Paediatric tests
Sample requirements
Samples should ideally be sent to the Cytogenetics Department on the same day/next day. Where a delay is inevitable, such as over weekends, please store the sample in a refrigerator before sending on the next working day but please DO NOT FREEZE. Lithium heparin and EDTA tubes are suitable for cytogenetic testing depending on the test required, please see below, samples in other tubes will be rejected. For sample labelling, sample tube guide and completion of referral form criteria please see referral requirements.
Karyotype and FISH
Please send a 1-2ml blood sample, well mixed, in a lithium heparin (usually green cap) container. Gel tubes may be used but please do not centrifuge or allow to separate. For neonates or children who are difficult to bleed we will attempt to process smaller blood samples.
Chromosomal Microarray
For microarray (neurodevelopmental disorders) please send a 3-5ml blood sample in an EDTA container. Bloods in other tubes will not be processed.
Fanconi Anaemia
Please send a minimum of a 2ml blood sample, well mixed, in a lithium heparin container. Please note that from April 2021, Fanconi Anaemia referrals should be sent to Sheffield Diagnostic services. Please see SDGS website for details.
Acceptance and rejection criteria
Lithium heparin is the preferred tube for karyotype testing. Bloods received in EDTA will be processed but the quality may be compromised. Bloods in any other tube will not be processed. For paediatrics the volume required is 1-2ml, smaller volumes may be attempted but the success or quality of the test may compromised.
Referral categories and tests
Karyotype - neonates
- Features suggestive of Down (trisomy 21), Patau (trisomy 13) or Edwards (trisomy 18) syndromes
- Ambiguous genitalia or gender uncertainty
- Dysmorphic features, hypotonia or other congenital abnormalities
- Confirmation of a prenatal cytogenetic test
Karyotype - paediatrics
- Features suggestive of Turner syndrome (e.g. short stature, delayed secondary sexual development) or other disorders of sex development
- Features suggestive of a chromosome instability
FISH - Fluorescence In Situ Hybridisation
We have a number of FISH probes available - please see available constitutional FISH probes. For specific exclusion of the syndromes mentioned on the available FISH test list please indicate on the referral card which syndrome is to be tested for. For other FISH tests please contact the Cytogenetics Department to discuss your requirements. Please note, that microarray analysis for probands suspected to have a microdeletion syndrome is a more appropriate test. Please see neurodevelopmental disorders.
Chromosomal microarray - paediatrics
We recommend patients meet some of the following criteria:
- Developmental delay
- Learning disability
- Facial dysmorphism or congenital abnormalities
- Behavioural problems/autistic spectrum
Please refer to the link for neurodevelopmental disorders.
Chromosome Instability Syndromes
We offer an urgent test for Fanconi Anaemia (for which we require at least 2ml of blood in lithium heparin). Test for other chromosome instability syndromes (e.g. Bloom Syndrome, Ataxia Telangiectasia, Nijmegan Syndrome) are offered by other laboratories. Please contact the Cytogenetics Department to discuss your requirements.
Reporting times
Please see our reporting timetable.
Limitations
Please see our postnatal limitations of testing.
Storage and future testing
Fixed material from neonate and paediatric samples is archived for at least 6 months from the date of receipt. Cases with a normal karyotype are then discarded; cases with a structural chromosome abnormality are stored for 5 years. For samples referred for array testing, the remaining DNA is stored within Molecular Genetics.
Page last updated 28/10/2020. Please note that if printed, the information is only valid on the day of printing.