Test Directory

Test Code
5147
Test Name
Atypical Hemolytic Uremic Syndrome Susceptibility And Related Disorders NGS Panel
CPT Codes
81479
Expected Turnaround Time
Typically 2 to 4 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
Next Generation Sequencing and Copy Number Variation Analysis
Performing Location
Genomics - Snowdrift
Alternate Names
aHUS
Description

Hemolytic uremic syndromes are microvascular occlusive disorders characterized by a mechanical hemolytic anemia, thrombocytopenia and acute kidney injury. Atypical hemolytic uremic syndrome (aHUS) is a thrombotic microangiopathy not usually associated with prodromal diarrhea, which generally results from an infectious cause. aHUS is associated with mutations in several genes involved in the activation or regulation of the alternative complement pathway (AP). aHUS may also be associated with autoantibodies directed against products of certain deleted or rearranged AP genes. Mutations in the AP genes display incomplete penetrance and variable expressivity.  Individuals with a mutation in an AP gene have approximately 50% chance of developing atypical hemolytic uremic syndrome. Other factors, such as pregnancy, exposure to certain medication, and infections, may trigger development of disease. Additionally, individuals with mutations in more than one AP gene are typically at higher risk for developing disease. A form of hemolytic uremic syndrome, also termed Nephrotic syndrome type 7, is caused by mutations in the DGKE gene. A related disorder, thrombotic thrombocytopenia purpura, is caused by mutations in the ADAMTS13 genes. Hemolytic uremic syndrome may also be a component of methylmalonic aciduria and homocystinuria, cblC type, a disorder of cobalamin metabolism. This later inborn error of metabolism is caused by mutations in the MMACHC gene.

The Atypical hemolytic uremic syndrome and related disorders NGS panel consists of thirteen genes: ADAMTS13, C3, CD46, CFB, CFH, CFHR1, CFHR2, CFHR3, CFHR5, CFI, DGKE, MMACHC and THBD.

 

 

Gene

Disorder

MIM

Inheritance

ADAMTS13

Thrombotic thrombocytopenic purpura, congenital (TTP) 

274150

AR

C3

Hemolytic uremic syndrome, atypical, susceptibility to, 5 (AHUS5)

Complement component 3 deficiency, autosomal recessive (C3D)

612925

613779

AD

AR

CD46

Hemolytic uremic syndrome, atypical, susceptibility to, 2 (AHUS2)

612922

AD/AR

CFB

Hemolytic uremic syndrome, atypical, susceptibility to, 4 (AHUS4)

612924

AD

CFH

Hemolytic uremic syndrome, atypical, susceptibility to, 1 (AHUS1)

Complement factor h deficiency (CFHD)

235400

609814

AD / AR

AD / AR

CFHR1

Hemolytic uremic syndrome, atypical, susceptibility to, 1 (AHUS1)

235400

AD / AR

CFHR2

C3 glomerulopathy with dense deposit disease

-

AD

CFHR3

Hemolytic uremic syndrome, atypical, susceptibility to, 1 (AHUS1)

235400

AD / AR

CFHR5

CFHR5 deficiency

614809

AD

CFI

Hemolytic uremic syndrome, atypical, susceptibility to, 3 (AHUS3)

612923

AD

DGKE

Nephrotic syndrome, type 7 (NPHS7)

615008

AR

MMACHC

Methylmalonic aciduria and homocystinuria, cblC type  

277400

AR

THBD

Hemolytic uremic syndrome, atypical, susceptibility to, 6 (AHUS6)

612926

AD

Testing Schedule
Monday-Friday
Genes
ADAMTS13, C3, CD46, CFB, CFH, CFHR1, CFHR2, CFHR3, CFHR5, CFI, DGKE, MMACHC, THBD
Disease Group
Hematological, Nephrology