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Congenital Generalized Lipodystrophy (CGL) via the AGPAT2 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
AGPAT2 81479 81479,81479 $990
Test Code Test Copy Genes Test CPT Code Gene CPT Codes Copy CPT Code Base Price
8709AGPAT281479 81479,81479 $990 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. If the Sanger option is selected, CNV detection may be ordered through Test #600.

An additional 25% charge will be applied to STAT orders. STAT orders are prioritized throughout the testing process.

Click here for costs to reflex to whole PGxome (if original test is on PGxome Sequencing platform).

Click here for costs to reflex to whole PGnome (if original test is on PGnome Sequencing platform).

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

For Sanger Sequencing click here.

Turnaround Time

3 weeks on average for standard orders or 2 weeks on average for STAT orders.

Please note: Once the testing process begins, an Estimated Report Date (ERD) range will be displayed in the portal. This is the most accurate prediction of when your report will be complete and may differ from the average TAT published on our website. About 85% of our tests will be reported within or before the ERD range. We will notify you of significant delays or holds which will impact the ERD. Learn more about turnaround times here.

Targeted Testing

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

EMAIL CONTACTS

Genetic Counselors

Geneticist

  • McKenna Kyriss, PhD

Clinical Features and Genetics

Clinical Features

Congenital generalized lipodystrophy (CGL) is a group of heterogeneous autosomal recessive disorders characterized by a near complete loss of adipose tissue from birth and predisposition to metabolic complications later in life including diabetes mellitus, hypertriglyceridaemia and hepatic steatosis (Patni et al. 2015). Four distinct subtypes of CGL have been defined and are caused by defects in four respective genes. Type 1 CGL is caused by defects in the AGPAT2 gene (Agarwal et al. 2002). Other clinical features of Type 1 CGL include preserved mechanical adipose tissue, focal lytic lesions in the long bones after puberty, as well as acromegaloid features with enlarged mandible, hands and feet.

Genetics

Congenital generalized lipodystrophy (CGL) is inherited in an autosomal recessive manner (Patni et al. 2015). Four distinct subtypes of CGL have been defined and are caused by defects in four respective genes: AGPAT2, BSCL2, CAV1 and PTRF. The encoded proteins of these genes play key roles in phospholipid and triglyceride synthesis, the fusion of lipid droplets, and the biogenesis of caveolae within adipocytes.

The AGPAT2 gene (six coding exons) encodes 1-acyl-sn-glycerol-3-phosphate acyltrans­ferase β, which is involved in triglyceride biosynthesis. So far, documented genetic defects of AGPAT2 include missense and truncating pathogenic variants (Human Gene Mutation Database). A large deletion within the AGPAT2 gene has also been reported (Human Gene Mutation Database).

Clinical Sensitivity - Sequencing with CNV PGxome

In a study of 45 unrelated families with congenital generalized lipodystrophy, sequencing for the AGPAT2 and BSCL2 genes found pathogenic variants in AGPAT2 in 26 families and in BSCL2 in 11 families, respectively (Agarwal et al. 2003).

Testing Strategy

This test provides full coverage of all coding exons of the AGPAT2 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. PGnome panels typically provide slightly increased coverage over the PGxome equivalent. PGnome sequencing panels have the added benefit of additional analysis and reporting of deep intronic regions (where applicable).

Dependent on the sequencing backbone selected for this testing, discounted reflex testing to any other similar backbone-based test is available (i.e., PGxome panel to whole PGxome; PGnome panel to whole PGnome).

Indications for Test

Candidates for this test are patients with congenital generalized lipodystrophy. This test may also be considered for the reproductive partners of individuals who carry pathogenic variants in AGPAT2.

Gene

Official Gene Symbol OMIM ID
AGPAT2 603100
Inheritance Abbreviation
Autosomal Dominant AD
Autosomal Recessive AR
X-Linked XL
Mitochondrial MT

Disease

Name Inheritance OMIM ID
Congenital Generalized Lipodystrophy Type 1 AR 608594

Citations

  • Agarwal A.K. et al. 2002. Nature Genetics. 31: 21-3. PubMed ID: 11967537
  • Agarwal A.K. et al. 2003. The Journal of Clinical Endocrinology and Metabolism. 88: 4840-7. PubMed ID: 14557463
  • Human Gene Mutation Database (Bio-base).
  • Patni N., Garg A. 2015. Nature Reviews Endocrinology. 11: 522-34. PubMed ID: 26239609

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.
  • PGnome sequencing panels can be ordered via the myPrevent portal only at this time.

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

If ordering a Duo or Trio test, the proband and all comparator samples are required to initiate testing. If we do not receive all required samples for the test ordered within 21 days, we will convert the order to the most effective testing strategy with the samples available. Prior authorization and/or billing in place may be impacted by a change in test code.


Specimen Types

Specimen Requirements and Shipping Details

PGxome (Exome) Sequencing Panel

PGnome (Genome) Sequencing Panel

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ORDER OPTIONS

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View Ordering Instructions

1) Select Test Method (Platform)


1) Select Test Type


2) Select Additional Test Options

No Additional Test Options are available for this test.

Note: acceptable specimen types are whole blood and DNA from whole blood only.
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