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Test Code
5417
Test Name
CADASIL NGS Panel
CPT Codes
81405, 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
  • CADASIL1
  • CADASIL2
  • CARASIL
Description

Autosomal dominant cerebral arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is caused by mutations in the HTRA1 and NOTCH3 genes. It is a progressive disorder of the small arteries of the brain leading to brain infarcts, migraine, seizures, mood disorders / severe depressive episodes, cognitive impairment and dementia. The disorder manifests in early adulthood. Migraine with aura is a common early symptom. Recurrent strokes usually start at the age of 30-50 followed by progressive neuropsychiatric symptoms and eventually a subcortical type of vascular dementia. Autosomal recessive cerebral arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL) is allelic to CADASIL2. Additional findings in CARASIL include alopecia and lumbar disc disease. The age of onset is usually in early adulthood.

The CADASIL NGS panel consists of two genes: HTRA1 and NOTCH3.

Gene

Disorder

MIM

Inheritance

HTRA1

Cerebral arteriopathy, autosomal dominant,

with subcortical infarcts and leukoencephalopathy, type 2 (CADASIL2)

Cerebral arteriopathy, autosomal recessive, 

with subcortical infarcts and leukoencephalopathy (CARASIL)

616779

600142

AD

AR

NOTCH3

Cerebral arteriopathy, autosomal dominant, 

with subcortical infarcts and leukoencephalopathy, type 1 (CADASIL1)

125310

AD
Testing Schedule
Monday-Friday
Genes
HTRA1, NOTCH3
Disease Group
Craniosynostosis and Craniofacial Disorders, Neuromuscular
The American Medical Association (AMA) Current Procedural Terminology (CPT) codes published by HNL Lab Medicine are guidelines and are intended for informational purposes only. CPT coding is the exclusive responsibility of the billing entity. View the Terms.
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