Test Directory

Test Code
1012
Test Name
Acromicric Dysplasia
CPT Codes
81479
Included Tests
Exons 41 and 42 only
Expected Turnaround Time
Typically 1 to 2 weeks from receipt of a sample in the laboratory. All cases involving ongoing pregnancies will be expedited.
Clinical Utility
Genetic analysis to provide a molecular diagnosis of this disorder. Recommended for individuals with a personal and/or family history of this disorder to ensure appropriate treatment and establish recurrence risk for family members.
Specimen and Container Info

Non-Prenatal Specimens

Preferred/Alternate

Specimen Type

Containers

Volume

Preferred Specimen Type

Whole Blood

Lavender Top (EDTA)

3 mL

Alternate Specimen Type

Genomic DNA

1.5 mL Tube

3 µg (at a concentration of at least 30 ng/µl), preferably in TE solution.

Alternate Specimen Type

Fibroblasts

T-25 Flasks

2 confluent T-25 flasks, filled to capacity

Alternate Specimen Type

Saliva (Whole blood is recommended for CNV)

DNA Self-Collection Kit or Oragene Saliva Collection Kit for Young Children

Follow kit instructions (www.dnagenotek.com)

Prenatal Specimens

Either specimen type below is acceptable.

Specimen Type

Containers

Volume

Cultured cells

T-25 Flasks

2 confluent T-25 flasks derived from amnio or CVS samples.

Genomic DNA

1.5 mL Tube

3 µg (at a concentration of at least 30 ng/µl), preferably in TE solution.

NOTE: For specimens from outside of North America, the preferred specimen type is Genomic DNA. HNL Genomics does not recommend shipping whole blood or cultured cells from any location other than the United States, Canada, or Mexico.

Transport Instructions
  • Transport at room temperature within 24 hours.
  • If the specimen cannot be transported to the lab within 24 hours, refrigerate for up to 72 hours.
  • Do not freeze or expose to extreme temperatures, refrigerate for up to 72 hours if cannot be transported to lab within 24 hours. 
Stability Requirements

Room Temperature

24 hours

Refrigerated

72 hours

Causes for Rejection
  • Improperly labeled specimen (minimum of two patient identifiers)
  • Inappropriate specimen type
  • Incomplete or incorrect test request form
  • Insufficient volume
  • Specimen has leaked in transit
  • Specimen without a test order
Methodology
Sanger Sequencing
Performing Location
Genomics - Snowdrift
Alternate Names
GPHYSD1; GPHYSD2; ACMICD
Description

Geleophysic dysplasia 1, geleophysic dysplasia 2 and acromicric dysplasia - Geleophysic dysplasia is a genetically heterogeneous disorder caused by autosomal recessive mutations in the ADAMTSL2 gene (GPHYSD1; MIM 231050) or autosomal dominant mutations in exons 41 and 42 of the FBN1 gene (GPHYSD2; MIM 614185).  Typical findings in GPHYSD1 and GPHYSD2  include: mild facial abnormalities consisting of upturned corners of the mouth, a depressed nasal bridge and a flat, long philtrum, progressive growth retardation resulting in short stature, shortened tubular bones, small hands and feet, talipes equinovarus, restricted joint mobility, stenosis of cardiac valves, thick skin and hepatomegaly. Tracheal stenosis can result in respiratory insufficiency.  Death often occurs before 5 years of age.  Although few differences are noted between GPHYSD1 and GPHYSD2, a broad nasal bridge, narrow palpebral fissures and tip-toe walking have been more consistently observed in GPHYSD1.

ADAMTSL2 interacts with latent transforming growth factor %u03B2 binding protein-1 (LTBP1).  LTBP1 in turn plays a critical role in the storage and release of latent transforming growth factor %u03B2 (TGFB) in the extracellular matrix.  Mutations in ADAMTSL2 are suspected to result in increased bioavailability of TGFB and activation of various pathways. Exons 41 and 42 of FBN1 encode TGFB-binding protein-like domain 5.  The TGFB-binding protein-like domains of FBN1 are implicated in transforming growth factor signaling pathways.

Acromicric dysplasia (ACMICD; MIM 102370) is an autosomal dominant disorder caused by mutations in exons 41 and 42 of the FBN1 gene.  ACMICD shares many of the characteristic of geleophysic dysplasia including progressive growth retardation resulting in severe short stature, short hands and feet, generalized joint limitation and skin thickening.  Mild, but distinctive facial anomalies are a round face, well defined eyebrows with long eyelashes, a bulbous nose with anteverted nostrils, a long and prominent philtrum and thick lips with a small mouth. Some distinctive skeletal features have been reported to include notching of the femoral head, the second metacarpal and the fifth metacarpal. Other findings may include spine abnormalities, cone shaped epiphyses, delayed bone age, hoarse voice, and respiratory, tracheal and ear complications.  Acromicric dysplasia is allelic to Marfan syndrome, autosomal dominant Weill-Marchesani syndrome and autosomal dominant geleophysic dysplasia 2.

Testing Schedule
Monday-Friday
Genes
FBN1
MIM
102370
Disease Group
Skeletal Disorders