Investigations
1st investigations to order
DNA methylation testing
Test
Organize DNA methylation testing if Prader-Willi syndrome (PWS) is suspected, which will confirm the diagnosis in >99% of patients.[1][3]
In general, key features that should prompt DNA methylation testing in an infant are hypotonia, difficulty feeding, and/or hypogonadism.[2] A full list of clinical features by age that can help guide which patients should undergo DNA methylation testing has been proposed. See Criteria.
DNA methylation testing does not identify the specific genotype (deletion, maternal uniparental disomy of chromosome 15, or imprinting defect) of PWS; this requires further genetic testing by a medical geneticist.[3]
Result
no paternal allele at 15q11-q13
Investigations to consider
further genetic testing
Test
Refer the patient to a medical geneticist for further genetic testing if Prader-Willi syndrome is confirmed on DNA methylation testing, in order to determine the specific genotype.[3][25] Further genetic testing may include:[25]
Result
determination of genotype (deletion, maternal uniparental disomy, or imprinting defect)
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