Mitochondrial Genome Sequencing and Deletion Analysis

CPT: 81460; 81465
Updated on 11/5/2024
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Test Includes

This test includes the following genes: MT-ATP8, MT-ATP6, MT-CO1, MT-CO2, MT-CO3, MT-CYB, MT-ND1, MT-ND2, MT-ND3, MT-ND4L, MT-ND4, MT-ND5, MT-ND6, MT-RNR2, MT-TA, MT-TR, MT-TN, MT-TD, MT-TC, MT-TE, MT-TQ, MT-TG, MT-TH, MT-TI, MT-TL1, MT-TL2, MT-TK, MT-TM, MT-TF, MT-TP, MT-TS1, MT-TS2, MT-TT, MT-TW, MT-TY, MT-TV, MT-RNR1, MT-RNR2.

MT-ATP8, MT-ATP6, MT-CO1, MT-CO2, MT-CO3, MT-CYB, MT-ND1, MT-ND2, MT-ND3, MT-ND4L, MT-ND4, MT-ND5, MT-ND6, MT-RNR2, MT-TA, MT-TR, MT-TN, MT-TD, MT-TC, MT-TE, MT-TQ, MT-TG, MT-TH, MT-TI, MT-TL1, MT-TL2, MT-TK, MT-TM, MT-TF, MT-TP, MT-TS1, MT-TS2, MT-TT, MT-TW, MT-TY, MT-TV, MT-RNR1, MT-RNR2

This test includes the following genes: MT-ATP8, MT-ATP6, MT-CO1, MT-CO2, MT-CO3, MT-CYB, MT-ND1, MT-ND2, MT-ND3, MT-ND4L, MT-ND4, MT-ND5, MT-ND6, MT-RNR2, MT-TA, MT-TR, MT-TN, MT-TD, MT-TC, MT-TE, MT-TQ, MT-TG, MT-TH, MT-TI, MT-TL1, MT-TL2, MT-TK, MT-TM, MT-TF, MT-TP, MT-TS1, MT-TS2, MT-TT, MT-TW, MT-TY, MT-TV, MT-RNR1, MT-RNR2.


Expected Turnaround Time

2 - 4 weeks


Genes Assessed


      Specimen Requirements


      Specimen

      Whole blood at room temperature; oral swab; extracted DNA (from blood, oral swab or muscle only) or frozen muscle tissue

      Whole blood, oral swab, cultured fibroblasts, muscle, extracted DNA

      Whole blood at room temperature; oral swab; extracted DNA (from blood, oral swab or muscle only) or frozen muscle tissue


      Volume

      Whole blood: 4 mL; oral swab: 3 swabs; muscle: 75 milligrams; or extracted DNA: contact MNG Genetic Services 844-664-8378 (844-MNGTEST)

      4 mL blood, 1 buccal swab, 2 T-25 flasks cultured cells, 75 milligrams muscle, or 1 microgram DNA A260:A280 ratio of 1.8-2.0

      Whole blood: 4 mL; oral swab: 3 swabs; muscle: 75 milligrams; or extracted DNA: contact MNG Genetic Services 844-664-8378 (844-MNGTEST)


      Minimum Volume

      Whole blood: 2 mL; oral swab: 1 swab; muscle: 50 milligrams; or extracted DNA: contact MNG Genetic Services 844-664-8378 (844-MNGTEST)


      Container

      Whole blood: lavender-top (EDTA) tube; oral swab: OCD-100 DNA Genotek; muscle: sterile screw-capped vial; or extracted DNA: contact MNG Genetic Services 844-664-8378 (844-MNGTEST)

      Whole blood: lavender-top (EDTA) tube; oral swab: OCD-100 DNA Genotek device only; cultured cells: T-25 flask tissue; extracted DNA: sterile screw capped vial

      Whole blood: lavender-top (EDTA) tube; oral swab: OCD-100 DNA Genotek; muscle: sterile screw-capped vial; or extracted DNA: contact MNG Genetic Services 844-664-8378 (844-MNGTEST)


      Collection

      Whole blood: standard phlebotomy; oral swab: follow kit instructions; muscle: snap freeze in liquid nitrogen and maintain at -80°C; or extracted DNA: contact MNG Genetic Services 844-664-8378 (844-MNGTEST)

      Draw blood into EDTA tube. Collect swab specimen per guidelines in Labcorp kit. Transfer extracted DNA into sterile screw capped tube. Collect biopsy and/or culture cells per established policy.

      Whole blood: standard phlebotomy; oral swab: follow kit instructions; muscle: snap freeze in liquid nitrogen and maintain at -80°C; or extracted DNA: contact MNG Genetic Services 844-664-8378 (844-MNGTEST)


      Storage Instructions

      Maintain whole blood and oral swab specimens at room temperature or refrigerate at 4°C. Do not freeze. Muscle specimen: Maintain frozen and ship on dry ice.

      Blood: Ship ASAP, but stable up to 5 days post-collection at room temperature. Do not freeze. Swab: 60 day post-collection room temperature stability; DNA: Ship at room temperature after extraction. Fibroblast: Ship flask in insulated container at room temp or refrigerated. Muscle: Ship in insulated container with 5 to 7 pounds of dry ice.

      Maintain whole blood and oral swab specimens at room temperature or refrigerate at 4°C. Do not freeze. Muscle specimen: Maintain frozen and ship on dry ice.


      Stability Requirements

      Room temperature: whole blood: 14 days; swab: 60 days; muscle: 0 days

      Refrigerated: whole blood: 30 days; swab: 60 days; muscle; 0 days

      Frozen: muscle: 15 years

      Room temperature: Blood: 5 days; Swab: 60 days; DNA: 30 days; Muscle: 0 days; Fibroblasts: 2 - 3 days

      • Refrigerated: Blood: 5 days; Swab: 60 days; DNA: 30 days; Muscle: 0 days; Fibroblasts: 2 - 3 days

      • Frozen: Blood: Do not freeze; Swab: 60 days; DNA: Indefinitely; Muscle: Indefinitely; Fibroblasts: Indefinitely

      Room temperature: whole blood: 14 days; swab: 60 days; muscle: 0 days

      Refrigerated: whole blood: 30 days; swab: 60 days; muscle; 0 days

      Frozen: muscle: 15 years


      Causes for Rejection

      Hemolyzed; quantity not sufficient for analysis; improper container; improper storage temperature

      Frozen blood EDTA tube; insufficient swab cell collection or incorrect oral swab device use; thawed and/or fatty muscle sample; extracted DNA A260:A280 ratio outside of 1.8-2.0 range.

      Hemolyzed; quantity not sufficient for analysis; improper container; improper storage temperature


      Test Details


      Use

      Diagnostic testing

      This test is used to diagnose mitochondrial disease that is caused by point mutations, small deletions/duplications or large deletions in the mitochondrial DNA (mtDNA). The test is also useful in assessing variants of uncertain significance in nuclear DNA genes that cause mtDNA deletion syndromes. While some disorders caused by mtDNA mutations only affect a single organ (e.g. the eye in Leber hereditary optic neuropathy [LHON]), many involve multiple organ systems and often present with prominent neurologic and myopathic features. Mitochondrial disorders may present at any age. Many individuals with mitochondrial disorders display a cluster of clinical features that into a discrete clinical syndrome, such as the Kearns-Sayre syndrome (KSS), chronic progressive external ophthaloplegia (CPEO), mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS), myoclonic epilepsy with ragged fibers (MERRF), neurogenic weakness with ataxia and retinitis pigmentosa (NARP), or Leigh syndrome (LS). However, considerable clinical variability exists and many individuals do not fit neatly into one particular category, which is well-illustrated by the overlapping spectrum of disease phenotypes. Mitochondrial DNA deletion syndromes predominately comprise three overlapping phenotypes that are usually simplex (i.e., a single occurrence in a family), but rarely may observed in different members of the same family or may evolve in a given individual over time. Inheritance of mitochondrial DNA deletion syndromes can be either autosomal recessive (with progressive external ophthalmoplegia [PEO] and multisystem involvement manifesting during early childhood/adulthood), or autosomal dominant (with less severe, often tissue-specific manifestations [e.g., chronic PEO] developing in later adulthood).

      Diagnostic testing


      Limitations

      This assay does not detect mitochondrial depletion. False positive or false negative results may occur for reasons that include homologous regions, blood transfusions, bone marrow transplantation, tissue-specific heteroplasmy, mislabeled samples or erroneous representation of family relationships. Low levels of heteroplasmy may not be reliably detected. Interpretation of the clinical significance of gene variations is limited by information about the variant that is available at the time of reporting and by the quality and quantity of clinical information provided with the sample. The interpretation of the clinical significance of variants may change.  

      This test was developed and its performance characteristics determined by Labcorp. It has not been cleared or approved by the Food and Drug Administration.

      This test was developed and its performance characteristics determined by Labcorp. It has not been cleared or approved by the Food and Drug Administration.<>

      This test was developed and its performance characteristics determined by Labcorp. It has not been cleared or approved by the Food and Drug Administration.

      This assay does not detect mitochondrial depletion. False positive or false negative results may occur for reasons that include homologous regions, blood transfusions, bone marrow transplantation, tissue-specific heteroplasmy, mislabeled samples or erroneous representation of family relationships. Low levels of heteroplasmy may not be reliably detected. Interpretation of the clinical significance of gene variations is limited by information about the variant that is available at the time of reporting and by the quality and quantity of clinical information provided with the sample. The interpretation of the clinical significance of variants may change.  

      This test was developed and its performance characteristics determined by Labcorp. It has not been cleared or approved by the Food and Drug Administration.


      Methodology

      Next-generation sequencing of long range PCR products to identify single nucleotide variants (SNVs), small indels and large deletions

      Next-Generation Sequencing

      Next-generation sequencing of long range PCR products to identify single nucleotide variants (SNVs), small indels and large deletions


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