{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T02:59:21Z","timestamp":1794020361219,"version":"4.8.0"},"reference-count":36,"publisher":"The Endocrine Society","issue":"5","license":[{"start":{"date-parts":[[2022,1,13]],"date-time":"2022-01-13T00:00:00Z","timestamp":1642032000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Ambry Genetics"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,4,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Practice guidelines to identify individuals with hereditary pheochromocytomas and paragangliomas (PPGLs) advocate for sequential gene testing strategy guided by specific clinical features and predate the routine use of multigene panel testing (MGPT).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To describe results of MGPT for hereditary PPGL in a clinically and ancestrally diverse cohort.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Commercial laboratory based in the United States.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Clinical data and test results were retrospectively reviewed in 1727 individuals who had targeted MGPT from August 2013 through December 2019 because of a suspicion of hereditary PPGL.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Overall, 27.5% of individuals had a pathogenic or likely pathogenic variant (PV), 9.0% had a variant of uncertain significance, and 63.1% had a negative result. Most PVs were identified in SDHB (40.4%), followed by SDHD (21.1%), SDHA (10.1%), VHL (7.8%), SDHC (6.7%), RET (3.7%), and MAX (3.6%). PVs in FH, MEN1, NF1, SDHAF2, and TMEM127 collectively accounted for 6.5% of PVs. Clinical predictors of a PV included extra-adrenal location, early age of onset, multiple tumors, and positive family history of PPGL. Individuals with extra-adrenal PGL and a positive family history were the most likely to have a PV (85.9%). Restricting genetic testing to SDHB\/C\/D misses one-third (32.8%) of individuals with PVs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Our data demonstrate a high diagnostic yield in individuals with and without established risk factors, a low inconclusive result rate, and a substantial contribution to diagnostic yield from rare genes. These findings support universal testing of all individuals with PPGL and the use of concurrent MGPT as the ideal platform.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgac014","type":"journal-article","created":{"date-parts":[[2022,1,13]],"date-time":"2022-01-13T17:42:36Z","timestamp":1642095756000},"page":"e1917-e1923","source":"Crossref","is-referenced-by-count":49,"title":["Universal Germline Panel Testing for Individuals With Pheochromocytoma and Paraganglioma Produces High Diagnostic Yield"],"prefix":"10.1210","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5186-6208","authenticated-orcid":false,"given":"Carolyn","family":"Horton","sequence":"first","affiliation":[{"name":"Ambry Genetics, Aliso Viejo, CA 92656, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly","family":"LaDuca","sequence":"additional","affiliation":[{"name":"Ambry Genetics, Aliso Viejo, CA 92656, 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functional paraganglioma","volume":"23","author":"Amar","year":"2005","journal-title":"J Clin Oncol."},{"key":"2022041907512366300_CIT0002","doi-asserted-by":"crossref","first-page":"1701","DOI":"10.1210\/jc.2008-2756","article-title":"Genetics of pheochromocytoma and paraganglioma in Spanish patients","volume":"94","author":"Casc\u00f3n","year":"2009","journal-title":"J Clin Endocrinol Metab."},{"key":"2022041907512366300_CIT0003","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1111\/cen.12074","article-title":"Evaluation of SDHB, SDHD and VHL gene susceptibility testing in the assessment of individuals with non-syndromic phaeochromocytoma, paraganglioma and head and neck paraganglioma","volume":"78","author":"Jafri","year":"2013","journal-title":"Clin Endocrinol (Oxf)."},{"issue":"1","key":"2022041907512366300_CIT0004","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1007\/s00109-014-1205-7","article-title":"Germ-line PHD1 and PHD2 mutations detected in patients 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