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DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles

CPT4 code

Name of the Procedure:

DMPK (DM1 Protein Kinase) Gene Analysis; Myotonic Dystrophy Type 1 Gene Test, Evaluation to Detect Abnormal (Expanded) Alleles.

Summary

This test evaluates a patient's DNA to detect mutations in the DMPK gene, which are responsible for Myotonic Dystrophy Type 1 (DM1). It identifies abnormal (expanded) alleles that cause this genetic disorder.

Purpose

The procedure addresses the identification and confirmation of Myotonic Dystrophy Type 1, a genetic disorder that affects muscle function. The goals are to diagnose DM1 accurately, inform treatment decisions, and provide genetic counseling for affected families.

Indications

  • Symptoms such as muscle weakness, myotonia (delayed muscle relaxation), and fatigue.
  • Family history of Myotonic Dystrophy Type 1.
  • Congenital disabilities and developmental delays potentially linked to DM1.
  • Adults experiencing cataracts, heart conduction defects, or endocrine changes related to DM1.

Preparation

  • No special preparation is usually necessary for the patient.
  • The patient may need to provide a blood or saliva sample.
  • Genetic counseling may be suggested before the test.

Procedure Description

  1. Sample Collection: A blood sample is drawn from a vein, or a saliva sample is collected.
  2. DNA Extraction: The DNA is extracted from the sample in a lab.
  3. PCR and Southern Blot Analysis: Polymerase Chain Reaction (PCR) and Southern blot techniques are used to amplify and evaluate the DMPK gene.
  4. Detection: The DNA is examined for abnormal (expanded) alleles in the DMPK gene, which indicate the presence of DM1.

Duration

The procedure of taking a sample takes about 10-20 minutes. Laboratory analysis typically takes several days to a few weeks.

Setting

The sample collection can be performed in a doctor's office, hospital, or specialized genetic testing clinic. The DNA analysis is conducted in a laboratory.

Personnel

  • Phlebotomist or healthcare provider for sample collection.
  • Laboratory technician or geneticist for DNA analysis.
  • Genetic counselor for discussing results and implications with the patient.

Risks and Complications

  • Minimal risks from blood draw, such as slight bruising or infection at the puncture site.
  • Rare risk of anxiety or emotional distress from test results.

Benefits

  • Accurate diagnosis of Myotonic Dystrophy Type 1.
  • Informed medical decisions and management strategies.
  • Support for family planning through genetic counseling.
  • Potential early interventions and symptomatic treatments.

Recovery

  • No physical recovery needed from the sample collection.
  • Emotional or psychological support may be necessary after receiving test results.

Alternatives

  • Clinical diagnosis based on symptoms and family history (less precise).
  • Electromyography (EMG) to evaluate muscle function.
  • Muscle biopsy (more invasive and less specific).

Patient Experience

During the sample collection, the patient might feel a pinch or slight discomfort from the needle. Post-collection, the patient can resume normal activities immediately. Waiting for results can be anxiety-inducing; thus, emotional support and counseling are often beneficial.

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