Test Directory

Test Code
1539
Test Name
Ellis-van Creveld Syndrome And Weyers Acrofacial Dysostosis 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
EVC
Description

Ellis-van Creveld syndrome (EVC; MIM 225500) and Weyers acrofacial dysostosis (MIM 193530) are allelic disorders that share some clinical findings but differ in severity and pattern of inheritance. Ellis-van Creveld syndrome is an autosomal recessive disorder and is the more severe of the two. Typical findings associated with EVC include: short limbed mesomelic dwarfism, low iliac wings with spur like projections of the medial lateral aspects of the acetabuli, postaxial polydactyly of the hands and often feet with cone shaped epiphyses of the phalanges, fusion of the capitate and hamate, short dysplastic nails, short ribs, pectus carinatum, genu valgum, multiple oral frenula, neonatal teeth, dysplastic teeth, hypodontia, partial cleft lip, and genitourinary abnormalities. About 60% of patients with EVC are reported to have congenital heart defects, the most common defects are an atrial septal defect or an atrioventricular septal defect.

Weyers acrofacial dysostosis differs from EVC in that inheritance is autosomal dominant and patients are less severely affected. Patients with Weyers acrofacial dysostosis syndrome have mild short stature with postaxial polydactyly, dysplastic nails, hypodontia with dysplastic teeth, neonatal teeth and multiple frenula. Individuals do not have cardiac abnormalities or short ribs.

Mutations in the EVC and EVC2 genes have been described in both EVC and Weyers acrofacial dysostosis patients. The EVC and EVC2 genes are nonhomologous genes arranged in a head-to-head manner. The transcription start sites are separated by approximately 2.6 kb. The function of these genes is unknown. It has been demonstrated that sequencing of the EVC and EVC2 genes identifies a mutation in approximately two-thirds of EVC patients. This suggests that there is genetic heterogeneity.

It should be noted that the EVC phenotype is variable. For example, some individuals with a homozygous EVC mutation were reported to have features similar to Ellis-van Creveld syndrome including short stature, postaxial polydactyly, septal defects and hypodontia. However, these individuals did not meet the full clinical presentation of the syndrome because they had a normal chest size and no upper lip defects. In addition, these patients had rhizomelic rather than mesomelic limb shortening.

Testing Schedule
Monday-Friday
Genes
EVC, EVC2
MIM
225500
Disease Group
Skeletal Disorders