Spastic Paraplegia 35 via the FA2H 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 | |
|---|---|---|---|---|---|
| 8497 | FA2H | 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
Spastic paraplegia 35 (SPG35) is a complicated form of hereditary spastic paraplegia (HSP) characterized by childhood/adolescent onset of spasticity of the lower limbs, dysarthria, cognitive dysfunction and leukodystrophy on brain imaging. Other features include seizures, dystonia, ophthalmoplegia and optic atrophy. This disorder has a rapid progression and patients may become wheelchair-bound before their 20s (Edvardson et al. 2008; Dick et al. 2010; Liao et al. 2015). Some patients with SPG35 also have neurodegeneration with brain iron accumulation (NBIA) (Kruer et al. 2010; Pierson et al. 2012).
Genetics
SPG35 is inherited in an autosomal recessive (AR) manner. This disorder is caused by homozygous or compound heterozygous pathogenic variants in the FA2H gene (Dick et al. 2008). To date, different types of variants (missense, nonsense, splicing and frameshift deletions/duplications) have been found in FA2H to cause SPG35 (Human Gene Mutation Database). FA2H encodes fatty acid 2-hydroxylase, which is important for myelin formation. Dysfunction of FA2H may result in deterioration (demyelination) and a loss of white matter (leukodystrophy) (Alderson et al. 2004; Uchida et al. 2007; Edvardson et al. 2008).
Clinical Sensitivity - Sequencing with CNV PGxome
It is difficult to estimate the exact clinical sensitivity of this test due to the lack of large cohort studies. Almost all the pathogenic variants in the FA2H gene reported to date can be detected by sequencing.
Testing Strategy
This test provides full coverage of all coding exons of the FA2H 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
Patients with symptoms consistent with AR HSP may consider this test. This test may also be considered for the reproductive partners of individuals who carry pathogenic variants in FA2H.
Patients with symptoms consistent with AR HSP may consider this test. This test may also be considered for the reproductive partners of individuals who carry pathogenic variants in FA2H.
Gene
| Official Gene Symbol | OMIM ID |
|---|---|
| FA2H | 611026 |
| Inheritance | Abbreviation |
|---|---|
| Autosomal Dominant | AD |
| Autosomal Recessive | AR |
| X-Linked | XL |
| Mitochondrial | MT |
Disease
| Name | Inheritance | OMIM ID |
|---|---|---|
| Spastic paraplegia 35 | AR | 612319 |
Citations
- Alderson N.L. et al. 2004. The Journal of Biological Chemistry. 279: 48562-8. PubMed ID: 15337768
- Dick K.J. et al. 2008. Neurology. 71: 248-52. PubMed ID: 18463364
- Dick K.J. et al. 2010. Human Mutation. 31: E1251-60. PubMed ID: 20104589
- Edvardson S. et al. 2008. American Journal of Human Genetics. 83: 643-8. PubMed ID: 19068277
- Human Gene Mutation Database (Bio-base).
- Kruer M.C. et al. 2010. Annals of Neurology. 68: 611-8. PubMed ID: 20853438
- Liao X. et al. 2015. Clinical Genetics. 87: 85-9. PubMed ID: 24359114
- Pierson T.M. et al. 2012. European Journal of Human Genetics. 20: 476-9. PubMed ID: 22146942
- Uchida Y. et al. 2007. The Journal of Biological Chemistry. 282: 13211-9. PubMed ID: 17355976
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.