Test Id : SBULB
Spinobulbar Muscular Atrophy (Kennedy Disease), Molecular Analysis, Varies
Useful For
Suggests clinical disorders or settings where the test may be helpful
Molecular confirmation of clinically suspected cases of sporadic or familial spinobulbar muscular atrophy (SBMA)
Presymptomatic testing for individuals with a family history of SBMA and a documented expansion in the androgen receptor (AR) gene
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
For information see Inherited Motor Neuron Disease and Dementia Testing Algorithm
Method Name
A short description of the method used to perform the test
Polymerase Chain Reaction (PCR)
NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test
Aliases
Lists additional common names for a test, as an aid in searching
Kennedy's Disease
SBMA (Spinal and bulbar muscular atrophy)
Spinal bulbar muscular atrophy
Androgen Receptor
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
For information see Inherited Motor Neuron Disease and Dementia Testing Algorithm
Specimen Type
Describes the specimen type validated for testing
Varies
Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
Patient Preparation: A previous bone marrow transplant from an allogenic donor will interfere with testing. For information about testing patients who have received a bone marrow transplant, call 800-533-1710.
Specimen Type: Whole blood
Container/Tube:
Preferred: Lavender top (EDTA) or yellow top (ACD)
Acceptable: None
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 4 days/Frozen 4 days
Additional Information:
1. Specimens are preferred to be received within 4 days of collection. Extraction will be attempted for specimens received after 4 days, and DNA yield will be evaluated to determine if testing may proceed.
2. To ensure minimum volume and concentration of DNA is met, the requested volume must be submitted. Testing may be canceled if DNA requirements are inadequate.
Specimen Type: Extracted DNA
Container/Tube:
Preferred: Screw Cap Micro Tube, 2mL with skirted conical base
Acceptable: Matrix tube, 1mL
Collection Instructions:
1. The preferred volume is at least 100 mcL at a concentration of 75 ng/mcL.
2. Include concentration and volume on tube.
Specimen Stability Information: Frozen (preferred) 1 year/Ambient/Refrigerated
Additional Information: DNA must be extracted in a CLIA-certified laboratory or equivalent and must be extracted from a specimen type listed as acceptable for this test (including applicable anticoagulants). Our laboratory has experience with Chemagic, Puregene, Autopure, MagnaPure, and EZ1 extraction platforms and cannot guarantee that all extraction methods are compatible with this test. If testing fails, one repeat will be attempted, and if unsuccessful, the test will be reported as failed and a charge will be applied. If applicable, specific gene regions that were unable to be interrogated due to DNA quality will be noted in the report.
Special Instructions
Library of PDFs including pertinent information and forms related to the test
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: Neurology Patient Information
3. If not ordering electronically, complete, print, and send a Neurology Specialty Testing Client Test Request (T732) with the specimen.
Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
See Specimen Required
Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected
Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Varies | Varies | ||
Useful For
Suggests clinical disorders or settings where the test may be helpful
Molecular confirmation of clinically suspected cases of sporadic or familial spinobulbar muscular atrophy (SBMA)
Presymptomatic testing for individuals with a family history of SBMA and a documented expansion in the androgen receptor (AR) gene
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
For information see Inherited Motor Neuron Disease and Dementia Testing Algorithm
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
X-linked spinal and bulbar muscular atrophy (spinobulbar muscular atrophy [SBMA] or Kennedy disease) is characterized by onset of progressive muscle weakness, atrophy, and fasciculations typically in the fourth or fifth decade of life. Affected patients also have signs of androgen insensitivity such as gynecomastia, reduced fertility, and testicular atrophy. The clinical severity and age at onset can be quite variable, even within families. Because this is an X-linked disease, males manifest this disorder and females are generally asymptomatic carriers. However, there have been reports of female carriers who exhibit symptoms such as muscle weakness and cramping.
Spinobulbar muscular atrophy is caused by an expansion of the CAG trinucleotide repeat in exon 1 of the human androgen receptor (AR) gene. This trinucleotide repeat is polymorphic in the general population, with the number of repeats ranging from 11 to 34. The number of repeats found in affected individuals can range from 38 to 62. There is no consensus as to the clinical significance of alleles of 35 CAG repeats and literature suggests that alleles of 36 to 37 CAG repeats may be associated with reduced penetrance. As with other trinucleotide repeat disorders, anticipation is frequently observed, and larger CAG expansions are associated with earlier onset and a more rapid clinical progression.
Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
Normal alleles: 11-34 CAG repeats
Abnormal alleles: 36-62 CAG repeats
The interpretive report includes an overview of the findings as well as the associated clinical significance.
Interpretation
Provides information to assist in interpretation of the test results
The interpretive report includes an overview of the findings as well as the associated clinical significance.
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
For predictive testing, it is important to first document the presence of a CAG-repeat amplification in the androgen receptor (AR) gene in an affected family member to confirm that molecular expansion is the underlying mechanism of disease in the family.
It is strongly recommended that individuals undergoing predictive testing receive genetic counseling both prior to testing and after results are available.
Predictive testing of an asymptomatic child is not recommended.
Test results should be interpreted in the context of clinical findings, family history, and other laboratory data. Errors in our interpretation of results may occur if information given is inaccurate or incomplete.
Current evidence suggests that the majority of individuals with spinobulbar muscular atrophy have a CAG-repeat expansion. However, we cannot eliminate the possibility that another type of mutation not detected by our assay is present within the AR gene.
Clinical Reference
Recommendations for in-depth reading of a clinical nature
1. Pinsky L, Beitel LK, Trifiro MA: Spinobulbar Muscular Atrophy. In Scriver CR, Beaudet AL, Sly WS, et al. The Metabolic and Molecular Basis of Inherited Disease. Vol 4. 8th ed. McGraw-Hill Book Company, 2001;4147-4157
2. Breza M, Koutsis G. Kennedy's disease (spinal and bulbar muscular atrophy): a clinically oriented review of a rare disease. J Neurol. 2019;266(3):565-573. doi:10.1007/s00415-018-8968-7
Method Description
Describes how the test is performed and provides a method-specific reference
Direct mutation analysis. A PCR-based assay is used to detect amplification-type mutations (CAG-repeat expansion) within the AR gene. (Doyu M, Sobue G, Mukai E, et al. Severity of X-linked recessive bulbospinal neuronopathy correlated with size of the tandem CAG repeat in androgen receptor gene. Ann Neurol 1992;31[5]:707-710)
PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information
Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.
Varies
Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.
Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location
Indicates the location of the laboratory that performs the test
Fees :
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.
- Authorized users can sign in to Test Prices for detailed fee information.
- Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
- Prospective clients should contact their account representative. For assistance, contact Customer Service.
Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.
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
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
CPT codes are provided by the performing laboratory.
CPT codes are provided by the performing laboratory.
81204-AR (androgen receptor)(eg, spinal and bulba muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status)
LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
| Test Id | Test Order Name | Order LOINC Value |
|---|---|---|
| SBULB | Spinobulbar Musc Atrophy, Kennedy's | 35359-9 |
| Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
|---|---|---|
| 53341 | Result Summary | 50397-9 |
| 53342 | Result | 82939-0 |
| 53343 | Interpretation | 69047-9 |
| 53344 | Reason for Referral | 42349-1 |
| 53345 | Specimen | 31208-2 |
| 53346 | Source | 31208-2 |
| 53348 | Released By | 18771-6 |