Costello Syndrome

Costello syndrome is a complex developmental disorder characterized by short stature, mental retardation, facial dysmorphism, cardiovascular abnormalities, musculoskeletal abnormalities and tumor predisposition. Costello syndrome may present in utero with polyhydramnios, edema, and fetal overgrowth. After birth, feeding difficulties, failure to thrive, and mild to moderate developmental and growth delay are common. The facial features are typically coarse, with a wide forehead, epicanthal folds, depressed nasal bridge, low-set ears with large, thick lobes, and thick lips. About 63% of patients have cardiovascular malformations, most commonly pulmonic stenosis, hypertrophic cardiomyopathy, and tachyarrhythmia (Lin et al. 2002). The hair may be curly and the skin dark-colored, soft and lax, especially on the neck, palms and soles. Hands and feet are fleshy with deep palmar and plantar creases, and hyperextensible digits. During childhood, patients progressively develop benign skin tumors (papillomata) around the mouth, nose and anus. While these tumors are benign, 10%-15% of patients with Costello syndrome will also develop malignant tumors, such as rhabdomyosarcoma, neuroblastoma, ganglioneuroblastoma, and transitional carcinoma of the bladder.

Tests Available

Forms and Documents

Test Details

BRAF, HRAS, KRAS, MAP2K1, MAP2K2, NRAS, PTPN11, RAF1, RIT1, SHOC2, SOS1
  • Prenatal ultrasound findings suggestive of Noonan syndrome, including cystic hygroma
  • Fetus with ultrasound anomalies & parent with clinical diagnosis of Noonan syndrome
  • Next-Gen Sequencing

Ordering

357
2-3 weeks
20 mg CVS
20 mL Amniotic Fluid|2 T25 flasks of cultured amniocytes|2 T25 flasks of cultured chorionic villi|3 ug DNA Concentration

Billing

81404x1, 81405x2, 81406x3
Yes
Yes
* For price inquiries please email zebras@genedx.com

References

  1. Achiron, et al (2000) Noonan Syndrome: A cryptic condition in early gestation. Am J Med Genet 92:159-165
  2. Adekunle, et al (1999) Increased first trimester nuchal translucency: pregnancy and infant outcomes after routine screening for Down’s syndrome in an unselected antenatal population. Br J Radiol 72:457-60
  3. Tartaglia, et al (2001) Mutations in PTPN11, encoding the protein tyrosine phosphatase SHP-2, cause Noonan syndrome. Nat Genet 29:465-8
  4. Trauffer, et al (1994) The natural history of euploid pregnancies with first-trimester cystic hygromas. Am J Obstet Gynecol 170:1279-84
  5. Benacerraf, et al (1989) The prenatal sonographic features of Noonan syndrome. J Ultrasound Med 8:59-63
  6. Ferguson et al. (2006) PTPN11 gene analysis in fetuses with abnormal ultrasound findings: The GeneDx experience. Poster presentation at the Cardiofaciocutaneous Syndrome & Noonan Syndrome International Symposium, Nov 17-19, 2006, Potomac, MD
  7. Hiippala, et al (2001) Fetal nuchal translucency and normal chromosomes: a long-term follow-up study. Ultrasound Obstet Gynecol 18:18-22
  8. Reynders, et al (1997) First trimester isolated fetal nuchal lucency: Significance and outcome. J Ultrasound Med 16:101-105
  9. Souka, et al (2001) Outcome of pregnancy in chromosomally normal fetuses with increased nuchal translucency in the first trimester. Ultrasound Obstet Gynecol 18:9-17
  10. Pandit B et al. (2007) Nat Genet 39:1007-1012. Lee et al. (2009) Clin Genet. 75(2):190-4

Forms and Documents

Test Details

A2ML1, ACTB, ACTG1, BRAF, CBL, HRAS, KAT6B, KRAS, LZTR1, MAP2K1, MAP2K2, NF1, NRAS, NSUN2, PPP1CB, PTPN11, RAF1, RASA1, RASA2, RIT1, RRAS, SHOC2, SOS1, SOS2, SPRED1
  • Diagnosis in a patient based on clinical diagnosis
  • Diagnosis for known familial pathogenic variant(s)
  • Distinguish between causes and forms of RASopathies and disorders with phenotypically similar clinical presentations
  • Genetic counseling, especially regarding recurrence risk
  • Next-Gen Sequencing
  • Deletion/Duplication Analysis

Ordering

TA06
4 weeks
2-5 mL Blood - Lavender Top Tube
Oral Rinse (30-40 mL) | Buccal Swabs | Extracted DNA

Billing

81442x1
Yes
Yes
* For price inquiries please email zebras@genedx.com