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HelpTest Code HIESG Hyper-IgE Syndrome Gene Panel, Varies
Ordering Guidance
Targeted testing for familial variants (also called site-specific or known variants testing) is available for the genes on this panel. See FMTT / Familial Variant, Targeted Testing, Varies. To obtain more information about testing option, call 800-533-1710.
Shipping Instructions
Specimen preferred to arrive within 96 hours of collection.
Specimen Required
Patient Preparation: A previous bone marrow transplant from an allogenic donor will interfere with testing. Call 800-533-1710 for instructions for testing patients who have received a bone marrow transplant.
Submit only 1 of the following specimens:
Specimen Type: Whole blood
Container/Tube:
Preferred: Lavender top (EDTA) or yellow top (ACD)
Acceptable: Any anticoagulant
Specimen Volume: 3 mL
Collection Instructions:
1. Invert several times to mix blood.
2. Send whole blood specimen in original tube. Do not aliquot.
Specimen Stability Information: Ambient (preferred)4 days/Refrigerated
Specimen Type: Skin biopsy
Supplies: Fibroblast Biopsy Transport Media (T115)
Container/Tube: Sterile container with any standard cell culture media (eg, minimal essential media, RPMI 1640). The solution should be supplemented with 1% penicillin and streptomycin.
Specimen Volume: 4-mm punch
Specimen Stability Information: Refrigerated (preferred)/Ambient
Additional Information: A separate culture charge will be assessed under CULFB / Fibroblast Culture for Biochemical or Molecular Testing. An additional 3 to 4 weeks is required to culture fibroblasts before genetic testing can occur.
Specimen Type: Cultured fibroblasts
Container/Tube: T-25 flask
Specimen Volume: 2 Flasks
Collection Instructions: Submit confluent cultured fibroblast cells from a skin biopsy from another laboratory. Cultured cells from a prenatal specimen will not be accepted.
Specimen Stability Information: Ambient (preferred)/Refrigerated (<24 hours)
Additional Information: A separate culture charge will be assessed under CULFB / Fibroblast Culture for Biochemical or Molecular Testing, Tissue. An additional 3 to 4 weeks is required to culture fibroblasts before genetic testing can occur.
Forms
1. New York Clients-Informed consent is required. Document on the request form or electronic order that a copy is on file. The following documents are available:
-Informed Consent for Genetic Testing (T576)
-Informed Consent for Genetic Testing (Spanish) (T826)
2. Molecular Genetics: Congenital Inherited Diseases Patient Information (T521)
3. Inborn Errors of Immunity, Autoimmunity, and Autoinflammatory Disease Patient Information
Useful For
Providing a comprehensive genetic evaluation for patients with a personal or family history suggestive of hyper-IgE syndrome (HIES)
Establishing a diagnosis of HIES, allowing for appropriate management and surveillance for disease features based on the gene and/or variant involved
Identifying variants within genes known to be associated with HIES, allowing for predictive testing of at-risk family members and/or determination of targeted management (anticipatory guidance, management changes, specific therapies)
Genetics Test Information
This test utilizes next-generation sequencing to detect single nucleotide and copy number variants in 21 genes associated with hyper-IgE syndrome: AIRE, CARD11, CARD9, CARMIL2, DOCK8, ERBIN, IL6R, IL6ST, IL17RA, IL17RC, IL17F, PGM3, SPINK5, STAT1, STAT3, TGFBR1, TGFBR2, TRAF3IP2, TYK2, WAS, and ZNF341. See Targeted Genes and Methodology Details for Hyper-IgE Syndrome Gene Panel and Method Description for additional details.
Identification of a disease-causing variant may assist with diagnosis, prognosis, clinical management, recurrence risk assessment, familial screening, and genetic counseling for hyper-IgE syndrome.
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| CULFB | Fibroblast Culture for Genetic Test | Yes | No |
Testing Algorithm
For skin biopsy or cultured fibroblast specimens, fibroblast culture will be performed at an additional charge. If viable cells are not obtained, the client will be notified.
Special Instructions
Method Name
Sequence Capture and Targeted Next-Generation Sequencing (NGS)
Reporting Name
Hyper-IgE Syndrome Gene PanelSpecimen Type
VariesSpecimen Minimum Volume
Blood: 1 mL; Skin biopsy or cultured fibroblasts: See Specimen Required
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Varies | Varies | ||
Reject Due To
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.Clinical Information
Hyper IgE syndrome (HIES) is characterized by an increased susceptibility to infection (particularly recurrent skin and pulmonary infections), eczema, and elevated serum IgE. There is variable expression among individuals and additional features may be present, including vascular, skeletal, and connective tissue pathology. While the incidence of HIES is estimated to be between 1:100,000 to 1,000,000 at birth, this may be an underestimate due to incomplete penetrance.
Dominant negative variants in STAT3 were first identified as the genetic cause of HIES, which was referred to as Job syndrome. Now additional genes have been identified, and cases due to STAT3 variants are referred to as STAT3-HIES. Infection in STAT3-HIES is often due to Staphylococcus aureus and Candida species. While HIES may be inherited in an autosomal dominant pattern, many cases are de novo.
Genetic variants in additional genes have been identified that result in HIES. ZNF341 (zinc finger protein 341) deficiency results in an autosomal recessive form of HIES, also known as AR-HIES. Partial deficiency of interleukin (IL) 6 signal transducer (IL6ST) has been reported in both autosomal recessive and autosomal dominant forms of HIES, while complete IL6ST deficiency is typically fatal in utero or early in the neonatal period. Additionally, variants in PGM3, CARD11, and other genes have been identified as causes of HIES. Furthermore, other distinct immunodeficiency disorders or other conditions may have overlapping features with HIES (eg, elevated IgE or severe infection), making the diagnosis challenging. While the phenotypes of disorders leading to elevated IgE and predisposition to infection are often similar, the therapeutic options and treatment strategies differ.
Reference Values
An interpretive report will be provided
Interpretation
All detected variants are evaluated according to American College of Medical Genetics and Genomics (ACMG) recommendations.(1) Variants are classified based on known, predicted, or possible pathogenicity and reported with interpretive comments detailing their potential or known significance.
Day(s) Performed
Varies
Report Available
28 to 42 daysSpecimen Retention Time
Whole blood: 2 weeks (if available); Extracted DNA: 3 months; Cultured fibroblasts, skin biopsy: 1 monthPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
81443
88233- Tissue culture, skin, solid tissue biopsy (if appropriate)
88240- Cryopreservation (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| HIESG | Hyper-IgE Syndrome Gene Panel | 103740-7 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 619817 | Test Description | 62364-5 |
| 619818 | Specimen | 31208-2 |
| 619819 | Source | 31208-2 |
| 619820 | Result Summary | 50397-9 |
| 619821 | Result | 82939-0 |
| 619822 | Interpretation | 69047-9 |
| 619823 | Additional Results | 82939-0 |
| 619824 | Resources | 99622-3 |
| 619825 | Additional Information | 48767-8 |
| 619826 | Method | 85069-3 |
| 619827 | Genes Analyzed | 82939-0 |
| 619828 | Disclaimer | 62364-5 |
| 619829 | Released By | 18771-6 |