Mucopolysaccharidosis Type I: IDUA Gene Deletion/Duplication

Mucopolysaccharidosis type I or Hurler Syndrome (MPS I) is a progressive multisystem disorder with features that range over a continuum from mild to severe. MPS I is an autosomal recessive progressive disorder that results from the body's inability to make lysosomal alpha-L-iduronate, an enzyme that helps break down mucopolysaccharides. The enzyme deficiency found in MPS type I causes mucopolysaccharides to build up in the body, causing damage to many tissues and organs in the body.

MPS Type I is divided into three subtypes, but there is no clear distinction between the groups. Therefore, a classification based on disease severity has been suggested: Hurler as severe MPS I, Hurler-Scheie as intermediate MPS I, and Scheie as mild MPS I. Treatment is available through hematopoietic stem cell/bone marrow transplantation or enzyme replacement therapy.

MPS I is caused by mutations in the IDUA gene and the diagnosis relies on the demonstration of deficient activity of the lysosomal enzyme alpha-L-iduronidase in peripheral blood leukocytes or cultured fibroblasts. Diagnostic sequencing analysis of the IDUA gene coding region is now available for MPS type I patients and their at-risk relatives on a clinical basis.

For questions about testing for MPS I, call the Emory Genetics Laboratory at (404) 778-8499 or (855)831-7447. For further clinical information about lysosomal storage diseases, including management and treatment, call the Emory Lysosomal Storage Disease Center at (404) 778-8565 or (800) 200-1524.

References:
1). Beesley CE, Meaney CA, Greenland G, Adams V, Vellodi A, Young EP, Winchester BG (2001) Mutational analysis of 85 mucopolysaccharidosis type I families: frequency of known mutations, identification of 17 novel mutations and in vitro expression of missense mutations. Hum Genet 109:503-11
2). Muenzer J (2004) The mucopolysaccharidoses: a heterogeneous group of disorders with variable pediatric presentations. J Pediatr 144:S27-34

• Confirmation of a clinical diagnosis of MPS I Disease
• Prenatal testing for known familial mutations.
• Assessment of carrier status in high risk family members known mutation analysis.

DNA isolated from peripheral blood is hybridized to a CGH array to detect deletions and duplications.

The targeted CGH array has overlapping probes which cover the entire genomic region.

Please note that a "backbone" of probes across the entire genome are included on the array for analytical and quality control purposes. Rarely, off-target copy number variants causative of disease may be identified that may or may not be related to the patient's phenotype. Only known pathogenic off-target copy number variants will be reported. Off-target copy number variants of unknown clinical significance will not be reported.

Submit only 1 of the following specimen types

Preferred specimen type: Whole Blood

Type: Whole Blood

Specimen Requirements:

In EDTA (purple top) or ACD (yellow top) tube:
Infants (<2 years): 2-3 ml
Children (>2 years): 3-5 ml
Older Children & Adults: 5-10 ml

Specimen Collection and Shipping: Refrigerate until time of shipment. Ship sample within 5 days of collection at room temperature with overnight delivery.

Type: Saliva

Specimen Requirements:

Oragene^TM Saliva Collection kit (available through EGL) used according to manufacturer instructions.

Specimen Collection and Shipping: Store sample at room temperature. Ship sample within 5 days of collection at room temperature with overnight delivery.

• Mucopolysaccharide screen (urine GAG) (GA)
• Known mutation analysis (Custom Diagnostics) is available to test family members.
• Prenatal testing is available for known familial mutations only. Please call the Laboratory Genetic Counselor for specific requirements for prenatal testing before collecting a fetal sample.

Requisition Forms

• Comprehensive Molecular Test Requisition Form
• Lysosomal Storage Disorders Test Requisition Form
• Metabolic/Newborn Screening Follow-up Test Requisition Form

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