Targeted gene panel sequencing for the rapid diagnosis of acutely ill infants

Luca Brunelli, Sabrina M. Jenkins, James M. Gudgeon, Steven B. Bleyl, Christine E. Miller, Tatiana Tvrdik, Shale A. Dames, Betsy Ostrander, Josue A.F. Daboub, Brandon A. Zielinski, Erin K. Zinkhan, Hunter R. Underhill, Theodore Wilson, Joshua L. Bonkowsky, Christian C. Yost, Lorenzo D. Botto, Justin Jenkins, Theodore J. Pysher, Pinar Bayrak-Toydemir, Rong Mao

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Background: Exome/genome sequencing (ES/GS) have been recently used in neonatal and pediatric/cardiac intensive care units (NICU and PICU/CICU) to diagnose and care for acutely ill infants, but the effectiveness of targeted gene panels for these purposes remains unknown. Methods: RapSeq, a newly developed panel targeting 4,503 disease-causing genes, was employed on selected patients in our NICU/PICU/CICU. Twenty trios were sequenced from October 2015 to March 2017. We assessed diagnostic yield, turnaround times, and clinical consequences. Results: A diagnosis was made in 10/20 neonates (50%); eight had de novo variants (ASXL1, CHD, FBN1, KMT2D, FANCB, FLNA, PAX3), one was a compound heterozygote for CHAT, and one had a maternally inherited GNAS variant. Preliminary reports were generated by 9.6 days (mean); final reports after Sanger sequencing at 16.3 days (mean). In all positive infants, the diagnosis changed management. In a case with congenital myasthenia, diagnosis and treatment occurred at 17 days versus 7 months in a historical control. Conclusions: This study shows that a gene panel that includes the majority of known disease-causing genes can rapidly identify a diagnosis in a large number of tested infants. Due to simpler deployment and interpretation and lower costs, this approach might represent an alternative to ES/GS in the NICU/PICU/CICU.

Original languageEnglish (US)
Article numbere00796
JournalMolecular Genetics and Genomic Medicine
Volume7
Issue number7
DOIs
StatePublished - Jul 2019

Keywords

  • genetic diagnosis
  • neonatology
  • newborn
  • precision medicine
  • rapid sequencing

ASJC Scopus subject areas

  • Molecular Biology
  • Genetics
  • Genetics(clinical)

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  • Cite this

    Brunelli, L., Jenkins, S. M., Gudgeon, J. M., Bleyl, S. B., Miller, C. E., Tvrdik, T., Dames, S. A., Ostrander, B., Daboub, J. A. F., Zielinski, B. A., Zinkhan, E. K., Underhill, H. R., Wilson, T., Bonkowsky, J. L., Yost, C. C., Botto, L. D., Jenkins, J., Pysher, T. J., Bayrak-Toydemir, P., & Mao, R. (2019). Targeted gene panel sequencing for the rapid diagnosis of acutely ill infants. Molecular Genetics and Genomic Medicine, 7(7), [e00796]. https://doi.org/10.1002/mgg3.796