
Thyroid Panel
Thyroid Disorders and Thyroid Can-
cer Genetic (Thyroid) Panel:
This panel investigates genetic variances related to thyroid-related disorders, thyroid dyshormonogenesis, hyperthyroidism, hypothyroidism, thyroid cancers, hemochromatosis and secondary reduction of thyroid
hormone.
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What are thyroid-related disorders:
Thyroid-related disorders are medically
defined as problems with the thyroid include a variety of disorders that can result in the gland producing too little thyroid hormone (hypothyroidism) or too much (hyperthyroidism). Thyroid disorders can affect heart rate, mood,
energy level, metabolism, bone health,
pregnancy, and many other functions. In many cases, thyroid-related diseases run in families and there is a genetic root for these disorders. Some of the most common thyroid disorders are Hyperthyroidism, Graves’ disease, Hypothyroidism, Hashimoto’s
Thyroiditis, Thyroid Tumors, Thyroid Cancer, and Thyroid Disorders in Women. The thyroid next generation sequencing (NGS) panel investigate germline variations in genes associated with
these disorders, and other conditions
that may present with similar phenotypes.
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Clinical Utility:
The thyroid genetic testing panel result in more personalized treatment and symptom management, inform family members about their own risk factors,
connect patients to relevant resources and support, provide options for family planning.
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What is the outcome of genetic test
results:
A. Positive Result. A positive test result
indicates a pathogenic variant linked to thyroid-related disorder has been identified.
In some cases, thyroid-related disorders are dominant in which one copy of defective gene is sufficient to cause the disease. Some other thyroid-
related disorders are recessive disorders, meaning that both copies of defective genes must be present to cause the disease. Having a
heterozygous pathogenic variation means that the individual is a carrier of the disease and may not experience the disease condition. This knowledge provides the patient and health care provider an
opportunity to understand and, in
some cases, manage their treatment
plans.
B. Variation of uncertain significance (VUS). If genetic testing shows a change that has not been previously associated with thyroid-related disorders, the person’s test result may report a VUS. This result
may be interpreted as uncertain, which is to
say that the information does not help to clarify
contribution of VUS to disease condition and is typically not considered in making health care
decisions. Some gene variants may be
reclassified as researchers learn more about
variants. Variants that initially classified as
variants of uncertain significance may reclassified
as being benign (not clinically important) or may eventually be found to be associated with
disease phenotype. Therefore, it is important
for the person who is tested to keep in touch with the health care provider to ensure that they
receive updates if any new information on the variant is learned.
C. Negative result. A negative test result means that the laboratory did not find the specific disease linked
variant on list of genes that the test was designed to detect. Therefore, patient does not have a genetic variation associated with thyroid disorders in the
genes tested by the thyroid genetic
testing panel.
Purpose of the thyroid genetic test:
The thyroid genetic testing panel may be appropriate for anyone who has a personal or family history of thyroid- related disorders, particularly if those
conditions are affect more than one individual
in the family, or those conditions that are refractory to
treatment. This panel can help confirm a
diagnosis and guide the course of treatment.
Patients with thyroid-related disorders can benefit from supplement therapies, hormone replacement therapy, or go on preventive strategies.
Diagnosis through genetic testing can help with
the development of a management plan.
The thyroid genetic testing panel would help physicians to establish or confirm the appropriate diagnosis. By confirming diagnosis, the thyroid
genetic testing panel help to identify risks for additional related symptoms, prevent exposure to dangerous environmental factors, and assist in
modifying lifestyle changes.
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Method:
The test looks for inherited genetic variations (germline mutations) associated with thyroid
disorders. Genes are instructions, written in DNA,
for building protein molecules. Different people
can have different versions of the same gene.
Each version has a slightly different DNA sequence.
Some of these variants affect health, such as those gene variants linked to hypothyroidism.
Several genes involved in thyroid-
related disorders. Genes play prominent roles in both determination of thyroid hormone and thyrotropin
(TSH) concentrations, and susceptibility to autoimmune thyroid disease. Heritability studies
have suggested that up to 67% of circulating thyroid
hormone and TSH concentrations are genetically determined, suggesting agenetic basis for narrow intra-individual variations. Testing whether someone
carries a harmful (pathogenic) variant in one of thyroid disease related genes can confirm whether
a condition is, indeed, the result of an inherited
syndrome. The thyroid genetic test panel
investigates a panel of genes (listed below) for the presence of genetic changes compared to human reference (variants) that are linked to thyroid
disease related conditions. Express GeneTM
Thyroid Disorders and Thyroid Cancer Genetic (Thyroid) Panel is a Laboratory Developed Tests (LDT)
validated at Express Gene Molecular
Diagnostics Laboratory, using Twist Exome 2.0
and Illumina NovaSeq6000 Next Generation Sequencing (NGS)
Platform. This test has not been cleared
or approved by the FDA.
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Limitations of Testing:
This test is designed to detect individuals with a germline pathogenic variant. Repeat expansion disease, large deletion, duplication, and copy
number variations, are not detectable
by next generation sequencing (NGS) and require different test methodologies. Mutations in the
upstream and downstream regulatory regions and mutations outside exons of protein-coding genes are not investigated.
Certain types of variants, such as
structural rearrangements, inversions, translocations, variants in regions with low complexity, regions with complex architecture, short tandem repeats, or
segmental duplications cannot be detected by this method. Additionally, low level mosaicism, phasing, regions with matching pseudogenes causing
mapping ambiguity cause incorrect or
insufficient variant calling.
