

CYP21A2

Test methods and limitations

CYP21A2 long-range PCR was performed to capture the genomic sequences for the real CYP21A2 gene from this individual’s genomic DNA to prevent the pseudogene from being co-amplified. Next-generation sequencing (NGS) was performed on an Illumina system with 100 base pair paired-end reads. A base is considered to have sufficient coverage at 20X and an exon is considered fully covered if all coding bases plus three nucleotides of flanking sequence on either side are covered at 20X or more. Low coverage regions, if any, are limited to ~1% or less of the nucleotides in the test unless a pathogenic variant explaining the phenotype is discovered. A list of these regions is available upon request. Alignment to the human reference genome (hg19) is performed and annotated variants are identified in the targeted region. Variants are called at a minimum coverage of 8X and an alternate allele frequency of 20% or higher. Indels and Single nucleotide variants (SNVs) are confirmed by Sanger sequence analysis before reporting at the director's discretion. This assay cannot detect variants in regions of the exome that are not covered, such as deep intronic, promoter, and enhancer regions or long repetitive regions. Copy number variation (CNV) analysis was assessed using MLPA. This analysis cannot determine the location or orientation of a duplication. This assay is not designed to detect mosaicism; possible cases of mosaicism may be investigated at the discretion of the laboratory director.

Detailed sample requirements

DNA, Isolated
Test Details Page
Collection

Required DNA Quantity by Test Type*:

  • Next Generation Sequencing (NGS): Send >1000 ng total gDNA @ >15 ng/μL. Please ship samples in 10mM Tris. Do not use EDTA.
  • Sanger Sequencing: Send >500 ng total gDNA @ >15 ng/μL (varies by the size of the gene and the variants requested).
  • Non-Sanger Sequencing Tests: Send >500 ng total gDNA @ >15 ng/μL.
Sample Condition

* Required DNA Quality: High molecular weight DNA (>12kb). A260/A280 reading should be ≥ 1.8. A260/230 a ratio range of 1.8 to 2.2. Contact the laboratory for specific amounts if total ng cannot be met.

Shipping

Ship overnight at ambient temperature.

SPECIAL SAMPLE INSTRUCTIONS
  • Research Laboratories: DNA extracted in research laboratories is not acceptable. Only under exceptional circumstances (e.g., proband not available) will DNA extracted in a research laboratory be accepted for clinical testing. Additional testing (e.g., of other family members) may be required to confirm results.
  • Laboratories outside the United States: Non-US laboratories are not subject to CLIA regulations and will be reviewed on a case-by-case basis. Please call to speak with a laboratory genetic counselor before submitting a DNA sample from any non-CLIA-certified laboratory.
  • Special Notes: If extracted DNA is submitted, information regarding the method used for extraction should be sent along with the sample.
Whole Blood (EDTA)
Test Details Page
Collection Container(s)

EDTA (purple top)

Collection

Infants (< 2-years): 2 to 3 mL; Children (>2-years): 3 to 5 mL; Older children and adults: Minimum 5mL. The blood tube should be inverted several times immediately after blood collection to prevent coagulation.

Sample Condition

Store at ambient temperature. Do not refrigerate or freeze.

Shipping

Ship overnight at ambient temperature ensuring receipt within 5-days of collection.

SPECIAL SAMPLE INSTRUCTIONS

Clotted or hemolyzed samples are not accepted.

Saliva
Test Details Page
Collection Container(s)

Oragene™ Saliva Collection Kit or ORAcollect-Dx kit

Collection

Collect saliva on an Oragene™ Saliva Collection Kit ORAcollect-Dx kit according to the manufacturer's instructions.

Sample Condition

Store at ambient temperature. Do not refrigerate or freeze.

Shipping

Ship overnight at ambient temperature.

SPECIAL SAMPLE INSTRUCTIONS

Please contact Revvity Omics to request the saliva collection kit for patients who cannot provide a blood sample as whole blood is the preferred sample.

Testing using Saliva swabs is currently not available for customers in India. Contact the Revvity Omics laboratory for more information.

Dried Blood Spots
Test Details Page
Collection Container(s)

Dried blood spot card

Collection

Follow kit instructions. Briefly, allow blood to saturate the card until indicated areas are filled and blood has soaked through the card. Air dry the card at ambient temperature for at least 3 hours.

  • NBS: Please contact Revvity Omics to request the StepOne® kit.
  • Gene Sequencing: Please contact Revvity Omics to request the DBS collection kit.
  • For pre-punched DBS: The required minimum is 6 punches
Sample Condition

Follow the instructions provided with the collection set. Store the dried blood at ambient temperature for up to two days. If the specimen cannot be sent as soon as it is dry, the filter paper should be placed in a sealable plastic bag and stored in a refrigerator (≤ 8°C) or preferably in a freezer.

Shipping

Follow kit instructions. Double bag and ship overnight at ambient temperature.

How To Order

Step 1
Choose Your Test

Select the correct test for your patient, and download and fill out the Clinical Genomics test requisition form.

Step 2
Collect Sample

Obtain a sample for testing from the patient using one of the provided Revvity Omics test packs.
 

Step 3
Send Samples

Send samples and all required forms back to Revvity for processing using pre-paid shipping label.

Learn More

1. Build Your Custom Panel

Complete the Genomics Gene Tool Form, and a unique test code will be generated for you.

 

2. Complete and print the test requisition

Complete & print the test requisition.

Ensure that:

  • You entered your unique test code from the Genomics Gene Tool
  • All sections are complete
  • Your patient has signed an informed consent
     

3. Collect and Send Patient Sample

Collect patient sample.

  1. Obtain a sample for testing from the patient and confirm that the sample is correctly labeled with the patient's name and date of birth.
  2. Note: if you do not have a Revvity Omics kit available in your office, please email or call us at 1-866-354-2910.

Send patient sample.

Ship your test kit back using the pre-paid shipping label. Remember to include:

✔   Patient sample

✔   Completed informed consent

✔   Test requisition form

✔   Any applicable medical records or clinical notes
 

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