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Congenital Bile Acid Synthesis Defect Type 2 via the AKR1D1 Gene

Summary and Pricing

Test Method

Sequencing and CNV Detection via NextGen Sequencing using PG-Select Capture Probes
Test Code Test Copy GenesTest CPT Code Gene CPT Codes Copy CPT Codes Base Price
15223 AKR1D1 81479 81479,81479 $990 Order Options and Pricing
Test Code Test Copy Genes Test CPT Code Gene CPT Codes Copy CPT Code Base Price
15223AKR1D181479 81479,81479 $990 Order Options and Pricing

Pricing Comments

This test is also offered via our exome backbone with CNV detection (click here). The exome-based test may be higher priced, but permits reflex to the entire exome or to any other set of clinically relevant genes.

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

Testing run on PG-Select capture probes does not include exome-wide CNV analysis. Reflex is available to PGxome or an exome-based panel, or you can use this gene list to create a custom panel (click here).

Click here for costs to reflex to whole PGxome.

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.


Genetic Counselors


  • Chansonette Badduke, PhD

Clinical Features and Genetics

Clinical Features

Congenital bile acid synthesis defect type 2 (CBAS2) is a progressive liver disease of neonatal onset characterized by cholestasis (Lemonde et al. 2003; Ueki et al. 2009). Due to impaired bile acid synthesis, within the first weeks of life, affected infants start to present with malabsorption of lipids and lipid-soluble vitamins from the gastrointestinal tract. Clinical features include failure to thrive, jaundice, steatorrhea, hepatomegaly, cirrhosis, rickets and splenomegaly.


Recessive AKR1D1 pathogenic variants cause congenital bile acid synthesis defect type 2 (Lemonde et al. 2003; Ueki et al. 2009). The AKR1D1 gene (9 coding exons; also known as SRD5B1) encodes the steroid 5-beta-reductase, which is responsible for the catalysis of the 5-beta-reduction of bile acid intermediates and steroid hormones carrying a delta(4)-3-one structure. Genetic defects of AKR1D1 found to date include missense, nonsense, and small deletions (Human Gene Mutation Database). No large deletions and duplications have been reported.

Clinical Sensitivity - Sequencing with CNV PG-Select

Detection rate of pathogenic variants in the AKR1D1 gene in a large cohort of patients with congenital bile acid synthesis defect type 2 is unknown in the literature because only a limited number of cases have been reported. However, mutation detection rate is expected to be high if patients are strongly indicated both clinically and biochemically.

Testing Strategy

This test is performed using Next-Gen sequencing with additional Sanger sequencing as necessary.

This test provides full coverage of all coding exons of the AKR1D1 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.

Indications for Test

Candidates for this test are patients with congenital bile acid synthesis defect type 2. Testing is also indicated for family members of patients who have known AKR1D1 mutations. This test may also be considered for the reproductive partners of individuals who carry pathogenic variants in AKR1D1.


Official Gene Symbol OMIM ID
AKR1D1 604741
Inheritance Abbreviation
Autosomal Dominant AD
Autosomal Recessive AR
X-Linked XL
Mitochondrial MT


Name Inheritance OMIM ID
Bile Acid Synthesis Defect, Congenital, 2 AR 235555


  • Human Gene Mutation Database (Bio-base).
  • Lemonde et al. 2003. PubMed ID: 12970144
  • Ueki I. et al. 2009. Journal of Gastroenterology and Hepatology. 24: 776-85. PubMed ID: 19175828


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

Specimen Types

Specimen Requirements and Shipping Details

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View Ordering Instructions

1) Select Test Method (Platform)

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.

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