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MOLECULAR GENETICS TESTS - HUNTINGTON DISEASE |
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Background:
Huntington disease is an inherited autosomal dominant disease that gives
rise to progressive selective (localised) neural cell death associated
with choreic movements and dementia. Increases in the length of a CAG
triplet repeat, called 'Huntington' located on Chromosome 4p16.3 are
associated with the clinical disease. There is an inverse relationship
between repeat length and age of onset, the higher in frequency of
juvenile onset cases arising from paternal transmission. The normal
range of repeat sizes is between 5-30 whereas 30-36 is considered an
intermediate range where the risk of developing clinical disease is
undetermined. Those affected usually have allele size greater than 37
repeats.
Analysis:
- The laboratory routinely uses two sets of primers to rule out null alleles.
- The laboratory can now also perform a southern blot assay to confirm
homozygosity and to detect repeats in excess of the range of the PCR assay (more
than 80 repeats).
Indications for Testing:
- Confirmation of clinical diagnosis of Huntington disease.
- Carrier testing for individuals who have a family history of HD.
- Prenatal diagnosis in pregnancies at risk
NOTE:
For pre-symptomatic testing and prenatal diagnosis the patient must have
undergone genetic counseling through the established national protocol
for Huntington Disease Testing.
Speciment Requirements:
Blood: 3 x 4.0mL whole blood into EDTA tubes . Invert several times to
mix. Forward within 24-48 hours at ambient temperature.
Paediatric Samples: Minimum of 3mL whole blood in EDTA tubes.
Prenatal Samples:
- Chorionic Villus: Obtain 20mg chorionic villus sample (CVS) and
transfer to a vial containing transport medium.
- Amniotic Fluid: A minimum of 20mL amniotic fluid required. Bloody
specimens may reflect extensive contamination with maternal cells. Such a
specimen may not be suitable for testing.
NOTE:
- Maternal cell contamination is a potential problem when analysing DNA
from CVS samples or cultured amniotic cells. To rule out the presence of
maternal cell contamination a peripheral blood specimen in EDTA from the
mother must be sent with the prenatal sample (minimum 3ml whole blood in
EDTA required).
Tissue: 200 mg of tissue. Specimen must be snap frozen within one hour of
collection. Send specimen frozen on dry ice.
Paraffin blocks of tissue are also acceptable. The tissue sample should
not have had prolonged immersion in formalin before embedding.
NOTE:
- Referral reason plus adequate information and family history must be
submitted with the specimen. Pedigree must be included where appropriate.
Usual test turnaround time:
6 weeks once sample is received.
Cost of test:
HD - $438.75 Note: Prices excludes GST (12.5%)
and may change without notice.
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