- Williams et al. (2008). Am J Med Genet A. 146A: 2023–37.
- Patients with a clinical diagnosis of macrocephaly or other overgrowth syndrome.
Beckwith-Wiedemann Methylation: Methylation-specific MLPA (MS-MLPA) is used to test for BWS. One advantage of MS-MLPA is that in addition to detecting DNA methylation abnormalities (epimutations), similar to Southern blot and quantitative methylation sensitive PCR, it also detects deletions and duplications (CNVs) of the 11p15 region. CNVs are estimated to be present in ~10% of patients with BWS. The presence of a CNV can increase the recur¬rence risk from that of the general population up to a 50% risk. Both methylation and CNVs will be reported from this analysis.
Detection and Reference Range
Next Generation Sequencing: Clinical Sensitivity: Unknown. Pathogenic variants in the promoter region, some pathogenic variants in the introns and other regulatory element mutations cannot be detected by this analysis. Large deletions/duplications will not be detected by this analysis. Results of molecular analysis should be interpreted in the context of the patient's clinical/biochemical phenotype.
Analytical Sensitivity: ~99%.
Beckwith-Wiedemann Methylation: Hypomethylation of DMR2 (Lit1 gene) is expected to detect up to 60-70% of individuals with BWS. Hypermethylation of DMR1 (H19 gene) is expected to detect an additional 2-13% of individuals with BWS. Therefore, the total detection rate for both DMR1 and DMR2 methylation analysis is estimated to be 62-83%.
Beckwith-Wiedemann Methylation: For DMR1 (H19 gene), an increase in DNA methylation of greater than two standard deviations above the mean of normal is consistent with BWS. For DMR2 (Lit1 gene), a decrease in DNA methylation of greater than two standard deviations below the mean of normal is consistent with BWS.
Submit only 1 of the following specimen types
Type: Whole Blood
In EDTA (purple top) tube:
Infants (Children (>2 years): 3-5 ml
Older Children & Adults: 5-10 ml.
Specimen Collection and Shipping: Ship sample at room temperature with overnight delivery.
Type: Isolated DNA
In microtainer: 60 ug
Isolation using the QiagenTM Puregene kit for DNA extraction is recommended.
Specimen Collection and Shipping: Refrigerate until time of shipment in 100 ng/ul of TE buffer. Ship sample at room temperature with overnight delivery.
- Macrocephaly: Deletion/Duplication Panel