• Test Code:
    2832
  • Department:
  • Test Synonyms:
    XLIDACSL4AFF2AP1S2ARHGEF9ARXATP6AP2ATP7AATRXBCORBRWD3CASKCCDC22CDKL5CLIC2CNKSR2CUL4BDCXDKC1DLG3DMDFANCBFGD1FLNAFMR1FRMPD4FTSJ1GDI1GKGPC3GRIA3HCCSHPRT1HSD17B10HUWE1IDSIGBP1IL1RAPL1IQSEC2KDM5CKIAA2022L1CAMLAMP2MAOAMBTPS2MECP2MED12MID1NAA10NDPNDUFA1NHSNLGN3NLGN3NLGN4XNSDHLOCRLOFD1OPHN1OTCPAK3PCDH19PDHA1PGK1PHF6PHF8PLPPORCNPQBP1PRPS1PTCHD1RAB39BRBM10RPL10RPS6KA3SHROOM4SLC16A2SLC9A6SMC1ASMSSOX3SYN1SYPTIMM8ATSPAN7UBE2AUPF3BZDHHC15ZDHHC9ZNF711
  • CPT Code(s):
    81471
Background:

Syndromic and non-syndromic intellectual disability associated with genes on the X chromosome account for approximately 5% of intellectual disability (ID) in males; prevalence of X-linked ID is approximately 1/600-1000 for males (Lubs et al. 2012AJHG 90; Gecz et al. 2009 Trends Genet 25).  Most cases are non-syndromic, with few other features to aid in diagnosis.  Thus, screening large sets of genes on the X chromosome for sequence-level mutations provides a rapid and cost-effective method to detect changes in genes that can contribute to X-linked intellectual disability, particularly when family history suggests an X-linked inheritance pattern.  The current panel comprises 88 genes on the X chromosome that have been associated with ID.

Reasons for Referral:

  • Negative Fragile X testing (in males) and negative chromosomal microarray testing*
  • Unexplained intellectual disability
  • Familial intellectual disability with inheritance patterns suggestive of X-linked transmission

*Tests for Fragile X and for submicroscopic regional copy number gains and losses (chromosomal microarray) are available in our laboratory and may require additional specimen.  It is recommended that these tests be performed before the sequencing and del/dup panel.   Please contact our lab for more information.

Methodology:

Microarray Analysis – A customized CytoSure “exon-centric” array (Oxford Gene Technology) will be used to detect deletions and duplications. The targeted array has enhanced probes targeted to the exonic regions of the 88 X-linked Intellectual Disability genes medically relevant genes. The arrays will be run using Agilent SureScan technology. This array is an ideal complement to the next generation sequencing approach to provide a comprehensive mutation spectrum analysis for X-linked Intellectual Disability.

X-Linked Intellectual Disabilities Panel (88 genes): ACSL4, AFF2, AP1S2, ARHGEF9, ARX, ATP6AP2, ATP7A, ATRX, BCOR, BRWD3, CASK, CCDC22, CDKL5, CLIC2, CNKSR2, CUL4B, DCX, DKC1, DLG3, DMD, FANCB, FGD1, FLNA, FMR1, FRMPD4, FTSJ1, GDI1, GK, GPC3, GRIA3, HCCS, HPRT1, HSD17B10, HUWE1, IDS, IGBP1, IL1RAPL1, IQSEC2, KDM5C, KIAA2022, L1CAM, LAMP2, MAOA, MBTPS2, MECP2, MED12, MID1, NAA10, NDP, NDUFA1, NHS, NLGN3, NLGN4X, NSDHL, OCRL, OFD1, OPHN1, OTC, PAK3, PCDH19, PDHA1, PGK1, PHF6, PHF8, PLP1, PORCN, PQBP1, PRPS1, PTCHD1, RAB39B, RBM10, RPL10, RPS6KA3, SHROOM4, SLC16A2, SLC9A6, SMC1A, SMS, SOX3, SYN1, SYP, TIMM8A, TSPAN7, UBE2A, UPF3B, ZDHHC15, ZDHHC9, ZNF711

KDL also offers sequence analysis for the 88 X-linked Intellectual Disability genes.  Please contact Client Services at (855) 535-1522 for more information.

Specimen Requirements:

Blood: EDTA or ACD (Solution A or B):

  • Adult: 5 mL
  • Child: 5 mL
  • Infant: 2-3 mL

A REQUISITION FORM MUST ACCOMPANY ALL SAMPLES.  Please include detailed clinical information, including ethnicity, clinical history, and family history.

Test Performed (Days):

Weekly

Turn Around Time:

8 weeks

Shipment Sensitivity Requirements:

  • Package and ship specimen to remain cold, but not frozen. 
  • Ship via overnight express, using the FedEx priority overnight label provided. 
  • Contact Client Services for shipping kits and instructions at (855) 535-1522.

References:

Additional Info:

The Knight Cancer Institute at Oregon Health & Science University is a pioneer in the field of precision cancer medicine. The institute's director, Brian Druker, M.D., helped prove it was possible to shut down just the cells that enable cancer to grow. This breakthrough has made once-fatal forms of the disease manageable and transformed how cancer is treated. The OHSU Knight Cancer Institute is the only National Cancer Institute-designated Cancer Center between Sacramento and Seattle – an honor earned only by the nation's top cancer centers. It is headquarters for one of the National Cancer Institute's largest research collaboratives, SWOG, in addition to offering the latest treatments and technologies as well as hundreds of research studies and clinical trials.

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