Niemann-Pick Disease Types A and B via the SMPD1 Gene
Summary and Pricing
Test Method
Sequencing and CNV Detection via NextGen Sequencing using PG-Select Capture ProbesTest Code | Test Copy Genes | Test CPT Code | Gene CPT Codes Copy CPT Code | Base Price | |
---|---|---|---|---|---|
7833 | SMPD1 | 81479 | 81479,81479 | $990 | Order Options and Pricing |
Pricing Comments
Testing run on PG-select capture probes includes CNV analysis for the gene(s) on the panel but does not permit the optional add on of exome-wide CNV analysis. Any of the NGS platforms allow reflex to other clinically relevant genes, up to whole exome or whole genome sequencing depending upon the base platform selected for the initial test.
An additional 25% charge will be applied to STAT orders. STAT orders are prioritized throughout the testing process.
This test is also offered via a custom panel (click here) on our exome or genome backbone which permits the optional add on of exome-wide CNV or genome-wide SV analysis.
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.
Clinical Features and Genetics
Clinical Features
Niemann-Pick Disease (NPD) is one of several disorders of sphingolipid metabolism known as sphingolipidoses. NPD Types A and B (NPD-A and NPD-B) both result from deficient activity of acid-sphingomyelinase (ASM) and subsequent accumulation of sphingomyelin and other lipids in tissues. NPD-A and B are differentiated based on the age of onset, progression and clinical features. NPD-A is a uniformly fatal neurodegenerative disease with onset before the age of 6 months and death by the age of 3 years. The clinical hallmarks of NPD-A are hepatosplenomegaly, cherry-red maculae, failure to thrive, hypotonia, and severe psychomotor retardation. NPD-B is heterogeneous. Symptoms may begin in early childhood or adulthood and progression rate varies among affected individuals, with survival into adulthood. Clinical features of NPD-B may include hepatosplenomegaly, hematological findings, frequent respiratory infections and growth retardation. There is little or no central nervous involvement in NPD-B (Schuchman et al. In: Scriver et al. eds. The Metabolic and Molecular Bases of Inherited Disease. 8th ed.:3589–3610, 2001). ASM deficiency affects ~ 1:250,000 individuals (Meikle et al. JAMA 281(3):249-254, 1999). Both forms of the disease arise worldwide with high incidence in individuals of Turkish, Saudi and North African origins; however, the incidence of NPD-A is highest in Ashkenazi Jewish populations (Simonaro et al. Am J Hum Genet 71(6):1413-1419, 2002).
Genetics
NPD-A and B are inherited in an autosomal recessive manner and result from mutations in the SMPD1 gene (Levran et al. Proc Natl Acad Sci USA 88(9):3748-3752, 1991). SMPD1 encodes the ASM, which catalyzes the hydrolysis of sphingomyelin to phosphorylcholine and ceramide. Although over 160 mutations distributed along the gene have been detected in patients with NPD-A and B, four common mutations have been reported. Three of these mutations (Leu304Pro, Arg498Leu and Phe333Serfs*52) account for ~ 95% of patients with NPD-A, and one recurrent mutation, Arg608del, is responsible for most cases of NPD-B of Ashkenazi Jewish origin (Schuchman and Miranda. Genet Test 1(1):13-19, 1997). The majority of mutations are missense. However, nonsense, splicing, small insertions or deletions have been reported. To date, no pathogenic regulatory variants or large deletions have been reported.
Paternal imprinting at the SMPD1 gene has been reported; and heterozygous carrier individuals may therefore develop NPD-B (Simonaro et.al. Am J Hum Genet 78(5): 865-870, 2006).
Clinical Sensitivity - Sequencing with CNV PG-Select
This test detects ~99% of SMPD1 mutations (McGovern, M.M. and Schuchman, E. H. GeneReviews, 2009).
Thus far, no gross deletions or duplications have been reported in SMPD1 (Human Gene Mutation Database).
Testing Strategy
This test provides full coverage of all coding exons of the SMPD1 gene, plus ~10 bases of flanking noncoding DNA. We define full coverage as >20X NGS reads or Sanger sequencing.
Indications for Test
Patients with NPD-A and NPD-B and heterozygous carrier relatives. This test may also be considered for the reproductive partners of individuals who carry pathogenic variants in SMPD1.
Patients with NPD-A and NPD-B and heterozygous carrier relatives. This test may also be considered for the reproductive partners of individuals who carry pathogenic variants in SMPD1.
Gene
Official Gene Symbol | OMIM ID |
---|---|
SMPD1 | 607608 |
Inheritance | Abbreviation |
---|---|
Autosomal Dominant | AD |
Autosomal Recessive | AR |
X-Linked | XL |
Mitochondrial | MT |
Diseases
Name | Inheritance | OMIM ID |
---|---|---|
Niemann-Pick Disease, Type A | AR | 257200 |
Niemann-Pick Disease, Type B | AR | 607616 |
Related Test
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---|
Interstitial Lung Disease Panel |
Citations
- Human Gene Mutation Database (Bio-base).
- Levran, O., et.al. (1991). "Niemann-Pick disease: a frequent missense mutation in the acid sphingomyelinase gene of Ashkenazi Jewish type A and B patients." Proc Natl Acad Sci U S A 88(9): 3748-3752. PubMed ID: 2023926
- McGovern, M. M. and Schuchman, E.H. (2009). "Acid Sphingomyelinase Deficiency." GeneReviews. PubMed ID: 20301544
- Meikle, P. J. et.al. (1999). "Prevalence of lysosomal storage disorders." JAMA 281(3): 249-254. PubMed ID: 9918480
- Schuchman et al. In: Scriver et al. eds. The Metabolic and Molecular Bases of Inherited Disease. 8th ed.:3589–3610, 2001.
- Schuchman, E. H. and Miranda, S. R. (1997). "Niemann-Pick disease: mutation update, genotype/phenotype correlations, and prospects for genetic testing." Genet Test 1(1): 13-19. PubMed ID: 10464620
- Simonaro, C. M. et.al. (2006). "Imprinting at the SMPD1 locus: implications for acid sphingomyelinase-deficient Niemann-Pick disease." Am J Hum Genet 78(5): 865-870. PubMed ID: 16642440
- Simonaro, C. M., et.al. (2002). "The demographics and distribution of type B Niemann-Pick disease: novel mutations lead to new genotype/phenotype correlations." Am J Hum Genet 71(6): 1413-1419. PubMed ID: 12369017
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
ORDER OPTIONS
View Ordering Instructions1) Select Test Type
2) Select Additional Test Options
No Additional Test Options are available for this test.