Supravalvular Aortic Stenosis (SVAS) and Cutis Laxa via the ELN 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 | |
---|---|---|---|---|---|
4393 | ELN | 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
Supravalvular aortic stenosis is a congenital narrowing of the ascending aorta. The narrowing of the aorta can lead to shortness of breath, chest pain and heart failure. Supravalvular aortic stenosis can occur as an isolated condition or as one feature of Williams-Beuren syndrome. Williams-Beuren syndrome is caused by a microdeletion of ~1.5 mb at 7q11.23 that encompasses 25 genes including the ELN gene. Isolated or non-syndromic Supravalvular aortic stenosis has an incidence of ~1 in 20,000 live births (Metcalfe et al. Eur J Hum Genet 8:955-963, 2000). Autosomal dominant cutis laxa is characterized by loose, sagging skin resulting in a premature aged appearance. Occasionally, aortic aneurysms and obstructive pulmonary disease are present (Callewaert et al. Hum Mutat 32:445-455, 2011).
Genetics
ELN encodes for tropoelastin, a major component of elastin, which provides strength and flexibility to elastic fibers. Autosomal dominant supravalvular aortic stenosis (SVAS) is caused by point mutations or intragenic deletions of the ELN gene resulting in haploinsufficiency of the elastin protein (Li et al. Hum Mol Genet 6(7):1021-1028, 1998; Metcalfe et al., 2000; Micale et al. Eur J Hum Genet 18:317-323, 2010). Individuals with SVAS have connective tissue abnormalities, and do not have other features of Williams syndrome. Autosomal dominant cutis laxa is caused by frameshift mutations in the ELN gene, which produces an abnormal tropoelastin protein that functions in a dominant-negative manner (Tassabehji et al. Hum Mol Genet 7(6):1021-1028, 1998; Callewaert et al., 2011).
Clinical Sensitivity - Sequencing with CNV PG-Select
The clinical sensitivity of this test is 22%-35% for patients with SVAS without Williams syndrome (Metcalfe et al. Eur J Hum Genet 8:955-963, 2000; Micale et al. Eur J Hum Genet 18:317-323, 2010). Callewaert et al. found five de novo heterozygous frameshift variants in five probands with autosomal dominant cutis laxa (Callewaert et al. Hum Mutat 32:445-455, 2011)). This test will only detect copy number changes in the ELN gene, and therefore will not be able to determine how many additional genes are deleted or the breakpoints in patients with Williams syndrome.
Testing Strategy
This test provides full coverage of all coding exons of the ELN gene, plus ~10 bases of flanking noncoding DNA. We define full coverage as >20X NGS reads or Sanger sequencing.
Indications for Test
Candidates for this test are individuals with autosomal dominant supravalvular aortic stenosis without a 7q11.23 microdeletion or individuals with autosomal dominant cutis laxa.
Candidates for this test are individuals with autosomal dominant supravalvular aortic stenosis without a 7q11.23 microdeletion or individuals with autosomal dominant cutis laxa.
Gene
Official Gene Symbol | OMIM ID |
---|---|
ELN | 130160 |
Inheritance | Abbreviation |
---|---|
Autosomal Dominant | AD |
Autosomal Recessive | AR |
X-Linked | XL |
Mitochondrial | MT |
Diseases
Name | Inheritance | OMIM ID |
---|---|---|
Cutis Laxa, Autosomal Dominant | AD | 123700 |
Supravalvar Aortic Stenosis | AD | 185500 |
Related Test
Name |
---|
Comprehensive Cardiology Panel |
Citations
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.