Test Code MCP2Z MECP2 Gene, Full Gene Analysis, Varies
Ordering Guidance
Targeted testing (also called site-specific or known variant testing) is available for variants identified in this gene. See FMTT / Familial Variant, Targeted Testing, Varies. To obtain more information about this testing option, call 800-533-1710.
If the reason for testing indicates the RET gene or multiple endocrine neoplasia type 2 syndrome (MEN2), order RETZZ / Multiple Endocrine Neoplasia Type 2 Syndrome, RET, Full Gene Analysis, Varies. If this test is ordered in this situation, it will be canceled and RETZZ ordered and performed as the appropriate test.
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)/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 fibroblast
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. An additional 3 to 4 weeks is required to culture fibroblasts before genetic testing can occur.
Specimen Type: Blood spot
Supplies: Card-Blood Spot Collection (Filtration Paper) (T493)
Container/Tube:
Preferred: Collection card (Whatman Protein Saver 903 Paper)
Acceptable: PerkinElmer 226 (formerly Ahlstrom 226) filter paper or blood spot collection card
Specimen Volume: 5 Blood spots
Collection Instructions:
1. An alternative blood collection option for a patient older than 1 year is a fingerstick. For detailed instructions, see How to Collect Dried Blood Spot Samples.
2. Let blood dry on the filter paper at ambient temperature in a horizontal position for a minimum of 3 hours.
3. Do not expose specimen to heat or direct sunlight.
4. Do not stack wet specimens.
5. Keep specimen dry.
Specimen Stability Information: Ambient (preferred)/Refrigerated
Additional Information:
1. Due to lower concentration of DNA yielded from blood spot, it is possible that additional specimen may be required to complete testing.
2. For collection instructions, see Blood Spot Collection Instructions
3. For collection instructions in Spanish, see Blood Spot Collection Card-Spanish Instructions (T777)
4. For collection instructions in Chinese, see Blood Spot Collection Card-Chinese Instructions (T800)
Specimen Type: Saliva
Patient Preparation: Patient should not eat, drink, smoke, or chew gum 30 minutes prior to collection.
Supplies: Saliva Swab Collection Kit (T786)
Specimen Volume: 1 Swab
Collection Instructions: Collect and send specimen per kit instructions.
Specimen Stability Information: Ambient 30 days
Additional Information: Due to lower concentration of DNA yielded from saliva, it is possible that additional specimen may be required to complete testing.
Forms
1. New York Clients-Informed consent is required. Please 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.
Useful For
Establishing a molecular diagnosis in individuals with features of Rett syndrome and MECP2-related disorders
Identifying pathogenic variants within the MECP2 gene known to be associated with Rett syndrome and MECP2-related disorders, allowing for predictive testing of at-risk family members
Reflex Tests
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
CULFB | Fibroblast Culture for Genetic Test | Yes | No |
Special Instructions
Method Name
Sequence Capture and Targeted Next-Generation Sequencing followed by Polymerase Chain Reaction (PCR) and Sanger Sequencing
Reporting Name
MECP2 Gene, Full Gene AnalysisSpecimen Type
VariesSpecimen 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
Methyl-CpG-binding protein 2 (MeCP2) is encoded by the MECP2 gene located on the X chromosome and plays an important role in gene regulation. MeCP2 binds methylated DNA and is involved in both transcription activation and repression of other gene targets. As MECP2-related disorders are X-linked, female and male patients with disease-causing variants in the MECP2 gene present with unique variable phenotypes. In female patients, disease-causing variants in MECP2 can be associated with classic Rett syndrome, variant or atypical Rett syndrome, or mild learning disabilities. Distinct phenotypes in male patients with disease-causing MECP2 variants include MECP2-duplication syndrome; MECP2-related severe neonatal encephalopathy; pyramidal signs, parkinsonism, and macroorchidism syndrome (PPM-X); and syndromic/non-syndromic intellectual disability. MECP2 analysis is useful in identifying germline variants in individuals with these clinical presentations.
Rett Syndrome:
Classic Rett syndrome and other variant MECP2-related disorders result from loss of MeCP2 expression. Rett syndrome is an X-linked, panethnic condition associated with neurologic regression after a 6- to 18-month period of initial normal development. Main clinical findings include stereotypic hand movements such as hand wringing and loss of purposeful hand movements, loss of acquired language, and gait abnormalities. Bruxism, irregular breathing, seizures, acquired microcephaly, and impaired sleep patterns are also common.
Greater than 99% of individuals with Rett syndrome are simplex cases due to a de novo variant or inheritance from a parent with germline mosaicism. Asymptomatic or very mildly affected carrier mothers of classically affected daughters have been reported due to nonrandom X chromosome inactivation.
MECP2 Duplication Syndrome:
MECP2 duplication syndrome involves variably sized duplications of the MECP2 gene (ranging in size from 0.3 to 4 Mb) that result in MeCP2 protein overexpression. It is characterized by severe intellectual disability, hypotonia, feeding difficulties, and progressive spasticity. Seizures and recurrent respiratory infections are commonly reported as well.
In contrast to Rett syndrome, most male patients with MECP2 duplication syndrome inherit the duplication from their asymptomatic mothers, although rare de novo variants may occur. Additionally, female patients with an MECP2 duplication that do not demonstrate skewed X-inactivation may present with variable features of MECP2-duplication syndrome.
Reference Values
An interpretive report will be provided.
Day(s) Performed
Varies
Report Available
28 to 42 daysPerforming Laboratory
Mayo Clinic Laboratories in RochesterTest 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
81302
88233-Tissue culture, skin, solid tissue biopsy (if appropriate)
88240-Cryopreservation (if appropriate)
Specimen Minimum Volume
Blood: 1 mL; Skin biopsy, cultured fibroblasts, dried blood spots, or saliva: See Specimen Required