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Test Code OIBFG Osteogenesis Imperfecta and Bone Fragility Gene Panel, Varies


Ordering Guidance


Customization of this panel and single gene analysis for any gene present on this panel are available. For more information see CGPH/ Custom Gene Panel, Hereditary, Next-Generation Sequencing, Varies.

 

Targeted testing for familial variants (also called site-specific or known mutations testing) is available for the genes on this panel. See FMTT / Familial Variant, Targeted Testing, Varies. To obtain more information about this testing option, call 800-533-1710.



Additional Testing Requirements


All prenatal specimens must be accompanied by a maternal blood specimen; order MATCC / Maternal Cell Contamination, Molecular Analysis, Varies on the maternal specimen as this must be a different order number than the prenatal specimen.



Shipping Instructions


Specimen preferred to arrive within 96 hours of collection.



Necessary Information


Prior Authorization is available, but not required, for this test. If proceeding with the prior authorization process, submit the required form with the specimen.



Specimen Required


Patient Preparation: A previous bone marrow transplant from an allogenic donor will interfere with testing. For instructions for testing patients who have received a bone marrow transplant, call 800-533-1710.

 

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

 

Prenatal Specimens

Due to its complexity, consultation with the laboratory is required for all prenatal testing; call 800-533-1710 to speak to a genetic counselor. 

 

Specimen Type: Amniotic fluid

Container/Tube: Amniotic fluid container

Specimen Volume: 20 mL

Specimen Stability Information: Refrigerated (preferred)/Ambient

Additional information:

1. A separate culture charge will be assessed under CULAF / Culture for Genetic Testing, Amniotic Fluid.

2. All prenatal specimens must be accompanied by a maternal blood specimen; order MATCC / Maternal Cell Contamination, Molecular Analysis, Varies on the maternal specimen.

 

Specimen Type: Chorionic villi

Container/Tube: 15-mL tube containing 15 mL of transport media

Specimen Volume: 20 mg

Specimen Stability Information: Refrigerated

Additional Information:

1. A separate culture charge will be assessed under CULFB / Fibroblast Culture for Molecular Testing, Chorionic Villi/Products of Conception.

2. All prenatal specimens must be accompanied by a maternal blood specimen; order MATCC / Maternal Cell Contamination, Molecular Analysis, Varies on the maternal specimen.

 

Acceptable:

Specimen Type: Confluent cultured cells

Container/Tube: T-25 flask

Specimen Volume: 2 Flasks

Collection Instructions: Submit confluent cultured cells from another laboratory.

Specimen Stability Information: Ambient (preferred)/Refrigerated

Additional Information: All prenatal specimens must be accompanied by a maternal blood specimen; order MATCC / Maternal Cell Contamination, Molecular Analysis, Varies on the maternal specimen.


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. Connective Tissue/Cerebrovascular Disease Genetic Testing Patient Information

3. Osteogenesis Imperfecta and Bone Fragility Gene Panel (OIBFG) Prior Authorization Ordering Instructions

4. If not ordering electronically, complete, print, and send a Cardiovascular Test Request (T724) with the specimen.

Useful For

Providing a genetic evaluation for patients with a personal or family history suggestive osteogenesis imperfecta and other hereditary conditions associated with bone fragility

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
CULFB Fibroblast Culture for Genetic Test Yes No
CULAF Amniotic Fluid Culture/Genetic Test Yes No
MATCC Maternal Cell Contamination, B Yes No

Method Name

Sequence Capture and Targeted Next-Generation Sequencing followed by Polymerase Chain Reaction (PCR) and Sanger Sequencing

Reporting Name

OI and Bone Fragility Gene Panel

Specimen Type

Varies

Specimen Minimum Volume

Blood: 1 mL; Other specimen types: 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

Osteogenesis imperfecta (OI) is a hereditary skeletal dysplasia syndrome characterized primarily by bone fragility and skeletal deformities, with other possible features including dental abnormalities, hearing loss, and blue/gray sclera.(1,2) Historically, OI was classified into  subtypes based on clinical presentation only: nondeforming with persistently blue sclera (OI type I), perinatal lethal (OI type II), progressively deforming (OI type III), moderate (OI type IV), and with calcification of the interosseous membranes and/or hypertrophic callus (OI type V). While these clinical classifications are still commonly used, it is recommended that OI subtypes are classified by genetic etiology.(3) Currently, there are approximately 20 different genetic subtypes of OI with variable modes of inheritance and pathophysiology.(1-3)

 

The most common genetic etiology of OI is disease-causing variants in the COL1A1 and COL1A2 genes encoding the pro alpha 1(I) and pro alpha 2(I) chains of type I procollagen, respectively. It is estimated that up to 25% of cases of OI are caused by disease-causing variants in either COL1A1 or COL1A2.(1-3) Disease-causing variants in these genes result in the inability to properly synthesize the pro alpha 1/2 molecules ultimately leading to abnormal or absent collagen I, a critical molecule for the structural integrity of bone. COL1A1/2-associated OI is inherited in an autosomal dominant manner and can result in a spectrum of disease severity, classified into OI types I-IV.(3)

 

Other genetic etiologies of OI are associated with genes involved in bone mineralization, collagen modification, collagen processing, collagen cross-linking, and osteoblast differentiation and function.(3) The majority of these less common genetic OI subtypes are inherited in an autosomal recessive manner, with the exception of autosomal dominant IFITM5-associated OI (also known as OI type V), and X-linked recessive MBTPS2-associated OI (also known as OI type XVII).

 

Several genetic conditions leading to bone fragility have significant overlap with OI. Additional conditions covered by this panel include ALPL-associated hypophosphatasia, ANO5-associated gnathodiaphyseal dysplasia, FKBP10-associated Bruck syndrome, LRP5-associated osteoporosis, P4HB-associated Cole-Carpenter syndrome, PLOD2-associated Bruck syndrome, PLS3-associated X-linked osteoporosis, TAPT1-associated osteochondrodysplasia, and XYLT2-associated spondyloocular syndrome with bone fragility, cataracts and hearing defects.

Reference Values

An interpretive report will be provided.

Day(s) Performed

Varies

Report Available

28 to 42 days

Performing 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

81406 x2

81408 x2

81479

81479 (if appropriate for government payers)