Klippel-Feil Syndrome via the MEOX1 Gene
Summary and Pricing 
Test Method
Exome Sequencing with CNV Detection
| Test Code | Test Copy Genes | Test CPT Code | Gene CPT Codes Copy CPT Code | Base Price | |
|---|---|---|---|---|---|
| 8759 | MEOX1 | 81479 | 81479,81479 | $990 | Order Options and Pricing |
Pricing Comments
Our favored testing approach is exome based NextGen sequencing with CNV analysis. This will allow cost effective reflexing to PGxome or other exome based tests. However, if full gene Sanger sequencing is desired for STAT turnaround time, insurance, or other reasons, please see link below for Test Code, pricing, and turnaround time information.
An additional 25% charge will be applied to STAT orders. STAT orders are prioritized throughout the testing process.
Click here for costs to reflex to whole PGxome (if original test is on PGxome Sequencing platform).
Click here for costs to reflex to whole PGnome (if original test is on PGnome Sequencing platform).
The Sanger Sequencing method for this test is NY State approved.
For Sanger Sequencing click here.Turnaround Time
3 weeks on average for standard orders or 2 weeks on average for STAT orders.
Please note: Once the testing process begins, an Estimated Report Date (ERD) range will be displayed in the portal. This is the most accurate prediction of when your report will be complete and may differ from the average TAT published on our website. About 85% of our tests will be reported within or before the ERD range. We will notify you of significant delays or holds which will impact the ERD. Learn more about turnaround times here.
Targeted Testing
For ordering sequencing of targeted known variants, go to our Targeted Variants page.
Clinical Features and Genetics
Clinical Features
Patients with Klippel-Feil Syndrome share the defining characteristic of fused cervical vertebrae. Klippel-Feil is a heterogeneous collection of disorders rather than a single disease entity (Tracy et al. Clin Orthopedics Related Res 424:183-190, 2004). Common clinical features include a short neck, low posterior hairline, restricted range of head movement, and scoliosis. Less common clinical features include rib abnormalities, kidney and heart malformations, deafness, ocular anomalies and respiratory problems. In one series of patients, the average age at onset of symptoms was 12 years (Samartzis et al. Spine 31(21):E798-E804, 2006).
Genetics
Klippel-Feil syndrome 2 (OMIM#214300) is inherited in an autosomal recessive manner and is caused by mutations in the MEOX1 gene. MEOX1, coded by MEOX1, is a homeodomain-containing protein that is highly expressed in mesodermally derived embryonic tissues and plays a key role in all somite development (Skuntz , S. et al. Dev Biol 332(2):383-395, 2009). To date, only two causative mutations (c.644C>T, p.Arg222* and c.94delG, p.Ala32Profs*165) have been reported in two unrelated Klippel-Feil syndrome families (Mohamed, J. Y. Am J Hum Genet 92(1):157-161, 2013).
Clinical Sensitivity - Sequencing with CNV PGxome
Analytical sensitivity may be high because the two reported mutations are expected to be detected by sequencing. Clinical sensitivity is currently unknown due to limitations in the medical literature regarding the disease causing mutations of the MEOX1 gene (Mohamed, J. Y. et al. Am J Hum Genet 92(1):157-161, 2013).
Testing Strategy
This test provides full coverage of all coding exons of the MEOX1 gene plus 10 bases of flanking noncoding DNA in all available transcripts along with other non-coding regions in which pathogenic variants have been identified at PreventionGenetics or reported elsewhere. We define full coverage as >20X NGS reads or Sanger sequencing. PGnome panels typically provide slightly increased coverage over the PGxome equivalent. PGnome sequencing panels have the added benefit of additional analysis and reporting of deep intronic regions (where applicable).
Dependent on the sequencing backbone selected for this testing, discounted reflex testing to any other similar backbone-based test is available (i.e., PGxome panel to whole PGxome; PGnome panel to whole PGnome).
Indications for Test
Candidates for this test are patients with symptoms consistent with Klippel-Feil syndrome, and the family members of patients who have known mutations. This test may also be considered for the reproductive partners of individuals who carry pathogenic variants in MEOX1.
Candidates for this test are patients with symptoms consistent with Klippel-Feil syndrome, and the family members of patients who have known mutations. This test may also be considered for the reproductive partners of individuals who carry pathogenic variants in MEOX1.
Gene
| Official Gene Symbol | OMIM ID |
|---|---|
| MEOX1 | 600147 |
| Inheritance | Abbreviation |
|---|---|
| Autosomal Dominant | AD |
| Autosomal Recessive | AR |
| X-Linked | XL |
| Mitochondrial | MT |
Disease
| Name | Inheritance | OMIM ID |
|---|---|---|
| Klippel-Feil syndrome 2, autosomal recessive | AR | 214300 |
Related Test
| Name |
|---|
| Klippel-Feil Syndrome via the GDF6 Gene |
Citations
- Mohamed, J. Y. et al. (2013). “Mutations in MEOX1, encoding mesenchyme homeobox 1, cause Klippel-Feil anomaly." Am J Hum Genet 92(1):157-161. PubMed ID: 23290072
- Samartzis, D.D. et.al. (2006). "Classification of congenitally fused cervical patterns in Klippel-Feil patients: epidemiology and role in the development of cervical spine-related symptoms." Spine 31(21): E798-804. PubMed ID: 17023841
- Skuntz, S. et al. (2009) "Lack of the mesodermal homeodomain protein MEOX1 disrupts sclerotome polarity and leads to a remodeling of the cranio-cervical joints of the axial skeleton." Dev Biol 332(2):383-395. PubMed ID: 19520072
- Tracy, M. R. et.al. (2004). "Klippel-Feil syndrome: clinical features and current understanding of etiology." Clin Orthop Relat Res (424): 183-90. PubMed ID: 15241163
Ordering/Specimens
Ordering Options
We offer several options when ordering sequencing tests. For more information on these options, see our Ordering Instructions page. To view available options, click on the Order Options button within the test description.
myPrevent - Online Ordering
- The test can be added to your online orders in the Summary and Pricing section.
- Once the test has been added log in to myPrevent to fill out an online requisition form.
- PGnome sequencing panels can be ordered via the myPrevent portal only at this time.
Requisition Form
- A completed requisition form must accompany all specimens.
- Billing information along with specimen and shipping instructions are within the requisition form.
- All testing must be ordered by a qualified healthcare provider.
For Requisition Forms, visit our Forms page
If ordering a Duo or Trio test, the proband and all comparator samples are required to initiate testing. If we do not receive all required samples for the test ordered within 21 days, we will convert the order to the most effective testing strategy with the samples available. Prior authorization and/or billing in place may be impacted by a change in test code.
Specimen Types
Specimen Requirements and Shipping Details
PGxome (Exome) Sequencing Panel
PGnome (Genome) Sequencing Panel
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ORDER OPTIONS
View Ordering Instructions1) Select Test Type
2) Select Additional Test Options
No Additional Test Options are available for this test.