That could include review of antipsychotic plasma concentrations if available. The prescriber, patient, pharmacy  and the laboratory performing blood counts are all registered with a specified clozapine provider who must be advised that there is no history of neutropenia from any cause. The clozapine providers collaborate by sharing information regarding patients who have had clozapine related neutropenia or agranulocytosis so that clozapine cannot be used again on license. Clozapine may only be dispensed after a satisfactory blood result has been received by the risk monitoring agency at which point an individual prescription may be released to an individual patient only.Baseline tests usually also include; a physical examination including baseline weight, waist circumference and BMI, assessments of renal function and liver function, an ECG and other baseline bloods may also be taken to facilitate monitoring of possible myocarditis, these might include C reactive protein (CRP) and troponin. In Australia and New Zealand pre-clozapine echocardiograms are also commonly performed. A number of service protocols are available and there are variations in the extent of preclozapine work ups. Some might also include fasting lipids, HbA1c and prolactin. At the Maudsley Hospital in the UK the Treat service also routinely performs a wide variety of other investigations including multiple investigations for other causes of psychosis and comorbidities including; MRI brain imaging, thyroid function tests, B12, folate and serum calcium levels, infection screening for blood borne viruses including Hepatitis B and C, HIV and syphilis as well as screening for autoimmune psychosis by anti-NMDA, anti-VGKC and Anti-nuclear Antibody  screening.
A number of children diagnosed with the disorder have been born to parents who were first cousins. It can also be associated with uniparental isodisomy. Diagnosis
Treatment
Epidemiology
Fumarase deficiency is extremely rare - until around 1990 there had only been 13 diagnosed and identified cases worldwide.A cluster of 20 cases has since been documented in the twin towns of Colorado City, Arizona and Hildale, Utah, both of which were formerly known as "Short Creek" (or the Short Creek Community). The two towns combine to form a community of 10,000 members of the Fundamentalist Church of Jesus Christ of Latter Day Saints who have a history of practicing successive endogamy, or marriage within their own communities. Nicknamed "Polygamists Downs", the syndrome has been blamed on cousin marriage, but in a larger sense is related to the reproductive isolation of a community among whom 85% are blood relatives of John Y. Barlow or Joseph Smith Jessop.Since the initial cluster from FLDS communities were reported, it is now estimated that there are 100 documented cases worldwide. See also
Hereditary leiomyomatosis and renal cell cancer
Founder effect

References
Further reading
Pithukpakorn, Manop; Toro, Jorge R. (November 2, 2010) [July 31, 2006]. "Hereditary Leiomyomatosis and Renal Cell Cancer". GeneReviews. Seattle WA: University of Washington. PMID 20301430. == External links ==