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Familial Cerebral Cavernous Malformations
KRIT1
CCM2
PDCD10
Cerebral cavernous malformations (CCM) are predominantly central nervous system vascular lesions formed by a cluster of grossly dilated blood vessels. Features and symptoms can include seizures, epilepsy, focal neurological deficits, chronic headaches, stroke, and cerebral hemorrhage. Individuals may be clinically asymptomatic; MRI may be necessary to diagnose asymptomatic lesions in at-risk individuals. CCM is inherited in an autosomal dominant manner with incomplete penetrance and disease-causing mutations have been identified in 3 genes:
KRIT1, CCM2
, and
PDCD10
. A mutation in one of these three genes is identified in 78% of individuals with a clinical diagnosis and family history of CCM; the detection rate is lower (45-67%) in isolated cases, in which individuals have multiple lesions. Individuals of Southwest-American Hispanic ancestry have a common mutation in
KRIT1
.
GeneDx offers bi-directional sequence analysis of the complete coding regions of the
KRIT1, CCM2
, and
PDCD10
genes as well as deletion/duplication testing at the exon level by targeted array CGH (ExonArrayDx) for these genes. Analysis of KRIT1 is available in tiers. KRIT Tier 1 includes analysis of exons 14, 16, and 18 (previously published as exons 13, 15, and 17 using alternate nomenclature), where 56% of all mutations in
KRIT1
have been identified; this includes the common Southwest-American Hispanic Q455X mutation in exon 14. KRIT Tier 2 analysis includes sequencing of the remaining exons of
KRIT1
and concurrent ExonArrayDx analysis of the
KRIT1, CCM2
, and
PDCD10
genes. If negative, sequencing of CCM2 and PDCD10 is available. As approximately 81% of individuals with familial CCM are expected to have a mutation that could be identified in Tier 1 or 2, reflex testing is the most cost-effective approach. For individuals who present with early onset in childhood, sequencing first the
PDCD10
gene is indicated.
Once a disease-causing mutation is identified in an affected individual, mutation-specific testing of other at-risk family members and prenatal diagnosis are available.
Note, that buccal brushes can
NOT
be accepted for this test.
Information Sheet, including prices and CPT codes
Consent Document
Genetic Test Sample Submission Form (Test Requisition Form) including Payment Options
CCM, cerebral cavernous malformations, cavernous angioma, cavernous hemangioma, KRIT1, CCM2, PDCD10, CCM1, CCM3, Hispanic, seizure, headache, stroke, hemorrhage, epilepsy
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