Failure to follow up on a medically actionable finding from direct to consumer genetic testing: A case report

Abstract Background A 61‐year‐old woman underwent direct to consumer genetic testing and was found to be homozygous for the C282Y HFE variant (c.845G>A :p.Cys282Tyr) which is classified as pathogenic/likely pathogenic for hereditary hemochromatosis. However, no action was taken by the individual....

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Main Authors: Ramin Garmany, Christopher J. Lee, Richard R. Sharp, Iftikhar J. Kullo
Format: Article
Language:English
Published: Wiley 2020-06-01
Series:Molecular Genetics & Genomic Medicine
Subjects:
Online Access:https://doi.org/10.1002/mgg3.1252
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author Ramin Garmany
Christopher J. Lee
Richard R. Sharp
Iftikhar J. Kullo
author_facet Ramin Garmany
Christopher J. Lee
Richard R. Sharp
Iftikhar J. Kullo
author_sort Ramin Garmany
collection DOAJ
description Abstract Background A 61‐year‐old woman underwent direct to consumer genetic testing and was found to be homozygous for the C282Y HFE variant (c.845G>A :p.Cys282Tyr) which is classified as pathogenic/likely pathogenic for hereditary hemochromatosis. However, no action was taken by the individual. Methods The individual took part in the Mayo Clinic Return of Actionable Variants Empiric (RAVE) study and the actionable finding was confirmed and results disclosed in person by a genetic counselor with subsequent referral to a hepatologist. Results Further testing revealed iron overload with an elevated ferritin level (560 ng/ml) and increased ferritin saturation (74%). Phlebotomy was initiated with subsequent normalization of the ferritin levels (252 ng/ml). Conclusion This case highlights that actionable genetic results may not be acted on after direct to consumer testing and the need for effective genetic counseling after such testing.
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spelling doaj.art-3256c96b25464454b8bebf4f68735fd62022-12-22T00:34:24ZengWileyMolecular Genetics & Genomic Medicine2324-92692020-06-0186n/an/a10.1002/mgg3.1252Failure to follow up on a medically actionable finding from direct to consumer genetic testing: A case reportRamin Garmany0Christopher J. Lee1Richard R. Sharp2Iftikhar J. Kullo3Department of Cardiovascular Medicine Mayo Clinic Rochester MN USADepartment of Cardiovascular Medicine Mayo Clinic Rochester MN USABiomedical Ethics Research Program Mayo Clinic Rochester MN USADepartment of Cardiovascular Medicine Mayo Clinic Rochester MN USAAbstract Background A 61‐year‐old woman underwent direct to consumer genetic testing and was found to be homozygous for the C282Y HFE variant (c.845G>A :p.Cys282Tyr) which is classified as pathogenic/likely pathogenic for hereditary hemochromatosis. However, no action was taken by the individual. Methods The individual took part in the Mayo Clinic Return of Actionable Variants Empiric (RAVE) study and the actionable finding was confirmed and results disclosed in person by a genetic counselor with subsequent referral to a hepatologist. Results Further testing revealed iron overload with an elevated ferritin level (560 ng/ml) and increased ferritin saturation (74%). Phlebotomy was initiated with subsequent normalization of the ferritin levels (252 ng/ml). Conclusion This case highlights that actionable genetic results may not be acted on after direct to consumer testing and the need for effective genetic counseling after such testing.https://doi.org/10.1002/mgg3.1252C282Y HFEdirect to consumer genetic testinggenetic counselinghereditary hemochromatosis
spellingShingle Ramin Garmany
Christopher J. Lee
Richard R. Sharp
Iftikhar J. Kullo
Failure to follow up on a medically actionable finding from direct to consumer genetic testing: A case report
Molecular Genetics & Genomic Medicine
C282Y HFE
direct to consumer genetic testing
genetic counseling
hereditary hemochromatosis
title Failure to follow up on a medically actionable finding from direct to consumer genetic testing: A case report
title_full Failure to follow up on a medically actionable finding from direct to consumer genetic testing: A case report
title_fullStr Failure to follow up on a medically actionable finding from direct to consumer genetic testing: A case report
title_full_unstemmed Failure to follow up on a medically actionable finding from direct to consumer genetic testing: A case report
title_short Failure to follow up on a medically actionable finding from direct to consumer genetic testing: A case report
title_sort failure to follow up on a medically actionable finding from direct to consumer genetic testing a case report
topic C282Y HFE
direct to consumer genetic testing
genetic counseling
hereditary hemochromatosis
url https://doi.org/10.1002/mgg3.1252
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