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HelpTest ID: GATAS GATA-Binding Protein 2, GATA2, Full Gene Analysis, Next-Generation Sequencing, Varies
Ordering Guidance
For cases where the differential diagnosis remains broad, GATA2 may be evaluated as part of a gene panel. See HLHGP / Primary Hemophagocytic Lymphohistiocytosis (HLH) Gene Panel, Varies; SCCNP / Severe Congenital and Cyclic Neutropenia Gene Panel, Varies; or EBLPD / Epstein Barr Virus (EBV) Susceptibility and Lymphoproliferative Disorders Gene Panel, Varies.
Targeted testing for familial variants (also called site-specific or known variants testing) is available for variants identified in the GATA2 gene. See FMTT / Familial Variant, Targeted Testing, Varies. To obtain more information about testing option, call 800-533-1710.
Shipping Instructions
Specimen preferred to arrive within 96 hours of collection.
Specimen Required
Patient Preparation: A previous bone marrow transplant from an allogenic donor will interfere with testing. Call 800-533-1710 for instructions for testing patients who have received a bone marrow transplant.
Submit only 1 of the following specimens:
Specimen Type: Whole blood
Container/Tube:
Preferred: Lavender top (EDTA) or yellow top (ACD)
Acceptable: Any anticoagulant
Specimen Volume: 3 mL
Collection Instructions:
1. Invert several times to mix blood.
2. Send whole blood specimen in original tube. Do not aliquot.
Specimen Stability Information: Ambient (preferred) 4 days/Refrigerated
Specimen Type: Skin biopsy
Supplies: Fibroblast Biopsy Transport Media (T115)
Container/Tube: Sterile container with any standard cell culture media (eg, minimal essential media, RPMI 1640). The solution should be supplemented with 1% penicillin and streptomycin.
Specimen Volume: 4-mm punch
Specimen Stability Information: Refrigerated (preferred)/Ambient
Additional Information: A separate culture charge will be assessed under CULFB / Fibroblast Culture for Biochemical or Molecular Testing. An additional 3 to 4 weeks is required to culture fibroblasts before genetic testing can occur.
Specimen Type: Cultured fibroblasts
Container/Tube: T-25 flask
Specimen Volume: 2 Flasks
Collection Instructions: Submit confluent cultured fibroblast cells from a skin biopsy from another laboratory. Cultured cells from a prenatal specimen will not be accepted.
Specimen Stability Information: Ambient (preferred)/Refrigerated (<24 hours)
Additional Information: A separate culture charge will be assessed under CULFB / Fibroblast Culture for Biochemical or Molecular Testing. An additional 3 to 4 weeks is required to culture fibroblasts before genetic testing can occur.
Forms
1. New York Clients-Informed consent is required. Document on the request form or electronic order that a copy is on file. The following documents are available:
-Informed Consent for Genetic Testing (T576)
-Informed Consent for Genetic Testing (Spanish) (T826)
2. GATA2 Gene Sequencing Patient Information (T811) is recommended.
Useful For
Comprehensive evaluation of the GATA2 gene in patients with clinical or immunological symptoms suggestive of GATA-binding protein 2 (GATA2) deficiency
Screening family members of patients with confirmed GATA2 deficiency
Genetics Test Information
This test utilizes next-generation sequencing to detect single nucleotide and copy number variants in the GATA2 gene associated with GATA-binding protein 2 (GATA2) deficiency.
Identification of a disease-causing variant may assist with diagnosis, prognosis, clinical management, recurrence risk assessment, familial screening, and genetic counseling for GATA2 deficiency.
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| CULFB | Fibroblast Culture for Genetic Test | Yes | No |
Testing Algorithm
For skin biopsy or cultured fibroblast specimens, fibroblast culture will be performed at an additional charge. If viable cells are not obtained, the client will be notified.
Method Name
Sequence Capture and Targeted Next-Generation Sequencing (NGS) followed by Polymerase Chain Reaction (PCR) and Sanger Sequencing
Reporting Name
GATA2 Gene, Full Gene AnalysisSpecimen Type
VariesSpecimen Minimum Volume
Blood: 1 mL; Skin biopsy or cultured fibroblasts: See Specimen Required
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Varies | Varies | ||
Clinical Information
GATA-binding protein 2 (GATA2) deficiency causes multiple previously distinct clinical entities, including DCML deficiency (dendritic cell, monocyte, B and natural killer [NK] cell lymphocyte deficiency), MonoMAC syndrome (monocytopenia with Mycobacterium avium complex infection), Emberger syndrome (myelodysplastic syndrome [MDS] with lymphedema), NK cell deficiency, and familial MDS/acute myeloid leukemia. As such, there is a wide spectrum of clinical features, including severe viral infections (particularly with human papillomavirus, molluscum contagiosum, herpes simplex virus, Epstein-Barr virus, and cytomegalovirus), warts, fungal infections (particularly histoplasmosis and aspergillosis), mycobacterial infections, pulmonary alveolar proteinosis, bone marrow hypocellularity, neutropenia, sensorineural hearing loss, and congenital lymphedema. Immunological phenotypes include dendritic cell, monocyte, CD4+ T cell, B- and NK- cell deficiencies. Also, the loss of a specific NK-cell subset, CD56 bright NK cells, has been reported in these patients.
GATA2 is a zinc finger transcription factor involved in hematopoiesis, maintenance of the hematopoietic stem cell (HSC) pool, and for HSC progenitor differentiation. Disease-causing genetic variants in GATA2 result in loss-of-function and haploinsufficiency and are transmitted in an autosomal dominant manner or arise de novo. Null variants (frameshift, nonsense, splicing, and large deletions) account for most cases, while missense variants account for approximately 30% of cases, and noncoding variants in an intronic enhancer element and synonymous variants that impact splicing account for the remainder of cases. Genotype-phenotype correlations are difficult to make, as there is considerable clinical heterogeneity. Incomplete penetrance has been observed with GATA2 deficiency, and the age at presentation varies; however, by age 60 years, the penetrance is estimated to be 90%. Additionally, there may be a role for environmental factors triggering certain infectious manifestations.
The definitive treatment for GATA2 deficiency is HSC transplantation. Early genetic diagnosis of GATA2 deficiency may aid in selecting management strategies and allow for family screening and counseling.
Reference Values
An interpretive report will be provided
Interpretation
All detected variants are evaluated according to American College of Medical Genetics and Genomics (ACMG) recommendations.(1) Variants are classified based on known, predicted, or possible pathogenicity and reported with interpretive comments detailing their potential or known significance.
Clinical Reference
1. Richards S, Aziz N, Bale S, et al; ACMG Laboratory Quality Assurance Committee: Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology. Genet Med. 2015 May;17(5):405-424
2. Fabozzi F, Mastronuzzi A, Ceglie G, Masetti R, Leardini D: GATA 2 deficiency: Focus on immune system impairment. Frong Immunol. 2022 Jun 13;13:865773
3. Hsu AP, McReynolds LJ, Holland SM: GATA2 deficiency. Curr Opin Allergy Clin Immunol. 2015 Feb;15(1):104-109
4. Bresnick EH, Jung MM, Katsumura KR: Human GATA2 mutations and hematologic disease: how many paths to pathogenesis? Blood Adv. 2020 Sep 22;4(18):4584-4592
5. Kozyra EJ, Pastor VB, Lefkopoulos S, et al: Synonymous GATA2 mutations result in selective loss of mutated RNA and are common in patients with GATA2 deficiency. 2020 Oct;34(10):2673-2687
6. Tangye SG, Al-Herz W, Bousfiha A, et al: Human inborn errors of immunity: 2022 update on the classification from the International Union of Immunological Societies Expert Committee. J Clin Immunol. 2022 Oct;42(7):1473-1507. doi: 10.1007/s10875-022-01289-3
Day(s) Performed
Varies
Report Available
28 to 42 daysTest Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
81479
88233- Tissue culture, skin, solid tissue biopsy (if appropriate)
88240- Cryopreservation (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| GATAS | GATA2 Gene, Full Gene Analysis | 95771-2 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 619803 | Test Description | 62364-5 |
| 619804 | Specimen | 31208-2 |
| 619805 | Source | 31208-2 |
| 619806 | Result Summary | 50397-9 |
| 619807 | Result | 82939-0 |
| 619808 | Interpretation | 69047-9 |
| 619809 | Additional Results | 82939-0 |
| 619810 | Resources | 99622-3 |
| 619811 | Additional Information | 48767-8 |
| 619812 | Method | 85069-3 |
| 619813 | Genes Analyzed | 82939-0 |
| 619814 | Disclaimer | 62364-5 |
| 619815 | Released By | 18771-6 |
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