Key Information

TAT:

28 days

Price:

$1,200

CPT Code(s):

81479

Test Code:

DEPT

EpiSign Variant

EpiSign Variant is a targeted review of the methylation data intended to resolve variants of uncertain clinical significance in genes with a known epigenetic signature (see list below). When present, this signature can be used to provide supporting evidence during variant classification of a VUS. Additionally, EpiSign Variant may be ordered when the provider has a strong clinical suspicion for a condition included on EpiSign, but previous genetic testing has been negative.

EpiSign Variant can be requested to include all imprinting disorders if multiple conditions are in the patient’s differential or if you suspect multilocus imprinting disturbance (MLID).

EpiSign Brochure                             EpiSign FAQ

 EpiSign cover page for test pages              EpiSign FAQ website

ADNP, ANKRD11, ARID1A, ARID1B, ARID2, ATRX, BCL11B, BRWD3, CCNK, CDCA7, CDK13, CHD2, CHD4, CHD7, CHD8, CREBBP, CTCF, DDB1, DNMT1, DNMT3A, DNMT3B, DYRK1A, EED, EHMT1, EP300, EZH2, FAM50A, FANCA, FANCC, FANCD2, FANCG, FANCI, FANCL, FMR1, HELLS, HNRNPU, H1-4, JARID2, KANSL1, KAT6A, KAT6B, KDM2B, KDM3B, KDM5C, KDM6A, KMT2A, KMT2D, KMT2B, KMT5B, MEF2C, MEG3, MSL2, NIPBL, NSD1, NSD2, PHF6, PHIP, PLAGL1, POGZ, PQBP1, PRR12, RAD21, SETD1B, SETD2, SETD5, SIN3A, SLC32A1, SMARCA2, SMARCA4, SMARCB1, SMC1A, SMC3, SMS, SNURF, SOX11, SRCAP, SRSF1, TCF4, TET3, TRIP12, UBE2A, USP7, YY1, ZBTB24, ZC4H2, ZEB2, ZNF699, ZNF711

19p13.13 deletion syndrome (NFIX sequence variants not detected), 1p36 deletion syndrome, 7q11.23 duplication syndrome, Alpha-thalassemia/X-linked impaired intellectual development syndrome, Angelman syndrome (UBE3A sequence variants not detected), Arboleda-Tham syndrome, ARID1A duplication-related syndrome, Autosomal dominant cerebellar ataxia\, deafness\, and narcolepsy, Autosomal dominant intellectual developmental disorder\, type 7, Autosomal dominant intellectual developmental disorder\, type 21, Autosomal dominant intellectual developmental disorder\, type 23, Autosomal dominant intellectual developmental disorder\, type 51, BAFopathy 1: Coffin-Siris syndromes 1-4 and Nicolaides-Baraitser, BAFopathy 2: Coffin-Siris syndrome 1 & 2, Beck-Fahrner syndrome, Beckwith-Wiedemann syndrome (CDKN1C sequence variants not detected), Blepharophimosis-impaired intellectual development syndrome, Borjeson-Forssman-Lehmann syndrome, CHARGE syndrome, Chung-Jansen syndrome, Clark-Baraitser syndrome, Coffin-Siris syndrome 3, Coffin-Siris syndrome 4, Coffin-Siris syndrome 6, Coffin-Siris syndrome 9, Congenital heart defects\, dysmorphic facial features\, and intellectual development disorder, Cornelia de Lange syndrome, DEGCAGS syndrome, Developmental and epileptic encephalopathy 54, Developmental and epileptic encephalopathy 94, Developmental delay with variable intellectual disability and dysmorphic facies, Diabetes mellitus\, transient neonatal 1, Diets-Jongmans syndrome, Dystonia 28, Fanconi anemia, Fetal valproate syndrome, Floating-Harbor syndrome, Fragile X syndrome, Gabriele-de Vries syndrome, Genitopatellar syndrome, Hao-Fountain syndrome, Helsmoortel-Van der Aa syndrome, Hunter-McAlpine craniosynostosis syndrome, Immunodeficiency-centromeric instability-facial anomalies syndrome\, types 1-4, Intellectual developmental disorder with autism and macrocephaly, Intellectual developmental disorder with dysmorphic facies\, speech delay\, and T-cell abnormalities, Intellectual developmental disorder with seizures and language delay, Kabuki syndrome 1, Kabuki syndrome 2, Kagami-Ogata syndrome, KBG syndrome, KDM2B-related syndrome, Kleefstra syndrome 1, Klinefelter syndrome, KMT2D-related syndrome, Koolen-De Vries syndrome, Luscan-Lumish syndrome, Menke-Hennekam syndrome, Mowat-Wilson syndrome, MSL2-related syndrome, Mulchandani-Bhoj-Conlin syndrome, Multi-locus imprinting disturbance, Neurodevelopmental disorder with dysmorphic facies and behavioral abnormalities, Neurodevelopmental disorder with hypotonia\, stereotypic hand movements\, and impaired language, Neuroocular syndrome, Nicolaides-Baraitser syndrome, NSD2 duplication-related syndrome, Ohdo syndrome, SBBYS variant, Phelan-McDermid syndrome (SHANK3 sequence variants not detected), Pitt-Hopkins syndrome, Potocki-Lupski syndrome, Prader-Willi syndrome, PRC2-complex disorders: Weaver and Cohen-Gibson syndromes, Pseudohypoparathyroidism\, type 1A, Pseudohypoparathyroidism\, type 1B, Rahman syndrome, Rauch-Steindl syndrome, Renpenning syndrome, Rubinstein-Taybi syndrome 1, Rubinstein-Taybi syndrome 2, Russell-Silver syndrome, Sifrim-Hitz-Weiss syndrome, SLC32A1-related disorder, Smith-Magenis syndrome (RAI1 sequence variants not detected), Sotos syndrome, Tatton-Brown-Rahman syndrome, Temple syndrome, Trisomy 21 (Down syndrome), Turner syndrome, Velocardiofacial syndrome, White-Kernohan syndrome, White-Sutton syndrome, Wieacker-Wolff syndrome, Wiedemann-Steiner syndrome, Williams-Beuren region duplication syndrome, Williams-Beuren syndrome, Witteveen-Kolk syndrome, Wolf-Hirschhorn syndrome, X-linked intellectual developmental disorder\, type 93, X-linked intellectual developmental disorder\, type 97, X-linked syndromic intellectual developmental disorder\, Armfield type, X-linked syndromic intellectual developmental disorder\, Claes-Jensen type, X-linked syndromic intellectual developmental disorder\, Nascimento type, X-linked syndromic intellectual developmental disorder\, Snyder-Robinson type, Xp11.22 duplication syndrome

Technical Information

This test is performed by methylation array. The listed genes and conditions have undergone a detailed review by Greenwood Diagnostic Labs, and EpiSign has been validated for clinical use. Some conditions/genes have been classified as having a more moderate signature based on signature strength, small cohort size, or types of mutations tested. Click on the EpiSign brochure above to see a list of conditions with strong and moderate signatures. Females tested for X-linked conditions may have a moderate signature or a potentially false negative result. Also, this test will not detect females with Fragile X (FMR1) expansions.

As with many clinical tests, uncertain results are possible. Please note that a normal result does not rule out the possibility that the patient is affected with one of these conditions. In some cases follow-up testing may be suggested to further characterize the underlying genomic abnormality and to confirm or rule out a diagnosis.

Specimen Requirements

  • The preferred sample type is 3-4 ml of peripheral blood collected in an EDTA (purple top) tube. Extracted DNA is also accepted for this test provided the original specimen was whole blood collected in an EDTA tube. Blood kits are available by request.
  • Send approximately 5µg of extracted DNA at a requested concentration of 90-130 ng/µl.

Transport Instructions

  • The blood specimen should be kept at room temperature and delivered via overnight shipping. If shipment is delayed by one or two days, the specimen should be refrigerated and shipped at room temperature. Do not freeze the specimen. Samples collected on Friday can be safely designated for Monday delivery.
  • Extracted DNA should be sent at room temperature via overnight delivery.

Connect With Our Experts

Call 1-800-473-9411 to speak with our team of laboratory genetic counselors for questions or additional information.

Robin Fletcher, MS, CGC
Falecia Thomas, MS, CGC
Alex Finley, MS, CGC