Cornelia de Lange Syndrome and Wiedemann-Steiner Syndrome via the KMT2A Gene

Summary and Pricing

Test Method

Exome Sequencing with CNV Detection
Test Code Test Copy GenesTest CPT Code Gene CPT Codes Copy CPT Codes Base Price
11437 KMT2A 81479 81479,81479 $890 Order Options and Pricing
Test Code Test Copy Genes Test CPT Code Gene CPT Codes Copy CPT Code Base Price
11437KMT2A81479 81479 $890 Order Options and Pricing

Pricing Comments

Our favored testing approach is exome based NextGen sequencing with CNV analysis. This will allow cost effective reflexing to PGxome or other exome based tests. However, if full gene Sanger sequencing is desired for STAT turnaround time, insurance, or other reasons, please see link below for Test Code, pricing, and turnaround time information.

A 25% additional charge will be applied to STAT orders. View STAT turnaround times here.

For Reflex to PGxome pricing click here.

The Sanger Sequencing method for this test is NY State approved.

For Sanger Sequencing click here.

Targeted Testing

For ordering sequencing of targeted known variants, go to our Targeted Variants page.

Turnaround Time

18 days on average

EMAIL CONTACTS

Genetic Counselors

Geneticist

Clinical Features and Genetics

Clinical Features

Cornelia de Lange syndrome (CdLS) is characterized by distinctive facial features, growth retardation, hirsutism, and upper limb reduction defects that range from subtle phalangeal abnormalities to oligodactyly. Craniofacial features include synophrys, arched eyebrows, long eyelashes, small upturned nose, small widely spaced teeth, and microcephaly. IQ ranges from below 30 to 102 (mean: 53). Many individuals demonstrate autistic and self-destructive tendencies. Other frequent findings include cardiac septal defects, gastrointestinal dysfunction, hearing loss, myopia, and cryptorchidism or hypoplastic genitalia. Individuals with a milder phenotype have less severe growth, cognitive, and limb involvement, but often have facial features consistent with CdLS (Deardorff et al. GeneReview, 2011).

Genetics

KMT2A-related CdLS is inherited in autosomal dominant manner. Pathogenic KMT2A variants mainly cause Wiedemann-Steiner syndrome, which is characterized by hypertrichosis cubiti, short status, intellectual disability, and dysmorphic facial and skeletal features (Jones et al. 2012). The KMT2A protein (Histone-lysine N-methyltransferase 2A) coded by exons 1 to 36 of the KMT2A gene on 11q23.3 is a member of H3K4-specific methyltransferases that plays an essential role in early development and hematopoiesis (Shen et al. 2014). To date, approximately 15 unique pathogenic variants in KMT2A have been documented; most pathogenic variants were found in patients with Wiedemann-Steiner syndrome and only one de novo truncating pathogenic variant was reported in one patient with CdLS. The pathogenic variants include missense (4), nonsense (4), small del/ins (5), splicing (1) and large deletion (1). De novo pathogenic variants were found in five of the six Wiedemann-Steiner syndrome cases (Jones et al. 2012; Human Gene Mutation Database).

Clinical Sensitivity - Sequencing with CNV PGxome

In one study, a de novo KMT2A pathogenic variant was found in one out of 32 Turkish patients clinically diagnosed with Cornelia de Lange syndrome (Yuan et al. 2015). In another study, de novo KMT2A pathogenic variants were found in five of the six Wiedemann-Steiner syndrome patients (Jones et al. 2012).

Testing Strategy

This test provides full coverage of all coding exons of the KMT2A gene plus 10 bases of flanking noncoding DNA in all available transcripts along with other non-coding regions in which pathogenic variants have been identified at PreventionGenetics or reported elsewhere. We define full coverage as >20X NGS reads or Sanger sequencing.

Since this test is performed using exome capture probes, a reflex to any of our exome based tests is available (PGxome, PGxome Custom Panels).

Indications for Test

Candidates for this test are patients with symptoms consistent with CdLS or Wiedemann-Steiner syndrome, or patients who do not have pathogenic variants in the NIPBL, SMC1A, SMC3, RAD21, and HDAC8 genes.

Gene

Official Gene Symbol OMIM ID
KMT2A 159555
Inheritance Abbreviation
Autosomal Dominant AD
Autosomal Recessive AR
X-Linked XL
Mitochondrial MT

Disease

Name Inheritance OMIM ID
Wiedemann-Steiner Syndrome AD 605130

Citations

  • Deardorff, M.A. et al.  2011. Cornelia de Lange Syndrome. In: Pagon RA, Adam MP, Bird TD, Dolan CR, Fong C-T, Smith RJ, and Stephens K, editors. GeneReviews™, Seattle (WA): University of Washington, Seattle. PubMed ID: 20301283
  • Human Gene Mutation Database (Bio-base).
  • Jones et al. 2012. PubMed ID: 22795537
  • Shen E. et al. 2014. Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences. 369: PubMed ID: 25135975
  • Yuan et al. 2015. PubMed ID: 25574841

Ordering/Specimens

Ordering Options

We offer several options when ordering sequencing tests. For more information on these options, see our Ordering Instructions page. To view available options, click on the Order Options button within the test description.

myPrevent - Online Ordering

  • The test can be added to your online orders in the Summary and Pricing section.
  • Once the test has been added log in to myPrevent to fill out an online requisition form.

Requisition Form

  • A completed requisition form must accompany all specimens.
  • Billing information along with specimen and shipping instructions are within the requisition form.
  • All testing must be ordered by a qualified healthcare provider.

For Requisition Forms, visit our Forms page


Specimen Types

Specimen Requirements and Shipping Details

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ORDER OPTIONS

View Ordering Instructions

1) Select Test Type


2) Select Additional Test Options

STAT and Prenatal Test Options are not available with Patient Plus.

No Additional Test Options are available for this test.

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