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Megalencephaly-Polymicrogyria-Polydactyly-Hydrocephalus Syndrome 3 via the CCND2 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
13331 CCND2 81479 81479,81479 $890 Order Options and Pricing
Test Code Test Copy Genes Test CPT Code Gene CPT Codes Copy CPT Code Base Price
13331CCND281479 81479,81479 $890 Order Options and Pricing

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 backbone).

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

Turnaround Time

18 days on average for standard orders or 13 days 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

  • Li Fan, MD, PhD, FCCMG, FACMG

Clinical Features and Genetics

Clinical Features

Megalencephaly-polymicrogyria-polydactyly-hydrocephalus syndrome-3 is a very rare neurological disorder with onset at birth. The major symptoms include enlarged head circumference or macrocephaly, megalencephaly, ventriculomegaly, hydrocephalus, bilateral perisylvian polymicrogyria and postaxial polydactyly in hands and feet, severe developmental delay, severe intellectual disability with absent speech, and inability to walk without aid.  In certain cases, patients may present other neurological symptom such as structural focal epilepsy, drug-resistant epilepsy, seizures, and severe brain malformation extending to both brainstem and cerebellum with hypomyelination. Brain MRI reveals polymicrogyria, hydrocephalus and other brain malformations (Maini et al. 2018. PubMed ID: 29642246; Cappuccio et al. 2019. PubMed ID: 31056854; Mirzaa et al. 2014. PubMed ID: 24705253).  

As megalencephaly-polymicrogyria-polydactyly-hydrocephalus syndrome can be caused by defects in a number of genes (AKT3, CCND2, and PIK3R2) with variable and overlapping presentations, they can be difficult to diagnose by clinical manifestation and image studies only. An accurate molecular diagnosis is critical for treatment, prognosis, prediction of recurrence risk, as well as future family planning.

Genetics

CCND2-related megalencephaly-polymicrogyria-polydactyly-hydrocephalus syndrome-3 is inherited in autosomal dominant manner. Pathogenic variants in CCND2 include missense and nonsense. Large deletions/duplications in the CCND2 locus have not been reported (Human Gene Mutation Database). The vast majority of pathogenic variants are missense with a gain-of-function effectAlmost all cases carry a de novo variant (Mirzaa et al. 2014. PubMed ID: 24705253; Maini et al. 2018. PubMed ID: 29642246). Somatic mosaicism has also been reported (Mirzaa et al. 2014. PubMed ID: 24705253). CCND2 has been cited as a conditionally essential gene for growth of human tissue culture cells (Online Gene Essentiality, ogee.medgenius.info). CCND2 is relatively intolerant to loss-of-function variants (Genome Aggregation Database).

CCND2 encodes cyclin D2, a member of the cyclin D family which is called G1-phase regulators. Overexpression of cyclin D2 results in cell cycle arrest during early development. CCND2 is also a downstream mediator of the PI3K‐AKT pathway. CCND2 is expressed at higher levels in the brains of mouse embryos. A study in zebrafish of cyclin Dx (a member of cyclin D family) suggest that cyclin Dx is required for development of motor neuron progenitors (Lien et al. 2016. PubMed ID: 27323909). CCND2-related disorder is a less common cause of megalencephaly-polymicrogyria-polydactyly-hydrocephalus syndrome (Mirzaa et al. 2014. PubMed ID: 24705253; Maini et al. 2018. PubMed ID: 29642246).

Clinical Sensitivity - Sequencing with CNV PGxome

Clinical sensitivity of CCND2 in a large cohort of patients with CCND2-related disorder relevant phenotypes is unavailable in the literature because most studies are case reports. However, pathogenic variants in this gene are a rare cause of megalencephaly-polymicrogyria-polydactyly-hydrocephalus syndrome. Analytical sensitivity should be high.

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 CCND2 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

The test is recommended for patients suspected to have CCND2-related megalencephaly-polymicrogyria-polydactyly-hydrocephalus syndrome. Targeted testing is indicated for family members of patients who have a known pathogenic variant in CCND2.

Gene

Official Gene Symbol OMIM ID
CCND2 123833
Inheritance Abbreviation
Autosomal Dominant AD
Autosomal Recessive AR
X-Linked XL
Mitochondrial MT

Citations

  • Cappuccio et al. 2019. PubMed ID: 31056854
  • Genome Aggregation Database (gnomAD).
  • Human Gene Mutation Database (Biobase).
  • Lien et al. 2016. PubMed ID: 27323909
  • Maini et al. 2018. PubMed ID: 29642246
  • Mirzaa et al. 2014. PubMed ID: 24705253

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


Specimen Types

Specimen Requirements and Shipping Details

PGxome (Exome) Sequencing Panel

PGnome (Genome) Sequencing Panel

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ORDER OPTIONS

View Ordering Instructions

1) Select Test Method (Backbone)


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.
Total Price: $
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