273 Matching Annotations
  1. Last 7 days
    1. CaseMYH7-8: Japan, Asian

      CasePresentingHPOs: HP:0001639, HP:0006685 (Hypertrophic cardiomyopathy, Endomyocardial fibrosis)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo:


      CaseGenotypingMethod: Genomic DNA was extracted from whole blood from each proband. They each had 95 genes associated with DCM, HCM, and other inherited cardiovascular diseases sequenced with a panel, including both the exons and spicing regions. Variants were then filtered for rarity and pathogenicity.


      Variant: NM_000257.3:c.1357C>T (p.Arg453Cys)

      ClinVar: 14089 https://www.ncbi.nlm.nih.gov/clinvar/variation/14089/

      gnomAD: Not in gnomAD

    2. CaseMYH7-7: Japan, Asian

      CasePresentingHPOs: HP:0001639, HP:0006685 (Hypertrophic cardiomyopathy, Endomyocardial fibrosis)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo:


      CaseGenotypingMethod: Genomic DNA was extracted from whole blood from each proband. They each had 95 genes associated with DCM, HCM, and other inherited cardiovascular diseases sequenced with a panel, including both the exons and spicing regions. Variants were then filtered for rarity and pathogenicity.


      Variant: NM_000257.3:c.1358G>A (p.Arg453His)

      ClinVar: 42838 https://www.ncbi.nlm.nih.gov/clinvar/variation/42838/

      gnomAD: Not in gnomAD

    3. CaseMYH7-9: Japan, Asian

      CasePresentingHPOs: HP:0001639, HP:0006685 (Hypertrophic cardiomyopathy, Endomyocardial fibrosis)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo:


      CaseGenotypingMethod: Genomic DNA was extracted from whole blood from each proband. They each had 95 genes associated with DCM, HCM, and other inherited cardiovascular diseases sequenced with a panel, including both the exons and spicing regions. Variants were then filtered for rarity and pathogenicity.


      Variant: NM_000257.3:c.1012G>A (p.Val338Met)

      ClinVar: 164381 https://www.ncbi.nlm.nih.gov/clinvar/variation/164381/

      gnomAD: Not in gnomAD

    1. Case153: Female, 0.083 years onset, Japan, Asian

      DiseaseAssertion: Left ventricular noncompaction

      CasePresentingHPOs: HP:0030682, HP:0025169 (Left ventricular noncompaction, Left ventricular systolic dysfunction)

      HPOsFreeText: Left Ventricular Ejection Fraction at 46%, LVDD-Z score at 0.795

      CaseNotHPOs: HP:0011675 (Arrhythmia)

      NotHPOsFreeText: Congenital heart disease with significant hemodynamic changes

      CaseAddInfo: Sister also has LVNC


      CasePreviousTesting: Genes tested include the 8 sarcomere genes as well as 65 more listed in Table S1.

      CaseGenotypingMethod: Genomic DNA was extracted from whole blood from each of the probands. Next Generation Sequencing of 73 genes related to cardiac function was performed, incorporating PCR amplification, and any variants found were subjected to filtering for frequency and pathogenicity. Any variants suggested to be pathogenic were confirmed by Sanger sequencing afterwards.


      Variant: NM_000257.3:c.1342G>A (p.Glu448Lys)

      CAID: CA389050830 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000257.3:c.1342G%3EA

      gnomAD: Not in gnomAD

    2. Case361: Female, Birth onset, Japan, Asian

      DiseaseAssertion: Left ventricular noncompaction

      CasePresentingHPOs: HP:0030682, HP:0025169, HP:0001635 (Left ventricular noncompaction, Left ventricular systolic dysfunction, Heart failure)

      HPOsFreeText: Left Ventricular Ejection Fraction at 38%, LVDD-Z score at 0.977

      CaseNotHPOs: HP:0011675 (Arrhythmia)

      NotHPOsFreeText: Congenital heart disease with significant hemodynamic changes

      CaseAddInfo: No family history


      CasePreviousTesting: Genes tested include the 8 sarcomere genes as well as 65 more listed in Table S1.

      CaseGenotypingMethod: Genomic DNA was extracted from whole blood from each of the probands. Next Generation Sequencing of 73 genes related to cardiac function was performed, incorporating PCR amplification, and any variants found were subjected to filtering for frequency and pathogenicity. Any variants suggested to be pathogenic were confirmed by Sanger sequencing afterwards.


      Variant: NM_000257.3:c.896-1G>A

      CAID: CA389051805 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000257.3%3Ac.896-1G%3EA

      gnomAD: Not in gnomAD

    3. Case333: Male, Birth onset, Japan, Asian

      DiseaseAssertion: Left ventricular noncompaction

      CasePresentingHPOs: HP:0030682, HP:0025169, HP:0001635 (Left ventricular noncompaction, Left ventricular systolic dysfunction, Heart failure)

      HPOsFreeText: Left Ventricular Ejection Fraction at 10%, LVDD-Z score at -0.4

      CaseNotHPOs: HP:0011675 (Arrhythmia)

      NotHPOsFreeText: Congenital heart disease with significant hemodynamic changes

      CaseAddInfo: No family history


      CasePreviousTesting: Genes tested include the 8 sarcomere genes as well as 65 more listed in Table S1.

      CaseGenotypingMethod: Genomic DNA was extracted from whole blood from each of the probands. Next Generation Sequencing of 73 genes related to cardiac function was performed, incorporating PCR amplification, and any variants found were subjected to filtering for frequency and pathogenicity. Any variants suggested to be pathogenic were confirmed by Sanger sequencing afterwards.


      Variant: NM_000257.3:c.668C>T (p.Ala223Val)

      CAID: CA389052292 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000257.3:c.668C%3ET

      gnomAD: Not in gnomAD

    4. Case250: Male, 0.04 years onset, Japan, Asian

      DiseaseAssertion: Left ventricular noncompaction

      CasePresentingHPOs: HP:0030682, HP:0001635 (Left ventricular noncompaction, Heart failure)

      HPOsFreeText: Left Ventricular Ejection Fraction at 60%, LVDD-Z score at 1.6326

      CaseNotHPOs: HP:0011675 (Arrhythmia)

      NotHPOsFreeText: Congenital heart disease with significant hemodynamic changes

      CaseAddInfo: No family history


      CasePreviousTesting: Genes tested include the 8 sarcomere genes as well as 65 more listed in Table S1.

      CaseGenotypingMethod: Genomic DNA was extracted from whole blood from each of the probands. Next Generation Sequencing of 73 genes related to cardiac function was performed, incorporating PCR amplification, and any variants found were subjected to filtering for frequency and pathogenicity. Any variants suggested to be pathogenic were confirmed by Sanger sequencing afterwards.


      Variant: NM_000257.3:c.2030A>T (p.Glu677Val)

      CAID: CA389049283 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000257.3:c.2030A%3ET

      gnomAD: Not in gnomAD

    5. Case427: Female, 1.5 years onset, Japan, Asian

      DiseaseAssertion: Left ventricular noncompaction

      FamilyInfo: Father has DCM

      CasePresentingHPOs: HP:0030682, HP:0025169 (Left ventricular noncompaction, Left ventricular systolic dysfunction)

      HPOsFreeText: Left Ventricular Ejection Fraction at 44.1%, LVDD-Z score at 1.3709

      CaseNotHPOs: HP:0011675, HP:0001635 (Arrhythmia, Heart failure)

      NotHPOsFreeText: Congenital heart disease with significant hemodynamic changes

      CaseAddInfo:


      CasePreviousTesting: Genes tested include the 8 sarcomere genes as well as 65 more listed in Table S1.

      CaseGenotypingMethod: Genomic DNA was extracted from whole blood from each of the probands. Next Generation Sequencing of 73 genes related to cardiac function was performed, incorporating PCR amplification, and any variants found were subjected to filtering for frequency and pathogenicity. Any variants suggested to be pathogenic were confirmed by Sanger sequencing afterwards.


      Variant: NM_000257.3:c.2821C>T (p.Arg941Cys)

      CAID: CA389046936 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000257.3:c.2821C%3ET

      gnomAD: Not in gnomAD

    6. Case392: Male, 0.083 years onset, Japan, Asian

      DiseaseAssertion: Left ventricular noncompaction

      CasePresentingHPOs: HP:0030682, HP:0025169, HP:0001635 (Left ventricular noncompaction, Left ventricular systolic dysfunction, Heart failure)

      HPOsFreeText: Left Ventricular Ejection Fraction at 29%, LVDD-Z score at 2.1428

      CaseNotHPOs: HP:0011675 (Arrhythmia)

      NotHPOsFreeText: Congenital heart disease with significant hemodynamic changes

      CaseAddInfo: No family history


      CasePreviousTesting: Genes tested include the 8 sarcomere genes as well as 65 more listed in Table S1.

      CaseGenotypingMethod: Genomic DNA was extracted from whole blood from each of the probands. Next Generation Sequencing of 73 genes related to cardiac function was performed, incorporating PCR amplification, and any variants found were subjected to filtering for frequency and pathogenicity. Any variants suggested to be pathogenic were confirmed by Sanger sequencing afterwards.


      Variant: NM_000257.3:c.944A>G (p.Gln315Arg)

      CAID: CA389051698 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000257.3:c.944A%3EG

      gnomAD: Not in gnomAD

    7. Case378: Female, Birth onset, Japan, Asian

      DiseaseAssertion: Left ventricular noncompaction

      FamilyInfo: Sister has LVNC

      CasePresentingHPOs: HP:0030682, HP:0025169, HP:0001635, HP:0005110 (Left ventricular noncompaction, Left ventricular systolic dysfunction, Heart failure, Atrial fibrillation)

      HPOsFreeText: Left Ventricular Ejection Fraction at 20%, LVDD-Z score at 0.1

      CaseNotHPOs: N/A

      NotHPOsFreeText: Congenital heart disease with significant hemodynamic changes

      CaseAddInfo:


      CasePreviousTesting: Genes tested include the 8 sarcomere genes as well as 65 more listed in Table S1.

      CaseGenotypingMethod: Genomic DNA was extracted from whole blood from each of the probands. Next Generation Sequencing of 73 genes related to cardiac function was performed, incorporating PCR amplification, and any variants found were subjected to filtering for frequency and pathogenicity. Any variants suggested to be pathogenic were confirmed by Sanger sequencing afterwards.


      Variant: NM_000257.3:c.1859T>C (p.Leu620Pro)

      CAID: CA389049669 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000257.3:c.1859T%3EC

      gnomAD: Not in gnomAD

    8. Case298: Female, 6 years onset, Japan, Asian

      DiseaseAssertion: Left ventricular noncompaction

      CasePresentingHPOs: HP:0030682 (Left ventricular noncompaction)

      HPOsFreeText: Left Ventricular Ejection Fraction at 65%, LVDD-Z score at 2.1

      CaseNotHPOs: HP:0011675 (Arrhythmia)

      NotHPOsFreeText: Congenital heart disease with significant hemodynamic changes

      CaseAddInfo: No family history


      CasePreviousTesting: Genes tested include the 8 sarcomere genes as well as 65 more listed in Table S1.

      CaseGenotypingMethod: Genomic DNA was extracted from whole blood from each of the probands. Next Generation Sequencing of 73 genes related to cardiac function was performed, incorporating PCR amplification, and any variants found were subjected to filtering for frequency and pathogenicity. Any variants suggested to be pathogenic were confirmed by Sanger sequencing afterwards.


      Variant: NM_000257.3:c.2710C>T (p.Arg904Cys)

      ClinVar: 164316 https://www.ncbi.nlm.nih.gov/clinvar/variation/164316/

      gnomAD: Ashkenazi Jewish 9.921e-5, Overall 3.977e-6 https://gnomad.broadinstitute.org/variant/14-23893328-G-A

    1. 7

      Case7: Female, 13 years diagnosis, China, Asian

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      CasePresentingHPOs: HP:0001639, HP:0001667, HP:0001279 (Hypertrophic cardiomyopathy, Right ventricular hypertrophy, Syncope)

      HPOsFreeText: 2 SCD risk factors, NYHA class is II, Right ventricular wall thickness 12 mm

      CaseNotHPOs: HP:0002092, HP:0001642, HP:0030680, HP:0011675 (Pulmonary arterial hypertension, Pulmonary stenosis, Congenital heart disease, Arrhythmia)

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A


      CaseGenotypingMethod: Probands' genomic DNA was extracted from blood samples. WES was performed, with the resulting sequence data mapped to a reference genome and variants filtered for pathogenicity and predicted effects. All variants identified were confirmed via Sanger sequencing of the respective genes.


      Variant reported as below, but no SNP corresponds to the variant.

      Variant: NP_000248.2:p.R719E

      ClinVar: N/A

      gnomAD: N/A


      MultipleGeneVariants:

      MYOM1 Variant:

      Variant: NM_003803.3:c.2507G>T (p.Gly836Val)

      CAID: CA8874590 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_003803.3:c.2507G%3ET

      gnomAD: East Asian 5.044e-4, Overall 3.707e-5 https://gnomad.broadinstitute.org/variant/18-3129517-C-A


      AKAP9 Variant:

      Variant: NM_005751.4:c.11590T>C (p.Cys3864Arg)

      CAID: CA368165252 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_005751.4:c.11590T%3EC

      gnomAD: Not in gnomAD

    2. 1

      Case1: Male, 27 years diagnosis, China, Asian

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      CasePresentingHPOs: HP:0001639, HP:0001667 (Hypertrophic cardiomyopathy, Right ventricular hypertrophy)

      HPOsFreeText: 0 SCD risk factors, NYHA class is I, Right ventricular wall thickness 13 mm

      CaseNotHPOs: HP:0002092, HP:0001642, HP:0030680, HP:0011675 (Pulmonary arterial hypertension, Pulmonary stenosis, Congenital heart disease, Arrhythmia)

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A


      CaseGenotypingMethod: Probands' genomic DNA was extracted from blood samples. WES was performed, with the resulting sequence data mapped to a reference genome and variants filtered for pathogenicity and predicted effects. All variants identified were confirmed via Sanger sequencing of the respective genes.


      Variant listed as MYH7-478N. Typo is suspected, below is the entry for MYH7-I478N, the actual variant at this location

      Variant: NM_000257.3:c.1433T>A (p.Ile478Asn)

      CAID: CA389050614 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000257.3:c.1433T%3EA

      gnomAD: Not in gnomAD


      MultipleGeneVariants:

      TTN Variants:

      Unknown Variant

      Variant1: TTN-S3872fs

      CAID: N/A

      gnomAD: N/A


      Unknown Variant

      Variant2: TTN-S6350A

      CAID: N/A

      gnomAD: N/A


      Unknown Variant

      Variant3: TTN-P10663R

      CAID: N/A

      gnomAD: N/A


      ACTN2 Variant

      Unknown Variant

      Variant: ACTN2-P32fs

      CAID: N/A

      gnomAD: N/A

    1. CaseMYH7-21: Australia

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: 1 other proband shares this genotype

      CasePreviousTesting: See Table 1

      CaseGenotypingMethod: DNA was isolated from peripheral blood. Most participants underwent testing from the Illumina Cardiomyopathy Sequencing Panel, which includes 46 cardiomyopathy related genes. For others, whole exome sequencing or Sanger squencing was used. After the results were returned, variants were filtered for pathogenicity and rarity.

      Variant: NM_000257.3:c.2389G>A (p.Ala797Thr)

      ClinVar: 42901 https://www.ncbi.nlm.nih.gov/clinvar/variation/42901/

      gnomAD: African 1.230e-4, Overall 2.386e-5 https://gnomad.broadinstitute.org/variant/14-23894525-C-T

    2. CaseMYH7-34: Australia

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CasePreviousTesting: See Table 1

      CaseGenotypingMethod: DNA was isolated from peripheral blood. Most participants underwent testing from the Illumina Cardiomyopathy Sequencing Panel, which includes 46 cardiomyopathy related genes. For others, whole exome sequencing or Sanger squencing was used. After the results were returned, variants were filtered for pathogenicity and rarity.

      Variant: NM_000257.3:c.1370T>C (p.Ile457Thr)

      ClinVar: 42840 https://www.ncbi.nlm.nih.gov/clinvar/variation/42840/

      gnomAD: European (Non-Finnish) 8.790e-6, Overall 3.976e-6 https://gnomad.broadinstitute.org/variant/14-23898201-A-G

    3. CaseMYH7-25: Australia

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: 1 other proband shares this genotype

      CasePreviousTesting: See Table 1

      CaseGenotypingMethod: DNA was isolated from peripheral blood. Most participants underwent testing from the Illumina Cardiomyopathy Sequencing Panel, which includes 46 cardiomyopathy related genes. For others, whole exome sequencing or Sanger squencing was used. After the results were returned, variants were filtered for pathogenicity and rarity.

      Variant: NM_000257.3:c.2207T>C (p.Ile736Thr)

      ClinVar: 164342 https://www.ncbi.nlm.nih.gov/clinvar/variation/164342/

      gnomAD: Not in gnomAD

    4. CaseMYH7-28: Australia

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CasePreviousTesting: See Table 1

      CaseGenotypingMethod: DNA was isolated from peripheral blood. Most participants underwent testing from the Illumina Cardiomyopathy Sequencing Panel, which includes 46 cardiomyopathy related genes. For others, whole exome sequencing or Sanger squencing was used. After the results were returned, variants were filtered for pathogenicity and rarity.

      Variant: NM_000257.3:c.2155C>T (p.Arg719Trp)

      ClinVar: 14104 https://www.ncbi.nlm.nih.gov/clinvar/variation/14104/

      gnomAD: European (Non-Finnish) 6.481e-5, Overall 3.185e-5 https://gnomad.broadinstitute.org/variant/14-23895180-G-A

    5. CaseMYH7-10: Australia

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CasePreviousTesting: See Table 1

      CaseGenotypingMethod: DNA was isolated from peripheral blood. Most participants underwent testing from the Illumina Cardiomyopathy Sequencing Panel, which includes 46 cardiomyopathy related genes. For others, whole exome sequencing or Sanger squencing was used. After the results were returned, variants were filtered for pathogenicity and rarity.

      Variant: NM_000257.3:c.3592G>T (p.Asp1198Tyr)

      ClinVar: 520451 https://www.ncbi.nlm.nih.gov/clinvar/variation/520451/

      gnomAD: Not in gnomAD

    6. CaseMYH7-36: Australia

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CasePreviousTesting: See Table 1

      CaseGenotypingMethod: DNA was isolated from peripheral blood. Most participants underwent testing from the Illumina Cardiomyopathy Sequencing Panel, which includes 46 cardiomyopathy related genes. For others, whole exome sequencing or Sanger squencing was used. After the results were returned, variants were filtered for pathogenicity and rarity.

      Variant: NM_000257.3:c.1208G>A (p.Arg403Gln)

      ClinVar: 14087 https://www.ncbi.nlm.nih.gov/clinvar/variation/14087/

      gnomAD: Not in gnomAD

    7. CaseMYH7-24: Australia

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CasePreviousTesting: See Table 1

      CaseGenotypingMethod: DNA was isolated from peripheral blood. Most participants underwent testing from the Illumina Cardiomyopathy Sequencing Panel, which includes 46 cardiomyopathy related genes. For others, whole exome sequencing or Sanger squencing was used. After the results were returned, variants were filtered for pathogenicity and rarity.

      Variant: NM_000257.3:c.2221G>T (p.Gly741Trp)

      ClinVar: 177665 https://www.ncbi.nlm.nih.gov/clinvar/variation/177665/

      gnomAD: Not in gnomAD

    8. CaseMYH7-6: Australia

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: 2 other probands have this genotype

      CasePreviousTesting: See Table 1

      CaseGenotypingMethod: DNA was isolated from peripheral blood. Most participants underwent testing from the Illumina Cardiomyopathy Sequencing Panel, which includes 46 cardiomyopathy related genes. For others, whole exome sequencing or Sanger squencing was used. After the results were returned, variants were filtered for pathogenicity and rarity.

      Variant: NM_000257.3:c.4135G>A (p.Ala1379Thr)

      ClinVar: 42993 https://www.ncbi.nlm.nih.gov/clinvar/variation/42993/

      gnomAD: Latino 2.822e-5, Overall 3.535e-6 https://gnomad.broadinstitute.org/variant/14-23887453-C-T

    9. CaseMYH7-31: Australia

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: 1 other proband shares this genotype

      CasePreviousTesting: See Table 1

      CaseGenotypingMethod: DNA was isolated from peripheral blood. Most participants underwent testing from the Illumina Cardiomyopathy Sequencing Panel, which includes 46 cardiomyopathy related genes. For others, whole exome sequencing or Sanger squencing was used. After the results were returned, variants were filtered for pathogenicity and rarity.

      Variant: NM_000257.3:c.1954A>G (p.Arg652Gly)

      ClinVar: 177626 https://www.ncbi.nlm.nih.gov/clinvar/variation/177626/

      gnomAD: Not in gnomAD

    10. CaseMYH7-37: Australia

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CasePreviousTesting: See Table 1

      CaseGenotypingMethod: DNA was isolated from peripheral blood. Most participants underwent testing from the Illumina Cardiomyopathy Sequencing Panel, which includes 46 cardiomyopathy related genes. For others, whole exome sequencing or Sanger squencing was used. After the results were returned, variants were filtered for pathogenicity and rarity.

      Variant: NM_000257.3:c.1207C>T (p.Arg403Trp)

      ClinVar: 14102 https://www.ncbi.nlm.nih.gov/clinvar/variation/14102/

      gnomAD: Not in gnomAD

    11. CaseMYH7-13: Australia

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CasePreviousTesting: See Table 1

      CaseGenotypingMethod: DNA was isolated from peripheral blood. Most participants underwent testing from the Illumina Cardiomyopathy Sequencing Panel, which includes 46 cardiomyopathy related genes. For others, whole exome sequencing or Sanger squencing was used. After the results were returned, variants were filtered for pathogenicity and rarity.

      Variant: NM_000257.3:c.3064A>G (p.Lys1022Glu)

      CAID: CA389045738 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000257.3%3Ac.3064A%3EG

      gnomAD: Not in gnomAD

    12. CaseMYH7-18: Australia

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CasePreviousTesting: See Table 1

      CaseGenotypingMethod: DNA was isolated from peripheral blood. Most participants underwent testing from the Illumina Cardiomyopathy Sequencing Panel, which includes 46 cardiomyopathy related genes. For others, whole exome sequencing or Sanger squencing was used. After the results were returned, variants were filtered for pathogenicity and rarity.

      Variant: NM_000257.3:c.2578A>G (p.Lys860Glu)

      ClinVar: 192312 https://www.ncbi.nlm.nih.gov/clinvar/variation/192312/

      gnomAD: Not in gnomAD

    13. CaseMYH7-2: Australia

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CasePreviousTesting: See Table 1

      CaseGenotypingMethod: DNA was isolated from peripheral blood. Most participants underwent testing from the Illumina Cardiomyopathy Sequencing Panel, which includes 46 cardiomyopathy related genes. For others, whole exome sequencing or Sanger squencing was used. After the results were returned, variants were filtered for pathogenicity and rarity.

      Variant: NM_000257.3:c.5287G>A (p.Ala1763Thr)

      ClinVar: 177846 https://www.ncbi.nlm.nih.gov/clinvar/variation/177846/

      gnomAD: European (Non-Finnish) 1.238e-4, Overall 7.423e-5 https://gnomad.broadinstitute.org/variant/14-23884476-C-T

    1. 2

      Case2: Female, 14 years report, Netherlands

      CasePresentingHPOs: HP:0011663, HP:0011675, HP:0001279, HP:0005135, HP:0001707, HP:0001711, HP:0004308, HP:0001635 (Right ventricular cardiomyopathy, Arrhythmia, Syncope, Abnormal T-wave, Abnormality of the right ventricle, Abnormality of the left ventricle, Ventricular arrhythmia, Congestive heart failure)

      HPOsFreeText: Positive EPS inducibility

      CaseNotHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      NotHPOsFreeText: ECG Depolarization abnormality, Cardiac transplant

      CaseAddInfo:


      CasePreviousTesting: No variants were in any of DSP, PKP2, DSG2, DSC2, and JUP. Patients were tested for variants in ACTC1, MYBPC3, MYH7, MYL2, MYL3, TNNC1, TNNI3, TNNT2, and TPM1.

      CaseGenotypingMethod: 92 patients underwent panel sequencing of the specific genes listed above, and 45 were subject to Whole Exome Sequencing to locate variants. Afterwards, all variants were verified by PCR amplification and Sanger sequencing and filtered for pathogenicity.


      Variant: NM_000257.3:c.4499G>A (p.Arg1500Gln)

      ClinVar: 180439 https://www.ncbi.nlm.nih.gov/clinvar/variation/180439/

      gnomAD: European (Non-Finnish) 2.637e-5, Overall 1.591e-5 https://gnomad.broadinstitute.org/variant/14-23886382-C-T

    1. Pedigree 2

      Case: Pedigree 2 proband, male, 37yo at diagnosis, Iraqi‐Jewish

      CasePresentingHPOs: HP:0001639, HP:0005110, HP:0001708, HP:0005180 (hypertrophic cardiomyopathy, atrial fibrillation, right heart failure, tricuspid regurgitation)

      HPOsFreeText: clinical severity: moderate to asymptomatic

      CaseNotHPOs:

      NotHPOsFreeText: skeletal involvement

      CasePreviousTesting: exact genes sequenced not specified

      CaseGenotypingMethod: Fifty‐six genes known to cause HCM were sequenced in parallel

      Variant: NM_000257.3(MYH7):c.427C>T (p.Arg143Trp)

      ClinVar: 164401, https://www.ncbi.nlm.nih.gov/clinvar/variation/164401/

      gnomAD: 0.00002784, https://gnomad.broadinstitute.org/variant/14-23901923-G-A

      FamilyInfo: older brother had sudden death at 33yo with postmortem diagnosis of HCM, patient's siblings, aged 67 and 70, were also found to be heterozygous for this variant, though they are both clinically asymptomatic with no echocardiographic evidence of HCM

    1. CaseCM1832: Male, 0 years diagnosis, Japan, Asian

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: HP:0001939 (Abnormality of metabolism/homeostasis)

      NotHPOsFreeText: Neuromuscular disease, Malformation syndromes

      CaseAddInfo: No family history of cardiomyopathy or sudden death, Proband found in Supplementary Table 2, Mother is negative for this variant


      CasePreviousTesting: 8 patients with HCM and one with RCM were analyzed by NGS for the eight sarcomere-encoding genes and MYP.

      CaseGenotypingMethod: Probands were subject to PCR amplification and direct sequencing of 64 cardiomyopathy-associated genes, including the eight sarcomere-encoding genes. The variants were then filtered for rarity and tested for pathogenicity.


      Variant: NM_000257.3:c.2609G>T (p.Arg870Leu)

      ClinVar: 235031 https://www.ncbi.nlm.nih.gov/clinvar/variation/235031/

      gnomAD: Not in gnomAD

    2. CaseCM1839: Female, 12 years diagnosis, Japan, Asian

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: HP:0001939 (Abnormality of metabolism/homeostasis)

      NotHPOsFreeText: Neuromuscular disease, Malformation syndromes

      CaseAddInfo: Positive family history of cardiomyopathy or sudden death, Proband found in Supplementary Table 2


      CasePreviousTesting: 8 patients with HCM and one with RCM were analyzed by NGS for the eight sarcomere-encoding genes and MYP.

      CaseGenotypingMethod: Probands were subject to PCR amplification and direct sequencing of 64 cardiomyopathy-associated genes, including the eight sarcomere-encoding genes. The variants were then filtered for rarity and tested for pathogenicity.


      Variant: NM_000257.3:c.2221G>T (p.Gly741Trp)

      ClinVar: 177665 https://www.ncbi.nlm.nih.gov/clinvar/variation/177665/

      gnomAD: Not in gnomAD


      MultipleGeneVariants:

      (1) BAG3 Variant Variant: NM_004281.3:c.1015A>G (p.Ile339Val)

      ClinVar: 228453 https://www.ncbi.nlm.nih.gov/clinvar/variation/228453/

      gnomAD: East Asian 5.437e-5, Overall 3.976e-6 https://gnomad.broadinstitute.org/variant/10-121436081-A-G

    3. CaseCM1871: Male, 0 years diagnosis, Japan, Asian

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: HP:0001939 (Abnormality of metabolism/homeostasis)

      NotHPOsFreeText: Neuromuscular disease, Malformation syndromes

      CaseAddInfo: No family history of cardiomyopathy or sudden death, Proband found in Supplementary Table 2, Mother shows negative for this variant with no symptoms


      CasePreviousTesting: 8 patients with HCM and one with RCM were analyzed by NGS for the eight sarcomere-encoding genes and MYP.

      CaseGenotypingMethod: Probands were subject to PCR amplification and direct sequencing of 64 cardiomyopathy-associated genes, including the eight sarcomere-encoding genes. The variants were then filtered for rarity and tested for pathogenicity.


      Variant: NM_000257.3:c.2608C>T (p.Arg870Cys)

      ClinVar: 161326 https://www.ncbi.nlm.nih.gov/clinvar/variation/161326/

      gnomAD: Ashkenazi Jewish 9.923e-5, Overall 2.386e-5 https://gnomad.broadinstitute.org/variant/14-23894049-G-A

    4. CaseCM1844: Male, 6 years diagnosis, Japan, Asian

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: HP:0001939 (Abnormality of metabolism/homeostasis)

      NotHPOsFreeText: Neuromuscular disease, Malformation syndromes

      CaseAddInfo: No family history of cardiomyopathy or sudden death, Proband found in Supplementary Table 2, Mother and father are both negative for this variant


      CasePreviousTesting: 8 patients with HCM and one with RCM were analyzed by NGS for the eight sarcomere-encoding genes and MYP.

      CaseGenotypingMethod: Probands were subject to PCR amplification and direct sequencing of 64 cardiomyopathy-associated genes, including the eight sarcomere-encoding genes. The variants were then filtered for rarity and tested for pathogenicity.


      Variant: NM_000257.3:c.1357C>T (p.Arg453Cys)

      ClinVar: 14089 https://www.ncbi.nlm.nih.gov/clinvar/variation/14089/

      gnomAD: Not in gnomAD

    5. CaseCM0969: Male, 6 years diagnosis, Japan, Asian

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: HP:0001939 (Abnormality of metabolism/homeostasis)

      NotHPOsFreeText: Neuromuscular disease, Malformation syndromes

      CaseAddInfo: Positive family history of cardiomyopathy or sudden death, Proband found in Supplementary Table 2, Variant is asserted as novel, Both father and sister with HCM tested positive for this variant


      CasePreviousTesting: 8 patients with HCM and one with RCM were analyzed by NGS for the eight sarcomere-encoding genes and MYP.

      CaseGenotypingMethod: Probands were subject to PCR amplification and direct sequencing of 64 cardiomyopathy-associated genes, including the eight sarcomere-encoding genes. The variants were then filtered for rarity and tested for pathogenicity.


      Variant: NM_000257.3:c.2777T>C (p.Leu926Pro)

      ClinVar: 525005 https://www.ncbi.nlm.nih.gov/clinvar/variation/525005/

      gnomAD: Not in gnomAD

    1. CaseMYH7-8: N/A

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CaseGenotypingMethod: Testing for all 8 sarcomeric genes, plus GLA, LAMP2, and PRKAG2 was initiated in all probands. After the direct sequencing, the variants were filtered for pathogenicity and classified.

      Variant: NM_000257.3:c.427C>T (p.Arg143Trp)

      ClinVar: 164401 https://www.ncbi.nlm.nih.gov/clinvar/variation/164401/

      gnomAD: East Asian 1.087e-4, Overall 2.784e-5 https://gnomad.broadinstitute.org/variant/14-23901923-G-A

    2. CaseMYH7-16: N/A

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CaseGenotypingMethod: Testing for all 8 sarcomeric genes, plus GLA, LAMP2, and PRKAG2 was initiated in all probands. After the direct sequencing, the variants were filtered for pathogenicity and classified.

      Variant: NM_000257.3:c.2681A>G (p.Glu894Gly)

      ClinVar: 42922 https://www.ncbi.nlm.nih.gov/clinvar/variation/42922/

      gnomAD: Not in gnomAD

    3. CaseMYH7-22: N/A

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CaseGenotypingMethod: Testing for all 8 sarcomeric genes, plus GLA, LAMP2, and PRKAG2 was initiated in all probands. After the direct sequencing, the variants were filtered for pathogenicity and classified.

      Variant: NM_000257.3:c.2788G>A (p.Glu930Lys)

      ClinVar: 42933 https://www.ncbi.nlm.nih.gov/clinvar/variation/42933/

      gnomAD: Not in gnomAD

    4. CaseMYH7-26: N/A

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CaseGenotypingMethod: Testing for all 8 sarcomeric genes, plus GLA, LAMP2, and PRKAG2 was initiated in all probands. After the direct sequencing, the variants were filtered for pathogenicity and classified.

      Variant: NM_000257.3:c.2609G>A (p.Arg870His)

      ClinVar: 14120 https://www.ncbi.nlm.nih.gov/clinvar/variation/14120/

      gnomAD: European (Non-Finnish) 1.549e-5, Overall 7.072e-6 https://gnomad.broadinstitute.org/variant/14-23894048-C-T

    5. CaseMYH7-1: N/A

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CaseGenotypingMethod: Testing for all 8 sarcomeric genes, plus GLA, LAMP2, and PRKAG2 was initiated in all probands. After the direct sequencing, the variants were filtered for pathogenicity and classified.

      Variant: NM_000257.3:c.1987C>T (p.Arg663Cys)

      ClinVar: 42874 https://www.ncbi.nlm.nih.gov/clinvar/variation/42874/

      gnomAD: Not in gnomAD

    6. CaseMYH7-13: N/A

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CaseGenotypingMethod: Testing for all 8 sarcomeric genes, plus GLA, LAMP2, and PRKAG2 was initiated in all probands. After the direct sequencing, the variants were filtered for pathogenicity and classified.

      Variant: NM_000257.3:c.1208G>A (p.Arg403Gln)

      ClinVar: 14087 https://www.ncbi.nlm.nih.gov/clinvar/variation/14087/

      gnomAD: Not in gnomAD

    7. CaseMYH7-5: N/A

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CaseGenotypingMethod: Testing for all 8 sarcomeric genes, plus GLA, LAMP2, and PRKAG2 was initiated in all probands. After the direct sequencing, the variants were filtered for pathogenicity and classified.

      Variant: NM_000257.3:c.2198G>T (p.Gly733Val)

      ClinVar: 181177 https://www.ncbi.nlm.nih.gov/clinvar/variation/181177/

      gnomAD: Not in gnomAD

    8. CaseMYH7-2: N/A

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CaseGenotypingMethod: Testing for all 8 sarcomeric genes, plus GLA, LAMP2, and PRKAG2 was initiated in all probands. After the direct sequencing, the variants were filtered for pathogenicity and classified.

      Variant: NM_000257.3:c.5135G>A (p.Arg1712Gln)

      ClinVar: 36642 https://www.ncbi.nlm.nih.gov/clinvar/variation/36642/

      gnomAD: European (Non-Finnish) 4.657e-5, Overall 2.125e-5 https://gnomad.broadinstitute.org/variant/14-23884860-C-T

    1. 21

      CaseVI: Brazil, Caucasian

      DiseaseAssertion: Hypertrophic cardiomyopathy

      FamilyInfo: Family history of HCM

      CasePresentingHPOs: HP:0001712, HP:0001639 (Left ventricular hypertrophy, Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CasePreviousTesting: Only MYH7, MYBPC3, and TNNT2 were tested.

      CaseGenotypingMethod: DNA was extracted from peripheral blood and the above genes were subject to PCR amplification and directly sequenced. The resulting sequences were compared with the reference and filtered for pathogenicity.

      Variant: NM_000257.3:c.2389G>A (p.Ala797Thr)

      ClinVar: 42901 https://www.ncbi.nlm.nih.gov/clinvar/variation/42901/

      gnomAD: African 1.230e-4, Overall 2.386e-5 https://gnomad.broadinstitute.org/variant/14-23894525-C-T

    1. HCM1.1

      CaseHCM1.1: Indian

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: HP:0000819 (Diabetes mellitus)

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CasePreviousTesting: See Table 1

      CaseGenotypingMethod: DNA was extracted from the probands' blood, followed by sequencing of the coding regions and exon/intron boundaries of 15 genes associated with HCM. From there, they were amplified by PCR ampliication and variants were filtered by pathogenicity. Every unclassified variant was confirmed by Sanger sequencing afterwards.

      Variant: NM_000257.3:c.611G>A (p.Arg204His)

      ClinVar: 43095 https://www.ncbi.nlm.nih.gov/clinvar/variation/43095/

      gnomAD: East Asian 5.012e-5, Overall 1.767e-5 https://gnomad.broadinstitute.org/variant/14-23900998-C-T

    2. HCM34.1

      CaseHCM34.1: Mixed ancestry

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: HP:0000819 (Diabetes mellitus)

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CasePreviousTesting: See Table 1

      CaseGenotypingMethod: DNA was extracted from the probands' blood, followed by sequencing of the coding regions and exon/intron boundaries of 15 genes associated with HCM. From there, they were amplified by PCR ampliication and variants were filtered by pathogenicity. Every unclassified variant was confirmed by Sanger sequencing afterwards.

      Variant: NM_000257.3:c.1357C>T (p.Arg453Cys)

      ClinVar: 14089 https://www.ncbi.nlm.nih.gov/clinvar/variation/14089/

      gnomAD: Not in gnomAD

    3. HCM14.1

      CaseHCM14.1: Mixed ancestry

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: HP:0000819 (Diabetes mellitus)

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CasePreviousTesting: See Table 1

      CaseGenotypingMethod: DNA was extracted from the probands' blood, followed by sequencing of the coding regions and exon/intron boundaries of 15 genes associated with HCM. From there, they were amplified by PCR ampliication and variants were filtered by pathogenicity. Every unclassified variant was confirmed by Sanger sequencing afterwards.

      Variant: NM_000257.3:c.2167C>T (p.Arg723Cys)

      ClinVar: 14095 https://www.ncbi.nlm.nih.gov/clinvar/variation/14095/

      gnomAD: South Asian 3.266e-5, Overall 1.194e-5 https://gnomad.broadinstitute.org/variant/14-23895023-G-A

    1. CasePT-38: United States

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: HP:0001650, HP:0001658 (Aortic valve stenosis, Myocardial infarction)

      NotHPOsFreeText: N/A

      CaseAddInfo: Two other siblings have the same genotype


      CaseGenotypingMethod: DNA was collected from the participants using blood samples. 18 genes suspected on contributing to HCM were targeted and sequenced. The variants were then located and filtered for pathogenicity.


      Variant: NM_000257.3:c.727C>T (p.Arg243Cys)

      ClinVar: 43101 https://www.ncbi.nlm.nih.gov/clinvar/variation/43101/

      gnomAD: European (Non-Finnish) 6.482e-5, Overall 3.184e-5 https://gnomad.broadinstitute.org/variant/14-23900799-G-A

    2. CasePT-30: United States

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: HP:0001650, HP:0001658 (Aortic valve stenosis, Myocardial infarction)

      NotHPOsFreeText: N/A

      CaseAddInfo:


      CaseGenotypingMethod: DNA was collected from the participants using blood samples. 18 genes suspected on contributing to HCM were targeted and sequenced. The variants were then located and filtered for pathogenicity.


      Variant: NM_000257.3:c.2606G>A (p.Arg869His)

      ClinVar: 177667 https://www.ncbi.nlm.nih.gov/clinvar/variation/177667/

      gnomAD: African 1.230e-4, Overall 2.386e-5 https://gnomad.broadinstitute.org/variant/14-23894051-C-T

    3. CasePT-76: United States

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: HP:0001650, HP:0001658 (Aortic valve stenosis, Myocardial infarction)

      NotHPOsFreeText: N/A

      CaseAddInfo:


      CaseGenotypingMethod: DNA was collected from the participants using blood samples. 18 genes suspected on contributing to HCM were targeted and sequenced. The variants were then located and filtered for pathogenicity.


      Variant: NM_000257.3:c.2334C>G (p.Asp778Glu)

      ClinVar: 265252 https://www.ncbi.nlm.nih.gov/clinvar/variation/265252/

      gnomAD: Not in gnomAD

    4. CasePT-97: United States

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: HP:0001650, HP:0001658 (Aortic valve stenosis, Myocardial infarction)

      NotHPOsFreeText: N/A

      CaseAddInfo:


      CaseGenotypingMethod: DNA was collected from the participants using blood samples. 18 genes suspected on contributing to HCM were targeted and sequenced. The variants were then located and filtered for pathogenicity.


      Variant: NM_000257.3:c.4159G>A (p.Glu1387Lys)

      ClinVar: 181244 https://www.ncbi.nlm.nih.gov/clinvar/variation/181244/

      gnomAD: South Asian 3.266e-5, Overall 3.977e-6 https://gnomad.broadinstitute.org/variant/14-23887429-C-T

    5. CasePT-62: United States

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: HP:0001650, HP:0001658 (Aortic valve stenosis, Myocardial infarction)

      NotHPOsFreeText: N/A

      CaseAddInfo:


      CaseGenotypingMethod: DNA was collected from the participants using blood samples. 18 genes suspected on contributing to HCM were targeted and sequenced. The variants were then located and filtered for pathogenicity.


      Variant: NM_000257.3:c.1370T>C (p.Ile457Thr)

      ClinVar: 42840 https://www.ncbi.nlm.nih.gov/clinvar/variation/42840/

      gnomAD: European (Non-Finnish) 8.790e-6, Overall 3.976e-6 https://gnomad.broadinstitute.org/variant/14-23898201-A-G

    1. Family B, II:1

      CaseBII-1: Male, 23 years diagnosis, China, Asian

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: No family history, pedigree provided

      CasePresentingHPOs: HP:0001639, HP:0100749 (Hypertrophic cardiomyopathy, Chest pain)

      HPOsFreeText: Interventricular septal thickness at 15.6 mm, Left ventricular posterior wall thickness at 12.1 mm

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: Parents tested negative for variant, therefore it is asserted as de novo

      CasePreviousTesting: See list of sequenced genes

      CaseGenotypingMethod: Genomic DNA was isolated from whole blood of all patients and controls. Whole coding exons and exon-intron boundaries of the 19 HCM-related genes listed above were amplified and sequenced on Ion Torrent PGM. These variants were then filtered for pathogenicity and compared to the controls. Any mutations found were confirmed by conventional dideoxy sequencing and Sanger sequencing.

      Variant: NM_000257.3:c.2572C>T (p.Arg858Cys)

      ClinVar: 164324 https://www.ncbi.nlm.nih.gov/clinvar/variation/164324/

      gnomAD: Not in gnomAD

    2. A14

      CaseA14: Female, 44 years report, China, Asian

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: No family history

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: Interventricular septal thickness at 17.6 mm, Left ventricular posterior wall thickness at 8.8 mm, Left ventricular end-diastolic diameter at 42.7 mm, Left ventricular septal thickness at 36.6 mm, Left ventricular ejection fraction at 68%

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CasePreviousTesting: See list of sequenced genes

      CaseGenotypingMethod: Genomic DNA was isolated from whole blood of all patients and controls. Whole coding exons and exon-intron boundaries of the 19 HCM-related genes listed above were amplified and sequenced on Ion Torrent PGM. These variants were then filtered for pathogenicity and compared to the controls. Any mutations found were confirmed by conventional dideoxy sequencing and Sanger sequencing.

      Variant: NM_000257.3:c.161G>A (p.Arg54Gln)

      ClinVar: 42856 https://www.ncbi.nlm.nih.gov/clinvar/variation/42856/

      gnomAD: East Asian 2.506e-4, Overall 2.475e-5 https://gnomad.broadinstitute.org/variant/14-23902781-C-T

    1. CaseST4-91: Sweden

      DiseaseAssertion: Idiopathic Dilated Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001644 (Dilated cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: HP:0002140, HP:0000822, HP:0001654, HP:0030955, HP:0000819, HP:0002666, HP:0000845, HP:0000820 (Ischemic stroke, Hypertension, Valvular heart disease, Alcoholism, Diabetes mellitus, Pheochromocytoma, Acromegaly, Thyroid disease)

      NotHPOsFreeText: Patients were excluded for significant systemic infection, systemic diseases, previous cancer treatment including irradiation, and tachycardia-induced cardiomyopathy or other primary cardiomyopathy.

      CaseAddInfo: N/A

      CasePreviousTesting: See Supplemental Table 1

      CaseGenotypingMethod: Genomic DNA was extracted from the patients. 41 exons of previously-reported genes that were reported in DCM patients were amplified and directly sequenced. Afterwards, the variants were aligned and sorted for pathogenicity.

      Variant: NM_000257.3:c.1113G>C (p.Glu371Asp)

      CAID: CA389051328 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000257.3%3Ac.1113G%3EC

      gnomAD: Not in gnomAD

    1. CaseIP-2: Male, Taiwan, Birth diagnosis

      HPOsFreeText: 4MU enzyme activity at 0.43, MS/MS ennzyme activity at 0.13

      GenotypingMethod: GAA Gene Sequencing and PCR Amplification


      Variant in literature as c.1396C>T, however the reference has G there. Corrected for poossible typo.

      Variant1: NM_000152.4:c.1396G>T (p.Val466Phe)

      CAID: CA401366509 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.1396G%3ET

      gnomAD: Not in gnomAD


      Variant2: NM_000152.4:c.1935C>A (p.Asp645Glu)

      ClinVar: 4029 https://www.ncbi.nlm.nih.gov/clinvar/variation/4029/

      gnomAD: East Asian 1.729e-3, Overall 1.240e-4 http://gnomad.broadinstitute.org/variant/17-78086721-C-A


      CaseAddInfo: Infantile Onset Pompe Disease

    2. CaseLP2-2: Female, Taiwan, Birth diagnosis

      HPOsFreeText: GAA (MS/MS) enzyme activity at 0.08 umol/hr/L, Serum CK at 109 U/L

      GenotypingMethod: GAA Gene Sequencing and PCR Amplification


      Variant1: NM_000152.4:c.424_440del17 (p.Ser142Leufs*29)

      CAID: CA658795228 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.424_440del17

      gnomAD: Not in gnomAD


      Variant2: NM_000152.4:c.1958C>A (p.Thr653Asn)

      CAID: CA8815557 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.1958C%3EA

      gnomAD: East Asian 2.548e-4, Overall 1.825e-5 http://gnomad.broadinstitute.org/variant/17-78086744-C-A


      CaseAddInfo: Late Onset Pompe Disease

    3. CaseIP2-11: Male, Taiwan, Birth diagnosis

      HPOsFreeText: GAA (MS/MS) enzyme activity at 0.15 umol/hr/L, Serum CK at 662 U/L

      GenotypingMethod: GAA Gene Sequencing and PCR Amplification


      Variant1: NM_000152.4:c.1935C>A (p.Asp645Glu)

      ClinVar: 4029 https://www.ncbi.nlm.nih.gov/clinvar/variation/4029/

      gnomAD: East Asian 1.729e-3, Overall 1.240e-4 http://gnomad.broadinstitute.org/variant/17-78086721-C-A


      Variant2: NM_000152.4:c.1726G>A (p.Gly576Ser)

      ClinVar: 92467 https://www.ncbi.nlm.nih.gov/clinvar/variation/92467/

      gnomAD: East Asian 0.1427, Overall 0.01700 http://gnomad.broadinstitute.org/variant/17-78085871-G-A


      Variant3: NM_000152.4:c.2303C>T (p.Pro768Leu)

      CAID: CA401324900 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.2303C%3ET

      gnomAD: Not in gnomAD


      CaseAddInfo: Infantile Onset Pompe Disease, Nomenclature indicates that Variant 1 and 3 are in trans and that 2 is in cis with one of them

    4. CaseOPOPD-47: Male, Taiwan, Birth diagnosis

      HPOsFreeText: GAA (MS/MS) enzyme activity at 0.83 umol/hr/L

      GenotypingMethod: GAA Gene Sequencing and PCR Amplification


      Variant1: NM_000152.4:c.1461C>G (p.Phe487Leu)

      CAID: CA401366857 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.1461C%3EG

      gnomAD: Not in gnomAD


      Variant2: NM_000152.4:c.1726G>A (p.Gly576Ser)

      ClinVar: 92467 https://www.ncbi.nlm.nih.gov/clinvar/variation/92467/

      gnomAD: East Asian 0.1427, Overall 0.01700 http://gnomad.broadinstitute.org/variant/17-78085871-G-A


      CaseAddInfo: One Pompe Mutation allele and One Pseudodeficency Mutation allele

    5. CaseOPOPD-52: Female, Taiwan, Birth diagnosis

      HPOsFreeText: GAA (MS/MS) enzyme activity at 1.13 umol/hr/L

      GenotypingMethod: GAA Gene Sequencing and PCR Amplification


      Variant1: NM_000152.4:c.1726G>A (p.Gly576Ser)

      ClinVar: 92467 https://www.ncbi.nlm.nih.gov/clinvar/variation/92467/

      gnomAD: East Asian 0.1427, Overall 0.01700 http://gnomad.broadinstitute.org/variant/17-78085871-G-A


      Variant2: NM_000152.4:c.1850T>G (p.Val617Gly)

      CAID: CA401369628 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.1850T%3EG

      gnomAD: Not in gnomAD


      CaseAddInfo: One Pompe Mutation allele and One Pseudodeficency Mutation allele

    6. CaseOPOPD-72: Male, Taiwan, Birth diagnosis

      HPOsFreeText: GAA (MS/MS) enzyme activity at 1.31 umol/hr/L

      GenotypingMethod: GAA Gene Sequencing and PCR Amplification


      Variant1: NM_000152.4:c.1726G>A (p.Gly576Ser)

      ClinVar: 92467 https://www.ncbi.nlm.nih.gov/clinvar/variation/92467/

      gnomAD: East Asian 0.1427, Overall 0.01700 http://gnomad.broadinstitute.org/variant/17-78085871-G-A


      Variant2: NM_000152.4:c.2662G>T (p.Glu888Ter)

      ClinVar: 578595 https://www.ncbi.nlm.nih.gov/clinvar/variation/578595/

      gnomAD: East Asian 2.719e-4, Overall 1.998e-5 http://gnomad.broadinstitute.org/variant/17-78092467-G-T


      CaseAddInfo: One Pompe Mutation allele and One Pseudodeficency Mutation allele, 2 other patients have the same genotype

    7. CaseOPOPD-38: Female, Taiwan, Birth diagnosis

      HPOsFreeText: GAA (MS/MS) enzyme activity at 0.56 umol/hr/L

      GenotypingMethod: GAA Gene Sequencing and PCR Amplification


      Variant1: NM_000152.4:c.784G>A (p.Glu262Lys)

      ClinVar: 188806 https://www.ncbi.nlm.nih.gov/clinvar/variation/188806/

      gnomAD: East Asian 5.016e-5, Overall 1.417e-5 http://gnomad.broadinstitute.org/variant/17-78081447-G-A


      Variant2: NM_000152.4:c.1726G>A (p.Gly576Ser)

      ClinVar: 92467 https://www.ncbi.nlm.nih.gov/clinvar/variation/92467/

      gnomAD: East Asian 0.1427, Overall 0.01700 http://gnomad.broadinstitute.org/variant/17-78085871-G-A


      CaseAddInfo: One Pompe Mutation allele and One Pseudodeficency Mutation allele

    8. CaseOPTPD-1: Female, Taiwan, Birth diagnosis

      HPOsFreeText: GAA (MS/MS) enzyme activity at 1.47 umol/hr/L

      GenotypingMethod: GAA Gene Sequencing and PCR Amplification


      Variant1: NM_000152.4:c.1726G>A (p.Gly576Ser)

      ClinVar: 92467 https://www.ncbi.nlm.nih.gov/clinvar/variation/92467/

      gnomAD: East Asian 0.1427, Overall 0.01700 http://gnomad.broadinstitute.org/variant/17-78085871-G-A


      Variant2: NM_000152.4:c.546+5G>T

      ClinVar: 557811 https://www.ncbi.nlm.nih.gov/clinvar/variation/557811/

      gnomAD: East Asian 4.978e-4, Overall 3.824e-5 http://gnomad.broadinstitute.org/variant/17-78078936-G-T


      CaseAddInfo: One Pompe Mutation allele and Two Pseudodeficency Mutation alleles, Nomenclature indicates patient is homozygous for Variant 1 and Variant 2 is in cis with only one copy, 2 other patients have the same genotype

    9. CaseIP2-4: Female, Taiwan, Birth diagnosis

      HPOsFreeText: GAA (MS/MS) enzyme activity at 0.08 umol/hr/L, Serum CK at 385 U/L

      GenotypingMethod: GAA Gene Sequencing and PCR Amplification


      Variant1: NM_000152.4:c.1194+2T>C

      ClinVar: 370077 https://www.ncbi.nlm.nih.gov/clinvar/variation/370077/

      gnomAD: Not in gnomAD


      Variant2: NM_000152.4:c.1935C>A (p.Asp645Glu)

      ClinVar: 4029 https://www.ncbi.nlm.nih.gov/clinvar/variation/4029/

      gnomAD: East Asian 1.729e-3, Overall 1.240e-4 http://gnomad.broadinstitute.org/variant/17-78086721-C-A


      Variant3: NM_000152.4:c.1726G>A (p.Gly576Ser)

      ClinVar: 92467 https://www.ncbi.nlm.nih.gov/clinvar/variation/92467/

      gnomAD: East Asian 0.1427, Overall 0.01700 http://gnomad.broadinstitute.org/variant/17-78085871-G-A


      CaseAddInfo: Infantile Onset Pompe Disease, Nomenclature indicates Variant 1 and 2 are in trans, also that Variant 3 is in cis with only one of them

    10. CaseOPM-2: Male, Taiwan, Birth diagnosis

      HPOsFreeText: GAA (MS/MS) enzyme activity at 1.34 umol/hr/L

      GenotypingMethod: GAA Gene Sequencing and PCR Amplification


      Variant1: NM_000152.4:c.693-5C>T

      CAID: CA8814990 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.693-5C%3ET

      gnomAD: East Asian 3.516e-4, Overall 3.900e-5 http://gnomad.broadinstitute.org/variant/17-78081351-C-T


      Variant2: NM_000152.4:c.1726G>A (p.Gly576Ser)

      ClinVar: 92467 https://www.ncbi.nlm.nih.gov/clinvar/variation/92467/

      gnomAD: East Asian 0.1427, Overall 0.01700 http://gnomad.broadinstitute.org/variant/17-78085871-G-A


      CaseAddInfo: One Pompe Mutation, Nomenclature indicates Variants 1 and 2 are in cis and the other allele is Wildtype

    11. CaseLP2-10: Male, Taiwan, Birth diagnosis

      HPOsFreeText: GAA (MS/MS) enzyme activity at 0.06 umol/hr/L, Serum CK at 670 U/L

      GenotypingMethod: GAA Gene Sequencing and PCR Amplification


      Variant1: NM_000152.4:c.752C>T (p.Ser251Leu)

      ClinVar: 325781 https://www.ncbi.nlm.nih.gov/clinvar/variation/325781/

      gnomAD: East Asian 2.760e-3, Overall 3.540e-4 http://gnomad.broadinstitute.org/variant/17-78081415-C-T


      Variant2: NM_000152.4:c.761C>T (p.Ser254Leu)

      ClinVar: 325782 https://www.ncbi.nlm.nih.gov/clinvar/variation/325782/

      gnomAD: East Asian 2.759e-3, Overall 1.947e-4 http://gnomad.broadinstitute.org/variant/17-78081424-C-T


      Variant3: NM_000152.4:c.2662G>T (p.Glu888Ter)

      ClinVar: 578595 https://www.ncbi.nlm.nih.gov/clinvar/variation/578595/

      gnomAD: East Asian 2.719e-4, Overall 1.998e-5 http://gnomad.broadinstitute.org/variant/17-78092467-G-T


      CaseAddInfo: Late Onset Pompe Disease, Nomenclature indicates Variants 1 and 2 are in cis

    12. CaseOPOPD-10: Male, Taiwan, Birth diagnosis

      HPOsFreeText: GAA (MS/MS) enzyme activity at 1.34 umol/hr/L

      GenotypingMethod: GAA Gene Sequencing and PCR Amplification


      Variant1: NM_000152.4:c.693-5C>T

      ClinVar: CA8814990 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.693-5C%3ET

      gnomAD: East Asian 3.516e-4, Overall 3.900e-5 http://gnomad.broadinstitute.org/variant/17-78081351-C-T


      Variant2: NM_000152.4:c.1726G>A (p.Gly576Ser)

      ClinVar: 92467 https://www.ncbi.nlm.nih.gov/clinvar/variation/92467/

      gnomAD: East Asian 0.1427, Overall 0.01700 http://gnomad.broadinstitute.org/variant/17-78085871-G-A


      CaseAddInfo: One Pompe Mutation and One Pseudodeficency Mutation

    13. CaseLP2-7: Male, Taiwan, Birth diagnosis

      HPOsFreeText: GAA (MS/MS) enzyme activity at 0.22 umol/hr/L, Serum CK at 89 U/L

      GenotypingMethod: GAA Gene Sequencing and PCR Amplification


      Variant1: NM_000152.4:c.752C>T (p.Ser251Leu)

      ClinVar: 325781 https://www.ncbi.nlm.nih.gov/clinvar/variation/325781/

      gnomAD: East Asian 2.760e-3, Overall 3.540e-4 http://gnomad.broadinstitute.org/variant/17-78081415-C-T


      Variant2: NM_000152.4:c.761C>T (p.Ser254Leu)

      ClinVar: 325782 https://www.ncbi.nlm.nih.gov/clinvar/variation/325782/

      gnomAD: East Asian 2.759e-3, Overall 1.947e-4 http://gnomad.broadinstitute.org/variant/17-78081424-C-T


      Variant3: NM_000152.4:c.1054C>T (p.Gln352Ter)

      CAID: CA294891876 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA294891876

      gnomAD: Not in gnomAD


      CaseAddInfo: Late Onset Pompe Disease, Nomenclature indicates Variants 1 and 2 are in cis

    14. CaseOPOPD-67: Female, Taiwan, Birth diagnosis

      HPOsFreeText: GAA (MS/MS) enzyme activity at 0.93 umol/hr/L

      GenotypingMethod: GAA Gene Sequencing and PCR Amplification


      Variant1: NM_000152.4:c.1726G>A (p.Gly576Ser)

      ClinVar: 92467 https://www.ncbi.nlm.nih.gov/clinvar/variation/92467/

      gnomAD: East Asian 0.1427, Overall 0.01700 http://gnomad.broadinstitute.org/variant/17-78085871-G-A


      Variant2: NM_000152.4:c.2236T>G (p.Trp746Gly)

      ClinVar: 556431 https://www.ncbi.nlm.nih.gov/clinvar/variation/556431/

      gnomAD: East Asian 6.410e-4, Overall 3.186e-5 http://gnomad.broadinstitute.org/variant/17-78090813-T-G


      CaseAddInfo: One Pompe Mutation allele and One Pseudodeficency Mutation allele, 2 other patients have this genotype

    15. CaseOPM-1: Male, Taiwan, Birth diagnosis

      HPOsFreeText: GAA (MS/MS) enzyme activity at 0.97 umol/hr/L

      GenotypingMethod: GAA Gene Sequencing and PCR Amplification


      Variant1: NM_000152.4:c.1935C>A (p.Asp645Glu)

      ClinVar: 4029 https://www.ncbi.nlm.nih.gov/clinvar/variation/4029/

      gnomAD: East Asian 1.729e-3, Overall 1.240e-4 http://gnomad.broadinstitute.org/variant/17-78086721-C-A


      Variant2: NM_000152.4:c.1726G>A (p.Gly576Ser)

      ClinVar: 92467 https://www.ncbi.nlm.nih.gov/clinvar/variation/92467/

      gnomAD: East Asian 0.1427, Overall 0.01700 http://gnomad.broadinstitute.org/variant/17-78085871-G-A


      CaseAddInfo: One Pompe Mutation, Nomenclature indicates Variants 1 and 2 are in cis and the other allele is Wildtype

    16. CaseIP2-6: Female, Taiwan, Birth diagnosis

      HPOsFreeText: GAA (MS/MS) enzyme activity at 0.02 umol/hr/L, Serum CK at 709 U/L

      GenotypingMethod: GAA Gene Sequencing and PCR Amplification


      Variant1: NM_000152.4:c.1935C>A (p.Asp645Glu)

      ClinVar: 4029 https://www.ncbi.nlm.nih.gov/clinvar/variation/4029/

      gnomAD: East Asian 1.729e-3, Overall 1.240e-4 http://gnomad.broadinstitute.org/variant/17-78086721-C-A


      Variant2: NM_000152.4:c.1726G>A (p.Gly576Ser)

      ClinVar: 92467 https://www.ncbi.nlm.nih.gov/clinvar/variation/92467/

      gnomAD: East Asian 0.1427, Overall 0.01700 http://gnomad.broadinstitute.org/variant/17-78085871-G-A


      CaseAddInfo: Infantile Onset Pompe Disease, Nomenclature indicates that Variant 1 and 2 are in cis and the patient is homozygous for this allele, 2 more patients also have the same genotype

    1. 20 mg/kg (N = 16)

      Case8HPOsFreeText: 20 mg/kg GAA treatment, GAA activity at 8 pmol/punch/hr, GAA activity at 33% lower limit of normal

      CaseAddInfo: Late Onset Pompe Disease


      CaseGenotypingMethod: Method not described, only that the diagnosis was "confirmed … based on 2 GAA gene mutations"


      Variant1: NM_000152.4:c.-32-13T>G

      ClinVar: 4027 https://www.ncbi.nlm.nih.gov/clinvar/variation/4027/

      gnomAD: Ashkenazi Jewish 5.541e-3, Overall 3.401e-3 https://gnomad.broadinstitute.org/variant/17-78078341-T-G


      Variant2: NM_000152.4:c.2242dupG (p.Glu748Glyfs)

      ClinVar: 370651 https://www.ncbi.nlm.nih.gov/clinvar/variation/370651/

      gnomAD: European (Non-Finnish) 1.767e-5, Overall 7.975e-6 https://gnomad.broadinstitute.org/variant/17-78090813-T-TG


      CaseAddInfo:

    2. 20 mg/kg (N = 16)

      Case14HPOsFreeText: 20 mg/kg GAA treatment, GAA activity at 0.1 umol/h/L, GAA activity at 33% lower limit of normal

      CaseAddInfo: Late Onset Pompe Disease


      CaseGenotypingMethod: Method not described, only that the diagnosis was "confirmed … based on 2 GAA gene mutations"


      Variant1: NM_000152.4:c.-32-13T>G

      ClinVar: 4027 https://www.ncbi.nlm.nih.gov/clinvar/variation/4027/

      gnomAD: Ashkenazi Jewish 5.541e-3, Overall 3.401e-3 https://gnomad.broadinstitute.org/variant/17-78078341-T-G


      Variant2: NM_000152.4:c.1441T>C (p.Trp481Arg)

      ClinVar: 189007 https://www.ncbi.nlm.nih.gov/clinvar/variation/189007/

      gnomAD: African 8.031e-5, Overall 2.126e-5 https://gnomad.broadinstitute.org/variant/17-78084529-T-C


      CaseAddInfo:

    1. c.1942G > A(p.Gly648Ser)

      Case34

      HPOsFreeText: See Group Phenotypes


      CasePreviousTesting: Sanger sequencing

      CaseMethod1: Sanger sequencing and PCR Amplification

      CaseMethod2: Whole Exome Sequencing (WES)

      CaseGenotypingMethod: Patients were previously confirmed with Pompe disease by Sanger sequencing to capture the pathogenic variants. The process was repeated as part of the study taking care to amplify the coding regions and exon/intron boundaries to compare with the WES results afterwards.


      Variant: NM_000152.4:c.1942G>A (p.Gly648Ser)

      ClinVar: 188902 https://www.ncbi.nlm.nih.gov/clinvar/variation/188902/

      gnomAD: South Asian 3.365e-4, Overall 5.361e-5 http://gnomad.broadinstitute.org/variant/17-78086728-G-A


      CaseAddInfo: Infantile Onset Pompe Disease, Patient is homozygous for this variant

    2. c.1796C > A(p.Ser599Tyr)

      Case56

      HPOsFreeText: See Group Phenotypes


      CasePreviousTesting: Sanger sequencing

      CaseMethod1: Sanger sequencing and PCR Amplification

      CaseMethod2: Whole Exome Sequencing (WES)

      CaseGenotypingMethod: Patients were previously confirmed with Pompe disease by Sanger sequencing to capture the pathogenic variants. The process was repeated as part of the study taking care to amplify the coding regions and exon/intron boundaries to compare with the WES results afterwards.


      Variant1: NM_000152.4:c.1796C>A (p.Ser599Tyr)

      ClinVar: 551558 https://www.ncbi.nlm.nih.gov/clinvar/variation/551558/

      gnomAD: European (Non-Finnish) 2.683e-5, Overall 1.207e-5 http://gnomad.broadinstitute.org/variant/17-78086418-C-A


      Variant2: NM_000152.4:c.-32-13T>G

      ClinVar: 4027 https://www.ncbi.nlm.nih.gov/clinvar/variation/4027/

      gnomAD: Ashkenazi Jewish 5.541e-3, Overall 3.401e-3 http://gnomad.broadinstitute.org/variant/17-78078341-T-G


      CaseAddInfo: Juvenile Late Onset Pompe Disease

    3. c.784G > A(p.Glu262Lys)

      Case85

      HPOsFreeText: See Group Phenotypes


      CasePreviousTesting: Sanger sequencing

      CaseMethod1: Sanger sequencing and PCR Amplification

      CaseMethod2: Whole Exome Sequencing (WES)

      CaseGenotypingMethod: Patients were previously confirmed with Pompe disease by Sanger sequencing to capture the pathogenic variants. The process was repeated as part of the study taking care to amplify the coding regions and exon/intron boundaries to compare with the WES results afterwards.


      Variant1: NM_000152.4:c.784G>A (p.Glu262Lys)

      ClinVar: 188806 https://www.ncbi.nlm.nih.gov/clinvar/variation/188806/

      gnomAD: East Asian 5.016e-5, Overall 1.417e-5 http://gnomad.broadinstitute.org/variant/17-78081447-G-A


      Variant2: NM_000152.4:c.-32-13T>G

      ClinVar: 4027 https://www.ncbi.nlm.nih.gov/clinvar/variation/4027/

      gnomAD: Ashkenazi Jewish 5.541e-3, Overall 3.401e-3 http://gnomad.broadinstitute.org/variant/17-78078341-T-G


      CaseAddInfo: Adult Late Onset Pompe Disease, 2 other patients have the same genotype

    4. c.1978C > T(p.Arg660Cys)

      Case10

      HPOsFreeText: See Group Phenotypes


      CasePreviousTesting: Sanger sequencing

      CaseMethod1: Sanger sequencing and PCR Amplification

      CaseMethod2: Whole Exome Sequencing (WES)

      CaseGenotypingMethod: Patients were previously confirmed with Pompe disease by Sanger sequencing to capture the pathogenic variants. The process was repeated as part of the study taking care to amplify the coding regions and exon/intron boundaries to compare with the WES results afterwards.


      Variant1: NM_000152.4:c.1978C>T (p.Arg660Cys)

      ClinVar: 558604 https://www.ncbi.nlm.nih.gov/clinvar/variation/558604/

      gnomAD: East Asian 5.554e-5, Overall 4.142e-6 http://gnomad.broadinstitute.org/variant/17-78086764-C-T


      Variant2: NM_000152.4:c.2221G>A (p.Asp741Asn)

      ClinVar: 571521 https://www.ncbi.nlm.nih.gov/clinvar/variation/571521/

      gnomAD: East Asian 1.087e-4, Overall 7.971e-6 http://gnomad.broadinstitute.org/variant/17-78090798-G-A


      CaseAddInfo: Infantile Onset Pompe Disease

    5. c.1075G > T(p.Gly359*)

      Case1

      HPOsFreeText: See Group Phenotypes


      CasePreviousTesting: Sanger sequencing

      CaseMethod1: Sanger sequencing and PCR Amplification

      CaseMethod2: Whole Exome Sequencing (WES)

      CaseGenotypingMethod: Patients were previously confirmed with Pompe disease by Sanger sequencing to capture the pathogenic variants. The process was repeated as part of the study taking care to amplify the coding regions and exon/intron boundaries to compare with the WES results afterwards.


      Variant: NM_000152.4:c.1075G>T (p.Gly359Ter)

      ClinVar: 420101 https://www.ncbi.nlm.nih.gov/clinvar/variation/420101/

      gnomAD: Not in gnomAD


      CaseAddInfo: Infantile Onset Pompe Disease, Patient is homozygous for this variant

    6. c.1411_1414del4(p.Glu471fs*5)

      Case27

      HPOsFreeText: See Group Phenotypes


      CasePreviousTesting: Sanger sequencing

      CaseMethod1: Sanger sequencing and PCR Amplification

      CaseMethod2: Whole Exome Sequencing (WES)

      CaseGenotypingMethod: Patients were previously confirmed with Pompe disease by Sanger sequencing to capture the pathogenic variants. The process was repeated as part of the study taking care to amplify the coding regions and exon/intron boundaries to compare with the WES results afterwards.


      Variant1: NM_000152.4:c.1411_1414delGAGA (p.Glu471fs*5)

      ClinVar: 188874 https://www.ncbi.nlm.nih.gov/clinvar/variation/188874/

      gnomAD: East Asian 2.513e-4, Overall 1.781e-5 http://gnomad.broadinstitute.org/variant/17-78083827-CGAGA-C


      Significance of this variant is unknown.

      Variant2: NM_000152.4:c.460_465del (Arg154_Thre155del)

      ClinVar: 551306 https://www.ncbi.nlm.nih.gov/clinvar/variation/551306/

      gnomAD: Not in gnomAD


      CaseAddInfo: Infantile Onset Pompe Disease

    7. c.2481+102_2646+31del (p.Gly828_Asn882del)

      Case39

      HPOsFreeText: See Group Phenotypes


      CasePreviousTesting: Sanger sequencing

      CaseMethod1: Sanger sequencing and PCR Amplification

      CaseMethod2: Whole Exome Sequencing (WES)

      CaseGenotypingMethod: Patients were previously confirmed with Pompe disease by Sanger sequencing to capture the pathogenic variants. The process was repeated as part of the study taking care to amplify the coding regions and exon/intron boundaries to compare with the WES results afterwards.


      Variant1: NM_000152.4:c.2481+102_2646+31del (p.Gly828_Asn882del) (exon 18 del)

      ClinVar: 4031 https://www.ncbi.nlm.nih.gov/clinvar/variation/4031/

      gnomAD: Not in gnomAD


      Variant2: NM_000152.4:c.525delT (p.Glu176Argfs*45)

      CAID: 4033 https://www.ncbi.nlm.nih.gov/clinvar/variation/4033/

      gnomAD: European (Non-Finnish) 1.880e-4, Overall 9.959e-5 http://gnomad.broadinstitute.org/variant/17-78078909-CT-C


      CaseAddInfo: Infantile Onset Pompe Disease, 1 more patient has the same genotype

    8. c.-32-17_-32-10delins TCCCTGCTGAGCCTCCTACAGGCCTCCCGC

      Case49

      HPOsFreeText: See Group Phenotypes


      CasePreviousTesting: Sanger sequencing

      CaseMethod1: Sanger sequencing and PCR Amplification

      CaseMethod2: Whole Exome Sequencing (WES)

      CaseGenotypingMethod: Patients were previously confirmed with Pompe disease by Sanger sequencing to capture the pathogenic variants. The process was repeated as part of the study taking care to amplify the coding regions and exon/intron boundaries to compare with the WES results afterwards.


      Variant1: NM_000152.4:c.-32-17_-32-10delins TCCCTGCTGAGCCTCCTACAGGCCTCCCGC

      CAID: CA913184750 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA913184750

      gnomAD: Not in gnomAD


      Variant2: NM_000152.4:c.1447G>A (p.Gly483Arg)

      ClinVar: 285157 https://www.ncbi.nlm.nih.gov/clinvar/variation/285157/

      gnomAD: African 6.170e-5, Overall 7.972e-6 http://gnomad.broadinstitute.org/variant/17-78084535-G-A


      CaseAddInfo: Infantile Onset Pompe Disease

    9. c.2560C > T(p.Arg854*)

      Case77

      HPOsFreeText: See Group Phenotypes


      CasePreviousTesting: Sanger sequencing

      CaseMethod1: Sanger sequencing and PCR Amplification

      CaseMethod2: Whole Exome Sequencing (WES)

      CaseGenotypingMethod: Patients were previously confirmed with Pompe disease by Sanger sequencing to capture the pathogenic variants. The process was repeated as part of the study taking care to amplify the coding regions and exon/intron boundaries to compare with the WES results afterwards.


      Variant1: NM_000152.4:c.2560C>T (p.Arg854*)

      ClinVar: 4034 https://www.ncbi.nlm.nih.gov/clinvar/variation/4034/

      gnomAD: African 1.891e-3, Overall 2.090e-4 http://gnomad.broadinstitute.org/variant/17-78092070-C-T


      Variant2: NM_000152.4:c.-32-13T>G

      ClinVar: 4027 https://www.ncbi.nlm.nih.gov/clinvar/variation/4027/

      gnomAD: Ashkenazi Jewish 5.541e-3, Overall 3.401e-3 http://gnomad.broadinstitute.org/variant/17-78078341-T-G


      CaseAddInfo: Adult Late Onset Pompe Disease

    10. c.1327-2A > C

      Case30

      HPOsFreeText: See Group Phenotypes


      CasePreviousTesting: Sanger sequencing

      CaseMethod1: Sanger sequencing and PCR Amplification

      CaseMethod2: Whole Exome Sequencing (WES)

      CaseGenotypingMethod: Patients were previously confirmed with Pompe disease by Sanger sequencing to capture the pathogenic variants. The process was repeated as part of the study taking care to amplify the coding regions and exon/intron boundaries to compare with the WES results afterwards.


      Variant: NM_000152.4:c.1327-2A>C

      CAID: CA401366173 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.1327-2A%3EC

      gnomAD: Not in gnomAD


      CaseAddInfo: Infantile Onset Pompe Disease, Patient is homozygous for this variant

    11. c.1655T > C(p.Leu552Pro)

      Case53

      HPOsFreeText: See Group Phenotypes


      CasePreviousTesting: Sanger sequencing

      CaseMethod1: Sanger sequencing and PCR Amplification

      CaseMethod2: Whole Exome Sequencing (WES)

      CaseGenotypingMethod: Patients were previously confirmed with Pompe disease by Sanger sequencing to capture the pathogenic variants. The process was repeated as part of the study taking care to amplify the coding regions and exon/intron boundaries to compare with the WES results afterwards.


      Variant: NM_000152.4:c.1655T>C (p.Leu552Pro)

      ClinVar: 279811 https://www.ncbi.nlm.nih.gov/clinvar/variation/279811/

      gnomAD: European (Non-Finnish) 7.053e-5, Overall 3.188e-5 http://gnomad.broadinstitute.org/variant/17-78085800-T-C


      CaseAddInfo: Juvenile Late Onset Pompe Disease

    12. c.1143delC(p.Ala382Leufs*10)

      Case58

      HPOsFreeText: See Group Phenotypes


      CasePreviousTesting: Sanger sequencing

      CaseMethod1: Sanger sequencing and PCR Amplification

      CaseMethod2: Whole Exome Sequencing (WES)

      CaseGenotypingMethod: Patients were previously confirmed with Pompe disease by Sanger sequencing to capture the pathogenic variants. The process was repeated as part of the study taking care to amplify the coding regions and exon/intron boundaries to compare with the WES results afterwards.


      Variant1: NM_000152.4:c.1143delC (p.Ala382Leufs*10)

      CAID: 370263 https://www.ncbi.nlm.nih.gov/clinvar/variation/370263/

      gnomAD: European (Non-Finnish) 8.946e-6, Overall 4.031e-6 http://gnomad.broadinstitute.org/variant/17-78082353-AC-A


      Variant2: NM_000152.4:c.-32-13T>G

      ClinVar: 4027 https://www.ncbi.nlm.nih.gov/clinvar/variation/4027/

      gnomAD: Ashkenazi Jewish 5.541e-3, Overall 3.401e-3 http://gnomad.broadinstitute.org/variant/17-78078341-T-G


      CaseAddInfo: Adult Late Onset Pompe Disease

    13. c.1933G > A(p.Asp645Asn)

      Case32

      HPOsFreeText: See Group Phenotypes


      CasePreviousTesting: Sanger sequencing

      CaseMethod1: Sanger sequencing and PCR Amplification

      CaseMethod2: Whole Exome Sequencing (WES)

      CaseGenotypingMethod: Patients were previously confirmed with Pompe disease by Sanger sequencing to capture the pathogenic variants. The process was repeated as part of the study taking care to amplify the coding regions and exon/intron boundaries to compare with the WES results afterwards.


      Variant: NM_000152.4:c.1933G>A (p.Asp645Asn)

      ClinVar: 188728 https://www.ncbi.nlm.nih.gov/clinvar/variation/188728/

      gnomAD: African 6.599e-5, Overall 8.250e-6 http://gnomad.broadinstitute.org/variant/17-78086719-G-A


      CaseAddInfo: Infantile Onset Pompe Disease, Patient is homozygous for this variant, 1 more patient has the same genotype

    14. c.148_859-11del(p.Glu50Hisfs*37; exons2–4deletion)

      Case4

      HPOsFreeText: See Group Phenotypes


      CasePreviousTesting: Sanger sequencing

      CaseMethod1: Sanger sequencing and PCR Amplification

      CaseMethod2: Whole Exome Sequencing (WES)

      CaseGenotypingMethod: Patients were previously confirmed with Pompe disease by Sanger sequencing to capture the pathogenic variants. The process was repeated as part of the study taking care to amplify the coding regions and exon/intron boundaries to compare with the WES results afterwards.


      Variant1: NM_000152.4:c.148_859-11del (p.Glu50Hisfs*37; exons2–4deletion)

      CAID: CA658795223 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.148_859-11del

      gnomAD: Not in gnomAD


      Variant2: NM_000152.4:c.685_686insCGGC (p.Arg229fsProfs*102)

      CAID: CA658795233 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.685_686insCGGC

      gnomAD: Not in gnomAD


      CaseAddInfo: Infantile Onset Pompe Disease

    15. c.1445C > G(p.Pro482Arg)

      Case60

      HPOsFreeText: See Group Phenotypes


      CasePreviousTesting: Sanger sequencing

      CaseMethod1: Sanger sequencing and PCR Amplification

      CaseMethod2: Whole Exome Sequencing (WES)

      CaseGenotypingMethod: Patients were previously confirmed with Pompe disease by Sanger sequencing to capture the pathogenic variants. The process was repeated as part of the study taking care to amplify the coding regions and exon/intron boundaries to compare with the WES results afterwards.


      Variant1: NM_000152.4:c.1445C>G (p.Pro482Arg)

      CAID: CA401366794 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.1445C%3EG

      gnomAD: Not in gnomAD


      Variant2: NM_000152.4:c.-32-13T>G

      ClinVar: 4027 https://www.ncbi.nlm.nih.gov/clinvar/variation/4027/

      gnomAD: Ashkenazi Jewish 5.541e-3, Overall 3.401e-3 http://gnomad.broadinstitute.org/variant/17-78078341-T-G


      CaseAddInfo: Adult Late Onset Pompe Disease, 1 person more with the same genotype

    16. c.2560C > T(p.Arg854*)

      Case21

      HPOsFreeText: See Group Phenotypes


      CasePreviousTesting: Sanger sequencing

      CaseMethod1: Sanger sequencing and PCR Amplification

      CaseMethod2: Whole Exome Sequencing (WES)

      CaseGenotypingMethod: Patients were previously confirmed with Pompe disease by Sanger sequencing to capture the pathogenic variants. The process was repeated as part of the study taking care to amplify the coding regions and exon/intron boundaries to compare with the WES results afterwards.


      Variant1: NM_000152.4:c.2560C>T (p.Arg854*)

      ClinVar: 4034 https://www.ncbi.nlm.nih.gov/clinvar/variation/4034/

      gnomAD: African 1.891e-3, Overall 2.090e-4 http://gnomad.broadinstitute.org/variant/17-78092070-C-T


      Variant2: NM_000152.4:c.1129G>C (p.Gly377Arg)

      ClinVar: 497033 https://www.ncbi.nlm.nih.gov/clinvar/variation/497033/

      gnomAD: European (Non-Finnish) 2.356e-5, Overall 1.072e-5 http://gnomad.broadinstitute.org/variant/17-78082341-G-C


      CaseAddInfo: Infantile Onset Pompe Disease

    1. 15

      Case15: Female, 39 years onset, 40 years diagnosis, Italy

      HPOsFreeText: See Group Phenotypes, ERT started at 41, GAA Activity at ~6.5 pmol/min/mg before ERT and ~11 after

      GroupGenotypingMethod: PCR Amplification and GAA Gene Sequencing


      Variant1: NM_000152.4:c.-32-13T>G

      ClinVar: 4027 https://www.ncbi.nlm.nih.gov/clinvar/variation/4027/

      gnomAD: Ashkenazi Jewish 5.541e-3, Overall 3.401e-3 http://gnomad.broadinstitute.org/variant/17-78078341-T-G


      Variant2: NM_000152.4:c.2237G>A (p.Trp746Ter)

      ClinVar: 280063 https://www.ncbi.nlm.nih.gov/clinvar/variation/280063/

      gnomAD: European (Non-Finnish) 8.834e-6, Overall 3.988e-6 http://gnomad.broadinstitute.org/variant/17-78090814-G-A


      CaseAddInfo: Late Onset Pompe Disease

    2. 14

      Case14: Female, 15 years onset, 16 years diagnosis, Italy

      HPOsFreeText: See Group Phenotypes, ERT started at 16, GAA Activity at ~8 pmol/min/mg before ERT and ~12 after

      GroupGenotypingMethod: PCR Amplification and GAA Gene Sequencing


      Variant1: NM_000152.4:c.-32-13T>G

      ClinVar: 4027 https://www.ncbi.nlm.nih.gov/clinvar/variation/4027/

      gnomAD: Ashkenazi Jewish 5.541e-3, Overall 3.401e-3 http://gnomad.broadinstitute.org/variant/17-78078341-T-G


      Variant2: NM_000152.4:c.1927G>A (p.Gly643Arg)

      ClinVar: 4023 https://www.ncbi.nlm.nih.gov/clinvar/variation/4023/

      gnomAD: European (Non-Finnish) 3.667e-5, Overall 2.479e-5 http://gnomad.broadinstitute.org/variant/17-78086713-G-A


      CaseAddInfo: Late Onset Pompe Disease

    1. 1

      Case1: Female, Danish, 38 years report, 25 years onset

      CasePresentingHPOs: HP:0008956 (Thigh muscle atrophy)

      HPOsFreeText: 6-min walk test achieved 531 m, MRC score is 4/5 (thigh/calf), Forced vital capacity sitting/supine is 2.8/2.2 (L)

      NotHPOsFreetext: Not on ERT

      GroupGenotypingMethod: Mutation Analysis on the GAA Gene


      Variant1: NM_000152.4:c.-32-13T>A

      CAID: CA913184742 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA913184742

      gnomAD: Not in gnomAD


      Variant2: NM_000152.4:c.307T>G (p.Cys103Gly)

      ClinVar: 92483 https://www.ncbi.nlm.nih.gov/clinvar/variation/92483/

      gnomAD: European (Non-Finnish) 7.874e-6, Overall 3.578e-6 http://gnomad.broadinstitute.org/variant/17-78078692-T-G


      CaseAddInfo: Late Onset Pompe Disease

    2. 7

      Case7: Male, Danish, 20 years report, 1 year onset

      HPOsFreeText: MRC score is 4/5 (thigh/calf), Forced vital capacity sitting/supine is 5.6/5.3 (L), Has started ERT

      CaseNotHPOs: HP:0008956 (Thigh muscle atrophy)

      GroupGenotypingMethod: Mutation Analysis on the GAA Gene


      Variant1: NM_000152.4:c.2228A>G (p.Gln743Arg)

      CAID: CA401324753 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.2228A%3EG

      gnomAD: Not in gnomAD


      Variant2: NM_000152.4:c.2237G>C (p.Trp746Ser)

      ClinVar: 188484 https://www.ncbi.nlm.nih.gov/clinvar/variation/188484/

      gnomAD: African 3.210e-4, Overall 7.089e-5 http://gnomad.broadinstitute.org/variant/17-78090814-G-C


      Variant3: NM_000152.4:c.-32-13T>G

      ClinVar: 4027 https://www.ncbi.nlm.nih.gov/clinvar/variation/4027/

      gnomAD: Ashkenazi Jewish 5.541e-3, Overall 3.401e-3 http://gnomad.broadinstitute.org/variant/17-78078341-T-G


      CaseAddInfo: Late Onset Pompe Disease, Nomenclature indicates Variants 1 and 2 are in cis

    3. 4

      Case4: Male, French, 65 years report, 55 years onset

      HPOsFreeText: 6-min walk test achieved 540 m, MRC score is 5/5 (thigh/calf), Forced vital capacity sitting/supine is 2.7/1.8 (L), On the medications Statin and Allopurinol, Has started ERT

      CaseNotHPOs: HP:0008956 (Thigh muscle atrophy)

      GroupGenotypingMethod: Mutation Analysis on the GAA Gene


      Variant1: NM_000152.4:c.-32-13T>A

      CAID: CA913184742 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA913184742

      gnomAD: Not in gnomAD


      Variant2: NM_000152.4:c.3G>A

      CAID: CA401359809 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.3G%3EA

      gnomAD: European (Non-Finnish) 8.945e-6, Overall 4.041e-6 http://gnomad.broadinstitute.org/variant/17-78078388-G-A


      CaseAddInfo: Late Onset Pompe Disease

    1. PD/Pathogenic-6

      CasePD/Pathogenic-6: 4 weeks diagnosis

      HPOsFreeText: GAA activity 8.8 (nmol · h−1 · mg−1), Mean percentage of normal 12.3%

      GenotypingMethod: Newborn Screening Panels


      Variant1: NM_000152.4:c.1726G>A (p.Gly576Ser)

      ClinVar: 92467 https://www.ncbi.nlm.nih.gov/clinvar/variation/92467/

      gnomAD: East Asian 0.1427, Overall 0.01700 http://gnomad.broadinstitute.org/variant/17-78085871-G-A


      Variant2: NM_000152.4:c.2065G>A (p.Glu689Lys)

      ClinVar: 4030 https://www.ncbi.nlm.nih.gov/clinvar/variation/4030/

      gnomAD: East Asian 0.2355, Overall 0.05524 http://gnomad.broadinstitute.org/variant/17-78087041-G-A


      Chromosomal code not provided

      Variant3: NP_000143.2:p.N87Tfs*55

      ClinVar: N/A

      gnomAD: N/A


      CaseAddInfo: Patient has one pseudodeficency allele and one pathogenic allele, Nomenclature claims Variant 1 and 2 are in cis

    2. PD/VOUS-3

      CasePD/VOUS-3: 2 weeks diagnosis

      HPOsFreeText: GAA activity 11.3 (nmol · h−1 · mg−1), Mean percentage of normal 15.8%

      GenotypingMethod: Newborn Screening Panels


      Variant1: NM_000152.4:c.1726G>A (p.Gly576Ser)

      ClinVar: 92467 https://www.ncbi.nlm.nih.gov/clinvar/variation/92467/

      gnomAD: East Asian 0.1427, Overall 0.01700 http://gnomad.broadinstitute.org/variant/17-78085871-G-A


      Variant2: NM_000152.4:c.2065G>A (p.Glu689Lys)

      ClinVar: 4030 https://www.ncbi.nlm.nih.gov/clinvar/variation/4030/

      gnomAD: East Asian 0.2355, Overall 0.05524 http://gnomad.broadinstitute.org/variant/17-78087041-G-A


      Variant3: NM_000152.4:c.664G>A (p.Val222Met)

      ClinVar: 290223 https://www.ncbi.nlm.nih.gov/clinvar/variation/290223/

      gnomAD: South Asian 5.393e-3, Overall 6.931e-4 http://gnomad.broadinstitute.org/variant/17-78079665-G-A


      CaseAddInfo: Patient has one pseudodeficency allele and one allele of uncertain significance, Nomenclature claims Variant 1 and 2 are in cis

    3. PD/Pathogenic-10

      CasePD/Pathogenic-10: 2 weeks diagnosis

      HPOsFreeText: GAA activity 5.5 (nmol · h−1 · mg−1), Mean percentage of normal 7.8%

      GenotypingMethod: Newborn Screening Panels


      Variant1: NM_000152.4:c.271G>A (p.Asp91Asn)

      ClinVar: 4020 https://www.ncbi.nlm.nih.gov/clinvar/variation/4020/

      gnomAD: European (Non-Finnish) 0.03291, Overall 0.02049 http://gnomad.broadinstitute.org/variant/17-78078656-G-A


      Variant2: NM_000152.4:c.2161G>T (p.Glu721Ter)

      CAID: CA401370611 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.2161G%3ET

      gnomAD: Not in gnomAD


      Variant3: NM_000152.4:c.2237G>T (p.Trp746Leu)

      ClinVar: 284776 https://www.ncbi.nlm.nih.gov/clinvar/variation/284776/

      gnomAD: European (Non-Finnish) 1.244e-4, Overall 7.798e-5 http://gnomad.broadinstitute.org/variant/17-78090814-G-T


      CaseAddInfo: Patient has one pseudodeficency allele and one pathogenic allele, Nomenclature claims Variant 2 and 3 are in cis

    4. LOPD-15

      CaseLOPD-15: 2 weeks diagnosis

      HPOsFreeText: GAA activity 3.6 (nmol · h−1 · mg−1), Mean percentage of normal 5.1%

      GenotypingMethod: Newborn Screening Panels


      Variant1: NM_000152.4:c.271G>A (p.Asp91Asn)

      ClinVar: 4020 http://www.ncbi.nlm.nih.gov/clinvar/variation/4020

      gnomAD: European (Non-Finnish) 0.03291, Overall 0.02049 http://gnomad.broadinstitute.org/variant/17-78078656-G-A


      Chromosomal code not provided

      Variant2: NP_000143.2:p.V740Gfs*55

      ClinVar: N/A

      gnomAD: N/A


      Chromosomal code not provided and typo likely

      Variant3: NP_000143.2:p.T234 mol/L

      ClinVar: N/A

      gnomAD: N/A


      CaseAddInfo: Late Onset Pompe Disease, Nomenclature claims Variant 1 and 2 are in cis

    5. LOPD-18

      CaseLOPD-18: 2 weeks diagnosis

      HPOsFreeText: GAA activity 2.9 (nmol · h−1 · mg−1), Mean percentage of normal 4.0%

      GenotypingMethod: Newborn Screening Panels


      Variant1: NM_000152.4:c.-32-13T>G

      ClinVar: 4027 http://www.ncbi.nlm.nih.gov/clinvar/variation/4027

      gnomAD: Ashkenazi Jewish 5.541e-3, Overall 3.401e-3 http://gnomad.broadinstitute.org/variant/17-78078341-T-G


      Variant2: NM_000152.4:c.2188G>T (p.Glu730Ter)

      ClinVar: 495665 https://www.ncbi.nlm.nih.gov/clinvar/variation/495665/

      gnomAD: Not in gnomAD


      CaseAddInfo: Late Onset Pompe Disease

    6. PD/VOUS-2

      CasePD/VOUS-2: 2 weeks diagnosis

      HPOsFreeText: GAA activity 16.6 (nmol · h−1 · mg−1), Mean percentage of normal 23.3%

      GenotypingMethod: Newborn Screening Panels


      Variant1: NM_000152.4:c.1726G>A (p.Gly576Ser)

      ClinVar: 92467 https://www.ncbi.nlm.nih.gov/clinvar/variation/92467/

      gnomAD: East Asian 0.1427, Overall 0.01700 http://gnomad.broadinstitute.org/variant/17-78085871-G-A


      Variant2: NM_000152.4:c.2065G>A (p.Glu689Lys)

      ClinVar: 4030 https://www.ncbi.nlm.nih.gov/clinvar/variation/4030/

      gnomAD: East Asian 0.2355, Overall 0.05524 http://gnomad.broadinstitute.org/variant/17-78087041-G-A


      Variant3: NM_000152.4:c.2069C>T (p.Pro690Leu)

      ClinVar: 424308 https://www.ncbi.nlm.nih.gov/clinvar/variation/424308/

      gnomAD: East Asian 1.077e-4, Overall 2.337e-5 http://gnomad.broadinstitute.org/variant/17-78087045-C-T


      CaseAddInfo: Patient has one pseudodeficency allele and one allele of uncertain significance, Nomenclature claims Variant 1 and 2 are in cis

    7. LOPD-12

      CaseLOPD-12: 2 weeks diagnosis

      HPOsFreeText: GAA activity 2.0 (nmol · h−1 · mg−1), Mean percentage of normal 2.8%

      GenotypingMethod: Newborn Screening Panels


      Variant1: NM_000152.4:c.-32-13T>G

      ClinVar: 4027 http://www.ncbi.nlm.nih.gov/clinvar/variation/4027

      gnomAD: Ashkenazi Jewish 5.541e-3, Overall 3.401e-3 http://gnomad.broadinstitute.org/variant/17-78078341-T-G


      Chromosomal code not provided and typo likely

      Variant2: NP_000143.2:p.V350 mol/L

      ClinVar: N/A

      gnomAD: N/A


      CaseAddInfo: Late Onset Pompe Disease

    8. LOPD-14

      CaseLOPD-14: 2 weeks diagnosis

      HPOsFreeText: GAA activity 3.0 (nmol · h−1 · mg−1), Mean percentage of normal 4.2%

      GenotypingMethod: Newborn Screening Panels


      Variant1: NM_000152.4:c.-32-13T>G

      ClinVar: 4027 http://www.ncbi.nlm.nih.gov/clinvar/variation/4027

      gnomAD: Ashkenazi Jewish 5.541e-3, Overall 3.401e-3 http://gnomad.broadinstitute.org/variant/17-78078341-T-G


      Variant2: NM_000152.4:c.2509C>T (p.Arg837Cys)

      ClinVar: 456408 https://www.ncbi.nlm.nih.gov/clinvar/variation/456408/

      gnomAD: European (Non-Finnish) 4.676e-5, Overall 2.487e-5 http://gnomad.broadinstitute.org/variant/17-78092019-C-T


      CaseAddInfo: Late Onset Pompe Disease

    1. Patient 2 was a 29-year old Caucasian male

      Patient2: female, 29 yo, Caucasian

      CasePresentingHPOs: HP:0003724, HP:0008988, HP:0003691, HP:0003391, HP:0003551, HP:0040081, HP:0002910, HP:0003557, HP:0100295, HP:0100295, HP:0009051, HP:0004356, HP:0002111

      HPOsFreeText: paravertebral muscle atrophy, atrophies with paresis grade of 3-4 MRC, cannot stand from squatting position, impaired overhead work, CK = 1390 U/l, AST = 65 U/l, ALAT = 72 U/L, symmetrical atrophy of thigh muscle, fatty deposits in m. adductor magnus, flause signal elevation in the mm. semimembranosus and mm. biceps femoris bilateral, reticulation in the proximal vastus intermedius and vastus lateralis, vacuolated muscle fibres, PAS-positive glycogen storage with enhanced lysosomal activity in the PAS staining, increased lysosomal activity, GAA activity = 0.22nmol/spot x 21hrs

      CaseNotHPOs: HP:0001639

      CaseAddInfo:

      CasePreviousTesting: MRI of thigh muscle, muscle biopsy of mm. vastus lateralis, hematoxylin and eosin stain, Peri acid-Schiff reaction, Acid phosphatase staining, transthoracic echocardiogram, respiratory function test

      CaseGenotypingMethod: Sanger Sequencing

      Variant: NM_000152.4(GAA):c.-32-13T>G

      Clinvar: 4027, https://www.ncbi.nlm.nih.gov/clinvar/variation/4027/

      gnomAD: 0.003582, http://exac.broadinstitute.org/variant/17-78078341-T-G

    1. Case32: Female, 45 years report

      HPOsFreeText: ERT not started, 6 Minute Walking Test at 533 meters, Forced Vital Capacity at 77%

      GenotypingMethod: GAA Gene Sequencing


      Variant1: NM_000152.4:c.-32-13T>G

      ClinVar: 4027 http://www.ncbi.nlm.nih.gov/clinvar/variation/4027

      gnomAD: Ashkenazi Jewish 5.541e-3, Overall 3.401e-3 http://gnomad.broadinstitute.org/variant/17-78078341-T-G


      Variant2: NM_000152.4:c.1888+1G>A

      CAID: CA8815511 http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.1888%2B1G%3EA

      gnomAD: European (Non-Finnish) 9.843e-6, Overall 4.375e-6 http://gnomad.broadinstitute.org/variant/17-78086511-G-A


      CaseAddInfo: Late Onset Pompe Disease

    2. Case9: Female, 34 years report

      HPOsFreeText: 6 years of ERT completed, 6 Minute Walking Test at 452 meters, Forced Vital Capacity at 76%

      GenotypingMethod: GAA Gene Sequencing


      Variant1: NM_000152.4:c.1655T>C (p.Leu552Pro)

      ClinVar: 279811 https://www.ncbi.nlm.nih.gov/clinvar/variation/279811/

      gnomAD: European (Non-Finnish) 7.053e-5, Overall 3.188e-5 http://gnomad.broadinstitute.org/variant/17-78085800-T-C


      Variant2: NM_000152.4:c.1688A>T (p.Gln563Leu)

      CAID: CA401368995 http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.1688A%3ET

      gnomAD: Not in gnomAD


      CaseAddInfo: Late Onset Pompe Disease

    3. Case19: Male, 57 years report

      HPOsFreeText: 8 years of ERT completed, 6 Minute Walking Test at 273 meters, Forced Vital Capacity at 77%

      GenotypingMethod: GAA Gene Sequencing


      Variant1: NM_000152.4:c.-32-13T>G

      ClinVar: 4027 http://www.ncbi.nlm.nih.gov/clinvar/variation/4027

      gnomAD: Ashkenazi Jewish 5.541e-3, Overall 3.401e-3 http://gnomad.broadinstitute.org/variant/17-78078341-T-G


      Variant2: NM_000152.4:c.1819_1836del (p.Gly607_His612del )

      CAID: CA658795266 http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.1819_1836del

      gnomAD: Not in gnomAD


      CaseAddInfo: Late Onset Pompe Disease

    1. 31

      Case31: Male, 41yo (at enrollment and onset)

      CasePresentingHPOs: HP:0002094, HP:0003701, HP:0003327, HP:0003236, HP:0002098, HP:0002111, HP:0003458, HP:0100284

      HPOsFreeText: asymmetric weakness of extremities, CK = 573 IU/L, required use of ventilator, FVC = 33.7%, unspecific myopathic changes present in muscle pathology, DBS GAA activity = .05, mixed leukocyte GAA activity = 1.40

      CaseNotHPOs: HP:0001627

      NotHPOsFreeText:

      CaseAddInfo:

      CasePreviousTesting: clinical history, laboratory data, DBS and ML assays to measure GAA activity, electromyography, muscle pathology analysis

      CaseGenotypingMethod: full sequencing of GAA gene

      VariantAllele1: NM_000152.3:c.1822C>T

      CAID: CA8815488, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.3%3Ac.1822C%3ET

      gnomAD: 0.00001806, http://gnomad.broadinstitute.org/variant/17-78086444-C-T

      VariantAllele2: NM_000152.4(GAA):c.2238G>C (p.Trp746Cys)

      ClinVar: 265160, https://www.ncbi.nlm.nih.gov/clinvar/variation/265160/

      gnomAD: 0.0002987, http://exac.broadinstitute.org/variant/17-78090815-G-C

    1. 9

      Family 9 - Patient 9

      FamilyPresentingHPOs: HP:0007340, HP:0003701, HP:0000467, HP:0003327, HP:0010628, HP:0003306, HP:0002111, HP:0040081

      HPOsFreeText: muscle pathology with slight vacuolar myopathy with mild glycogen excess

      FamilyNotHPOs: HP:0002015, HP:0003691, HP:0002650

      Ethnicity: Iranian

      ProbandLabel:

      FamilyAddInfo: onset at 28yo, diagnosed at 35yo, MRC sum score = 81

      FamilyPreviousTesting: Respiratory Evaluation: FVC = 71%, CK = 748 U/L, muscle pathology examined, DBS enzyme activity (with inhibition) = 3.5 μmol/L/h

      FamilyGenotypingMethod: GAA analyzed with Sanger Sequencing for entire coding region and conserved exon-intron splice junctions, PCR performed for deletion screening

      VariantAllele1: NM_000152.4(GAA):c.-32-13T>G

      Clinvar: 4027, https://www.ncbi.nlm.nih.gov/clinvar/variation/4027/

      gnomAD: 0.003582, http://exac.broadinstitute.org/variant/17-78078341-T-G

      VariantAllele2: NM_000152.4(GAA):c.1799G>A (p.Arg600His)

      ClinVar: 370130, https://www.ncbi.nlm.nih.gov/clinvar/variation/370130/

      gnomAD: 8.675e-06, http://exac.broadinstitute.org/variant/17-78086421-G-A

    1. II.1

      CaseCII-1: N/A

      CasePresentingHPOs: N/A

      HPOsFreeText: Pretreatment phenylalanine level at 1515 umol/L

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      Variant1: NM_000277.3(PAH):c.194T>C (p.Ile65Thr)

      ClinVar: 636 https://www.ncbi.nlm.nih.gov/clinvar/variation/636/

      gnomAD: 0.0005574, https://gnomad.broadinstitute.org/variant/12-102894893-A-G?dataset=gnomad_r3

      Variant2: NM_000277.3(PAH):c.1065+1G>A

      ClinVar: 102501 https://www.ncbi.nlm.nih.gov/clinvar/variation/102501/

      gnomAD: 0.00004622, http://gnomad.broadinstitute.org/variant/12-103238113-C-T

    2. 11.2

      CaseAII-2: N/A

      CasePresentingHPOs: N/A

      HPOsFreeText: Pretreatment phenylalanine level at 375 umol/L

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      Variant1: NM_000277.3(PAH):c.165del (p.Phe55fs)

      ClinVar: 611 https://www.ncbi.nlm.nih.gov/clinvar/variation/611/

      gnomAD: 0.00002639, https://gnomad.broadinstitute.org/variant/12-103306571-CA-C?dataset=gnomad_r3

      Variant2: NM_000277.3(PAH):c.898G>T (p.Ala300Ser)

      ClinVar: 92751 https://www.ncbi.nlm.nih.gov/clinvar/variation/92751/

      gnomAD: 0.006318, https://gnomad.broadinstitute.org/variant/12-102851701-C-A?dataset=gnomad_r3

    3. II.2

      CaseBII-2: N/A

      CasePresentingHPOs: N/A

      HPOsFreeText: Pretreatment phenylalanine level at 270 umol/L

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      Variant1: NM_000277.3(PAH):c.688G>A (p.Val230Ile)

      ClinVar: 102784 https://www.ncbi.nlm.nih.gov/clinvar/variation/102784/

      gnomAD: 0.0009025, https://gnomad.broadinstitute.org/variant/12-102855154-C-T?dataset=gnomad_r3

      Variant2: NM_000277.3(PAH):c.1241A>G (p.Tyr414Cys)

      ClinVar: 593 https://www.ncbi.nlm.nih.gov/clinvar/variation/593/

      gnomAD: 0.0005264, https://gnomad.broadinstitute.org/variant/12-102840474-T-C?dataset=gnomad_r3

    1. 10

      Case 10 (Level 2)


      CasePreviousTesting: same as group

      CaseMethod1: PCR

      CaseGenotypingMethod: same as group __

      Variant1: NM_015506.2(MMACHC):c.658_660delAAG (p.Lys220del)

      ClinVar: 95707

      CAID: CA223197

      gnomAD: 0.0003071 (East Asian)


      CaseAddInfo: proband genotype, homozygous, no phenotypic info, sibling (fetus) also homozygous for variant

    2. 4

      Case 4 (Level 2)


      CasePreviousTesting: same as group

      CaseMethod1: PCR

      CaseGenotypingMethod: same as group


      Variant1: NM_015506.2(MMACHC):c.609G > A (p.Trp203Ter)

      ClinVar: 30800

      CAID: CA259906

      gnomAD: 0.0005562 (East Asian)

      __

      Variant2: NM_015506.2(MMACHC):c.467G>A (p.Gly156Asp)

      ClinVar: 554696

      CAID: CA340133108

      gnomAD: not in gnomAD


      CaseAddInfo: proband genotype, unknown cis or trans, no phenotypic info given, sibling (fetus) carrier of both variants. variant 2 is not in the table of 31 variants (Table 1).

    3. 61

      Case61(Level 2)


      CasePreviousTesting: same as group

      CaseMethod1: PCR

      CaseGenotypingMethod: same as group __

      Variant1: NM_015506.2(MMACHC):c.599G > A (p.Trp200Ter)

      ClinVar: n/a

      CAID: n/a

      gnomAD: 0.000008829 (European non-Finnish)


      Variant2: NM_015506.2(MMACHC):c.609G > A (p.Trp203Ter)

      ClinVar: 30800

      CAID: CA259906

      gnomAD: 0.0005562 (East Asian)


      CaseAddInfo: proband genotype, unknown cis or trans, no phenotypic info, sibling (fetus) carrier of p.W203X paternal variant

    4. 21

      Case 21 (Level 2)


      CasePreviousTesting: same as group

      CaseMethod1: PCR

      CaseGenotypingMethod: same as group __

      Variant1: NM_015506.2(MMACHC):c.467G > A (p.Gly156Ala)

      ClinVar: n/a

      in ClinVar it says that this nucleotide change corresponds to p.Gly156Asp (p.G156D), which is the paternal variant listed in case 4 that I mentioned was not also listed in Table 1 (list of all 31 variants found). I am wondering if p.G156A is a typo in case 21 Table 2 and Variant 18 Table 1

      CAID: CA340133108

      gnomAD: n/a


      Variant2: NM_015506.2(MMACHC):c.609G > A (p.Trp203Ter)

      ClinVar: 30800

      CAID: CA259906

      gnomAD: 0.0005562 (East Asian)


      CaseAddInfo: proband genotype, unknown cis or trans, no phenotypic info, sibling (fetus) carrier for p.G156A (possible typo??) maternal variant

    5. 52

      Case52(Level 2)


      CasePreviousTesting: same as group

      CaseMethod1: PCR

      CaseGenotypingMethod: same as group __

      Variant1: NM_015506.2(MMACHC):c.658_660delAAG (p.Lys220del)

      ClinVar: 95707

      CAID: CA223197

      gnomAD: 0.0003071 (East Asian)


      Variant2: NM_015506.2(MMACHC):c.365A > T (p.His121Leu)

      ClinVar: n/a

      CAID: n/a

      gnomAD: n/a


      CaseAddInfo: proband genotype, unknown cis or trans, no phenotypic info, sibling (fetus) carrier of p.K220del maternal variant

    6. 26

      Case 26 (Level 2)


      CasePreviousTesting: same as group

      CaseMethod1: PCR

      CaseGenotypingMethod: same as group __

      Variant1: NM_015506.2(MMACHC):c.440_441delGT

      ClinVar: n/a

      CAID: CA312741

      gnomAD: n/a


      Variant2: NM_015506.2(MMACHC):c.609G > A (p.Trp203Ter)

      ClinVar: 30800

      CAID: CA259906

      gnomAD: 0.0005562 (East Asian)


      CaseAddInfo: proband genotype, unknown cis or trans, no phenotypic info, sibling (fetus) carrier for p.W203X paternal variant

    7. 32

      Case32 (Level 2)


      CasePreviousTesting: same as group

      CaseMethod1: PCR

      CaseGenotypingMethod: same as group


      Variant1: NM_015506.2(MMACHC):c.666C > A (p.Tyr222Ter)

      ClinVar: 496436

      CAID: CA827827

      gnomAD: 0.00006537 (South Asian)


      Variant2: NM_015506.2(MMACHC):c.80A>G (p.Gln27Arg)

      ClinVar: 552467

      CAID: CA827620

      gnomAD: not in gnomAD


      CaseAddInfo: proband genotype, unknown cis or trans, no phenotypic info, sibling (fetus) carrier of p.Y222X maternal variant

    8. 17

      Case 17 (Level 2)


      CasePreviousTesting: same as group

      CaseMethod1: PCR

      CaseGenotypingMethod: same as group __

      Variant1: NM_015506.2(MMACHC):c.445_446insA (p.Cys149Ter)

      ClinVar: n/a

      CAID: n/a

      gnomAD: n/a


      Variant2: NM_015506.2(MMACHC):c.567dupT (p.Ile190Tyrfs*13)

      ClinVar: 556708

      CAID: CA522810899

      gnomAD: [0.0001024] (https://gnomad.broadinstitute.org/variant/1-45974604-G-GT) (East Asian)


      CaseAddInfo: proband genotype, unknown cis or trans, no phenotypic info, sibling (fetus) carrier for c.567dupT paternal variant

    1. Proband

      CaseF1P: Female, 8 yrs report, India

      CasePresentingHPOs: N/A

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: Proband for Family 1, Variant is demonstrated to activate a cryptic splice site and abolish the canon splice site leading to a premature termination and nonsense-mediated decay

      CasePreviousTesting: Blood phenylalanine before treatment was 1174 μmol/l, Blood tyrosine before treatment was 33 μmol/l

      CaseGenotypingMethod: N/A

      Variant: NM_000277.3(PAH):c.169-2A>G

      ClinVar: 555212 https://www.ncbi.nlm.nih.gov/clinvar/variation/555212/

      gnomAD: 0.00003267, http://gnomad.broadinstitute.org/variant/12-103288698-T-C

    2. Proband

      CaseF6P: 1 yr report, India

      CasePresentingHPOs: HP:0001010, HP:0000750, HP:0001249, HP:0006801, HP:0004923 (Hypopigmentation of the skin, Delayed speech and language development, Intellectual disability, Brisk deep tendon reflexes, Hyperphenylalaninemia)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: Family is consanguinous, Predicted to undergo NMD

      CasePreviousTesting: Blood phenylalanine before treatment was 1260 μmol/l, Blood tyrosine before treatment was N/A μmol/l, PKU diagnosis was based on ferric chloride test on patient urine samples and detection of elevated Phenylalanine levels in blood samples by using HPLC, in addition to analysis of clinical features.

      CaseGenotypingMethod: Genomic DNA was isolated from blood samples of proband and family members. PCR amplification and sequencing was used to screen for mutations. Each mutation was confirmed by bi-directional DNA sequencing.

      Variant: NM_000277.3(PAH):c.526C>T (p.Arg176Ter)

      ClinVar: 102723 https://www.ncbi.nlm.nih.gov/clinvar/variation/102723/

      gnomAD: 0.00008012, http://gnomad.broadinstitute.org/variant/12-103249094-G-A

    1. Table 1

      Case3b: Female, 9 d at initiation of follow up, East Indian ancestry, sibling of Case 3a (Family 1)

      HPOsFreeText: NBS C4-acylcarnitine 2.1 umol/L, Plasma C4-acylcarnitine 2.47 umol/L, urine C4-acylcarnitine 21.66 mmol/mol creatinine, Urine C4/C3 ratio 42

      NotHPOsFreeText: normal urine isobutyrylgycine ug/mg creatinine

      CaseAddInfo: unremarkable clinical condition

      Case3b (Level 2)


      CasePreviousTesting: same as group

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant: NM_014384.2(ACAD8):c.867C>A (p.His289Gln)

      ClinVar: 5358

      CAID: CA117441

      gnomAD: not in gnomAD


      CaseAddInfo: homozygous mutations, no data for SCAD gene variants

    2. Patient 8

      Case8: Male, 6 wks at initiation of follow up, European ancestry

      HPOsFreeText: NBS C4-acylcarnitine 1.8 umol/L, plasma C4 acylcarnitine 1.52 umol/L, in vitro probe isoC4-acylcarnitine 0.187 umol/ g protein, in vitro probe C4-acylcarnitine 0.573 umol/g protein, elevated urine C4-acylcarnitine 25.09 mmol/mol creatinine, Urine C4/C3 ratio 88

      NotHPOsFreeText: normal urine isobutyryglycine

      CaseAddInfo: unremarkable clinical condition

      Case8 (Level 2)


      CasePreviousTesting: same as group

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_014384.2(ACAD8):c.512C>G (p.Ser171Cys)

      ClinVar: 95589

      CAID: CA223125

      gnomAD: 0.02252 (European non-Finnish)


      Variant2: NM_014384.2(ACAD8):c.455T>C (p.Met152Thr)

      ClinVar: 5355

      CAID: CA117433

      gnomAD: 0.0001395 (European Non-Finnish)


      CaseAddInfo: compound heterozygote specified allele 1 and 2, but not maternal and paternal. Potential splice-site alteration at exon 3(+3A>G). ACADS (SCAD-deficient) gene variants 625G>A/625G>A.

    1. ID no. 765

      Case765: Female, 9 years report, Spain

      CasePresentingHPOs: HP:0003153, HP:0001256, HP:0007359, HP:0012000 (Cystathioninuria, Mild mental retardation, Partial seizures, EEG with generally recognized spikes)

      HPOsFreeText: Elevated urine cystathionine (750 umol/g creatine; reference <46) and Elevated tHcys in urine (61 umol/g creatine; reference <20), Elevated plasma tHcys (19 umol/l; reference <7.5), Elevated plasma cystathionine (10 umol/l; reference =0), Post treatment normal urine cystathionine (34 umol/g creatine)

      CaseNotHPOs: HP:0003345 (Glutathione synthetase deficiency)

      NotHPOsFreeText: N/A

      CaseAddInfo: Patient is homozygous for this variant

      CasePreviousTesting: Karyotype, magnetic resonance imaging, specific genetic tests for neurogenetic diseases and screening for inborn errors of metabolism (lactate, pyruvate, ammonium, uric acid, amino acids, organic acids, glycosaminoglycanes, creatine and guanidinoacetate, purines and pyrimidines, and isoelectric focusing pattern of transferrin), as well as folate, pyridoxine and cobalamine deficiencies, neural tumors and genetically determined homocystinurias, were all ruled out.

      CaseGenotypingMethod: All twelve exons of the CTH gene and the intronic flanking sequences of the subjects and their parents was PCR amplified and directly sequenced.

      Variant: NM_001902.5:c.200C>T (p.Thr67Ile)

      ClinVar: 2939 https://www.ncbi.nlm.nih.gov/clinvar/variation/2939/

      gnomAD: Ashkenazi Jewish 9.934e-3, Overall 6.308e-3 https://gnomad.broadinstitute.org/variant/1-70881670-C-T

    1. U3

      CaseREU3: Male, 6 yrs report, United Kingdom

      CasePresentingHPOs: HP:0001337, HP:0001263, HP:0000717, HP:0001382, HP:0012120 (Tremor, Global developmental delay, Autism, Joint hypermobility, Methylmalonic aciduria)

      HPOsFreeText: Malonic aciduria

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: Proband is homozygous for this variant

      CasePreviousTesting: All participants had undergone multiple standard and specialized biochemical tests, invasive procedures (e.g. muscle and/or skin biopsy, lumbar puncture) and targeted gene testing; MRI head not performed

      CaseGenotypingMethod: 16 broad classes of IEM was target enriched and sequenced. Any suspected pathogenic variants were confirmed with Sanger sequencing.

      Variant: NM_001243279.3:c.1453A>C (p.Ser485Arg)

      CAID: CA397148172, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA397148172

      gnomAD: Not in gnomAD

    1. 3

      CaseGM01566: Female, 16 years report, Caucasian, Europe

      CasePresentingHPOs: HP:0003153 (Cystathioninuria)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: Proband is a compound heterozygote for this variant, Variants were confirmed in trans by parental testing

      CasePreviousTesting: N/A

      CaseGenotypingMethod: Primers were developed and the CTH exons 1-12 and exon-intron boundaries were PCR amplified and sequenced. All sequence variations were verified by restriction enzyme analysis and/or repeat sequencing.

      Variant1: NM_001902.5:c.200C>T (p.Thr67Ile)

      ClinVar: 2939 https://www.ncbi.nlm.nih.gov/clinvar/variation/2939/

      gnomAD: Ashkenazi Jewish 9.934e-3, Overall 6.308e-3 https://gnomad.broadinstitute.org/variant/1-70881670-C-T

      Variant2: CTH, 1-BP DEL, 1220C AKA: NM_001902.5:c.1064del (p.Thr355Ilefs*19)

      ClinVar: 2938 https://www.ncbi.nlm.nih.gov/clinvar/variation/2938/

      gnomAD: European (Non-Finnish) 1.551e-4, Overall 8.845e-5 https://gnomad.broadinstitute.org/variant/1-70904381-AC-A

    1. m

      CaseBI2K: N/A

      CasePresentingHPOs: HP:0001875, HP:0001644, HP:0003756 (Neutropenia, Dilated cardiomyopathy, Skeletal myopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseGenotypingMethod: Five genes noted to have high heart and skeletal muscle expression were sequenced and ORFs created. After PCR amplification and direct sequencing of the TAZ gene (G4.5.), a unique missense variant was found in this proband.

      CasePreviousTesting: N/A

      CaseAddInfo: N/A

      Variant: NM_000116.5(TAZ):c.239-1G>C

      ClinVar: 11102, https://www.ncbi.nlm.nih.gov/clinvar/variation/11102/

      gnomAD: Not in gnomAD

    1. 3

      Case3: Female, 1y 5m, Chinese

      HPOsFreeText: (at 21 days) 1.96 C4, 0.17 C4/C2, 2.09 C4/C3

      NotHPOsFreeText: normal urine isobutyrylglycine

      Case3 (Level 2):


      CasePreviousTesting: same as group

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant: NM_014384.2:c.286G>A (p.Gly96Ser)

      ClinVar: n/a

      CAID: CA6372895

      gnomAD: 0.001453 (East Asian)


      CaseAddInfo:

    2. 6

      Case6: Male, 8y 11m, Chinese, part of Family 1

      CasePresentingHPOs: HP:0000750, HP:0001328 (speech delay, learning disability)

      HPOsFreeText: (at 8y 8m) 1.07 C4 umol/L, 0.13 C4/C2, 1.20 C4/C3

      Case6 (Level 2):


      CasePreviousTesting: same as group

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_014384.2:c.286G>A (p.Gly96Ser)

      ClinVar: n/a

      CAID: CA6372895

      gnomAD: 0.001453 (East Asian)

      Variant2: NM_014384.2:c.1092+1G>A

      ClinVar: n/a

      CAID: CA6373205

      gnomAD: 0.00005790 (Latino)


      CaseAddInfo: older brother of patient 5. Had not undergone expanded NBS at birth but presented with symptoms by age 8 and was diagnosed later since his younger sister has IBDHD. Trans heterozygous, inherited one allele from each parent

    1. The patient

      Case1: Male, 5 years onset, African

      CasePresentingHPOs: HP:0410020, HP:0003750, HP:0030234 (Fish odor, Muscle fatigue, Highly elevated creatine phosphokinase)

      HPOsFreeText: Increased fish odor under stress or effort, Elevated plasma creatine kinase (1066 U/L; reference 30–270), Riboflavin (10 mg/day) had no effect, High N,N-dimethylglycine in urine (449 mmol DMG/mol; over 20x normal)

      CaseNotHPOs: HP:0001249, HP:0040126, HP:0003138, HP:0040087, HP:0010919, HP:0010901, HP:0003614, HP:0001871, HP:0001410 (Intellectual disability, Abnormal serum cobalamin level, Increased blood urea nitrogen, Abnormal serum folate, Abnormality of homocysteine metabolism, Abnormality of methionine metabolism, Trimethylaminuria, Hematological abnormality, Liver dysfunction)

      NotHPOsFreeText: Normal serum cobalamin (222 pmol/L; reference 150–400) and urea (5 mmol/L; reference 2.5–7.5), Normal plasma folate (9.7 nmol/L; reference 4–15) and homocysteine (12 μmol/L; reference 8–18)

      CasePMIDs: 10767172, 10102904

      CaseAddInfo: Consanguinity of the parents is unknown, Brothers, sisters, and the two sons of the patient were without signs or symptoms, Patient is homozygous for this mutation

      CasePreviousTesting: Nuclear magnetic resonance (NMR) spectroscopy, Conventional metabolic screening techniques, Gas chromatography (GC) analysis, Analysis of the very-long-chain fatty acids and a carnitine ester profile in serum, Amino acid and organic acid analyses of blood and urine

      CaseGenotypingMethod: cDNA was prepared from the patient and control fibroblast cultures. PCR amplification was performed and the DMGDH gene was sequenced. After the mutation was confirmed, the area around it was again amplified and sequenced.

      Variant: NM_013391.3:c.326A>G (p.His109Arg)

      ClinVar: 4742 https://www.ncbi.nlm.nih.gov/clinvar/variation/4742/

      gnomAD: African 4.737e-3, Overall 5.205e-4 https://gnomad.broadinstitute.org/variant/5-78351682-T-C

    1. Supplementary Table 2

      CaseEPI4Kn2: Female, 1 month onset

      CasePresentingHPOs: HP:0002521, HP:0011167, HP:0032794, HP:0000618, HP:0003089, HP:0000473, HP:0003487, HP:0032988, HP:0008936, HP:0001276, HP:0010864 (Hypsarrhythmia, Focal tonic seizure, Myoclonic seizure, Blindness, Hamstring contractures, Torticollis, Babinski sign, Persistent head lag, Muscular hypotonia of the trunk, Hypertonia, Severe intellectual disability)

      HPOsFreeText: N/A

      CaseNotHPOs: HP:0001263 (Global developmental delay)

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CasePreviousTesting: Currently on vigabatrin, topiramate, and oxcarbazepine; Previously on phenobarbitone and levetriacetam; Bifrontal central frequent discharges on EEG; Normal brain imaging; No confirmed genetic or metabolic diagnosis, and no history of congenital TORCH infection, premature birth (before 32 weeks gestation), neonatal hypoxic-ischemic encephalopathy or neonatal seizures, meningitis/encephalitis, stroke, intra-cranial hemorrhage, significant head trauma, or evidence of acquired epilepsy

      CaseGenotypingMethod: Exome sequencing was performed from primary DNA in parental leukocytes. Coding regions of the genome were sequenced in a trio in order to determine which loci bearing de novo mutations were present according to specifications. All candidate de novo variants were confirmed with Sanger sequencing of the proband and parents.

      Variant: NM_004171.4(SLC1A2):c.244G>C (p.Gly82Arg)

      ClinVar: 254265, https://www.ncbi.nlm.nih.gov/clinvar/variation/254265/

      gnomAD: Not in gnomAD

    1. Family 2

      CaseFZ2: Male, Finland, 2.9 yrs deceased

      CasePresentingHPOs: HP:0001511, HP:0008897, HP:0001999, HP:0000973, HP:0100678, HP:0000963, HP:0010648, HP:0001388, HP:0100790, HP:0001374, HP:0001181, HP:0001762, HP:0002650, HP:0000938, HP:0000270, HP:0002645, HP:0012443, HP:0025356, HP:0008872, HP:0001252, HP:0001348, HP:0000518, HP:0002677, HP:0000325, HP:0011220, HP:0000337, HP:0000411, HP:0000369 (Intrauterine growth retardation, Postnatal growth retardation, Abnormal facial shape, Cutis laxa, Premature skin wrinkling, Thin skin, Dermal translucency, Joint laxity, Hernia, Congenital hip dislocation, Adducted thumb, Talipes equinovarus, Scoliosis, Osteopenia, Delayed cranial suture closure, Wormian bones, Abnormality of brain morphology, Psychomotor retardation, Feeding difficulties in infancy, Muscular hypotonia, Brisk reflexes, Cataract, Small foramen magnum, Triangular face, Prominent forehead, Broad forehead, Protruding ear, Low-set ears)

      HPOsFreeText: Typical facial gestalt, Reduced collagen type 1 and 3 production

      CaseNotHPOs: HP:0000252, HP:0005116, HP:0000486 (Microcephaly, Arterial tortuosity, Strabismus)

      NotHPOsFreeText: N/A

      CaseAddInfo: Variant is confirmed de novo in this and two other cases with the same variant and similar presentation, No family history,

      CasePreviousTesting: N/A

      CaseGenotypingMethod: ALDH18A1 and PYRC1 were investigated by Sanger sequencing, with the latter revealing no abnormalities and the former showing a heterozygous change at the Arg138 residue. qPCR was used to exclude the presence of a exonic deletion and investigation revealed no further variants in the coding regions. Familial sequencing revealed the inheritance was de novo with no variants in the parents.

      Variant: NM_002860.4(ALDH18A1):c.412C>T (p.Arg138Trp)

      ClinVar: 217259 https://www.ncbi.nlm.nih.gov/clinvar/variation/217259/

      gnomAD: Not in gnomAD

    2. Family 5

      CaseFZ5: Male, Mexico, 4 yrs report

      CasePresentingHPOs: HP:0001511, HP:0008897, HP:0001999, HP:0000973, HP:0100678, HP:0000963, HP:0010648, HP:0001388, HP:0001374, HP:0001181, HP:0001762, HP:0002650, HP:0000938, HP:0000270, HP:0025356, HP:0001252, HP:0001348, HP:0000518, HP:0000325, HP:0011220, HP:0000337, HP:0000411, HP:0000369, HP:0000252 (Intrauterine growth retardation, Postnatal growth retardation, Abnormal facial shape, Cutis laxa, Premature skin wrinkling, Thin skin, Dermal translucency, Joint laxity, Congenital hip dislocation, Adducted thumb, Talipes equinovarus, Scoliosis, Osteopenia, Delayed cranial suture closure, Psychomotor retardation, Muscular hypotonia, Brisk reflexes, Cataract, Triangular face, Prominent forehead, Broad forehead, Protruding ear, Low-set ears, Microcephaly)

      HPOsFreeText: Typical facial gestalt

      CaseNotHPOs: HP:0005116, HP:0000486, HP:0100790, HP:0002645, HP:0012443 (Arterial tortuosity, Strabismus, Hernias, Wormian bones, Abnormality of brain morphology)

      NotHPOsFreeText: N/A

      CaseAddInfo: Variant is confirmed de novo in this case with one other maternally-confirmed case with the same variant and similar presentation, No family history

      CasePreviousTesting: N/A

      CaseGenotypingMethod: ALDH18A1 and PYRC1 were investigated by Sanger sequencing, with the latter revealing no abnormalities and the former showing a heterozygous change at the Arg138 residue. qPCR was used to exclude the presence of a exonic deletion and investigation revealed no further variants in the coding regions. Familial sequencing revealed the inheritance was de novo with no variants in the parents.

      Variant: NM_002860.4(ALDH18A1):c.413G>T (p.Arg138Leu)

      ClinVar: 217261 https://www.ncbi.nlm.nih.gov/clinvar/variation/217261/

      gnomAD: Not in gnomAD

    1. CaseLE25: Male, 7 yrs report

      CasePresentingHPOs: HP:0000639 (Nystagmus)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: Variants confirmed in-trans via parental testing

      CasePreviousTesting: Specific plasma MMA levels, urine MMA levels, urine MA levels, and MMA/MA ratio available in Table 2

      CaseGenotypingMethod: See Group

      Variant1: NM_001243279.3:c.634G>A (p.Val212Met)

      CAID: CA397135749, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA397135749

      gnomAD: 0.00004778, https://gnomad.broadinstitute.org/variant/16-89167723-G-A

      Variant2: NM_001243279.3(ACSF3):c.1470G>C (p.Glu490Asp)

      ClinVar: 377432, https://www.ncbi.nlm.nih.gov/clinvar/variation/377432/

      gnomAD: 0.001502, https://gnomad.broadinstitute.org/variant/16-89211778-G-C

    2. CaseLE17: Male, 7 yrs report

      CasePresentingHPOs: N/A

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: Variants not confirmed in-trans due to lack of parental testing

      CasePreviousTesting: Specific plasma MMA levels, urine MMA levels, urine MA levels, and MMA/MA ratio available in Table 2

      CaseGenotypingMethod: See Group

      Variant1: NM_001243279.3:c.774_775del (p.Trp259Glyfs*10)

      CAID: CA1139532418, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA1139532418

      gnomAD: Not in gnomAD

      Variant2: NM_001243279.3(ACSF3):c.1672C>T (p.Arg558Trp)

      ClinVar: 31134, https://www.ncbi.nlm.nih.gov/clinvar/variation/31134/

      gnomAD: 0.004790, https://gnomad.broadinstitute.org/variant/16-89220556-C-T

    1. E

      CaseE: Male, French, Germany

      CasePresentingHPOs: HP:0010896, HP:0010897 (Hypersarcosinemia, Hypersarcosinuria)

      HPOsFreeText: Elevated blood Sarcosine (192 μmol/l; reference 0-9), Elevated urine Sarcosine (645 μmol/mmol; reference 0-36)

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: Phase of the variants are unknown

      CasePreviousTesting: N/A

      CaseGenotypingMethod: DNA was extracted from the probands and immediate family. The whole coding region and the exon-intron boundaries of the SARDH gene was then amplified and sequenced.

      Variant1: NM_007101.3:c.1540C>T (p.Arg514Ter)

      ClinVar: 39451 https://www.ncbi.nlm.nih.gov/clinvar/variation/39451/

      gnomAD: Latino 2.154e-4, Overall 1.120e-4 https://gnomad.broadinstitute.org/variant/9-136570084-G-A

      Variant2: NM_007101.3:c.2167C>T (p.Arg723Ter)

      ClinVar: 39450 https://www.ncbi.nlm.nih.gov/clinvar/variation/39450/

      gnomAD: African 9.899e-5, Overall 5.729e-6 http://gnomad.broadinstitute.org/variant/9-136536816-G-A

    2. D

      CaseD: Male, French, Quebec

      CasePresentingHPOs: HP:0010896, HP:0010897 (Hypersarcosinemia, Hypersarcosinuria)

      HPOsFreeText: Elevated blood Sarcosine (229 μmol/l; reference 0-9), Elevated urine Sarcosine (1213 μmol/mmol; reference 0-36)

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CasePreviousTesting: N/A

      CaseGenotypingMethod: DNA was extracted from the probands and immediate family. The whole coding region and the exon-intron boundaries of the SARDH gene was then amplified and sequenced.

      Variant: NM_007101.3:c.860C>T (p.Pro287Leu)

      ClinVar: 39449 https://www.ncbi.nlm.nih.gov/clinvar/variation/39449/

      gnomAD: European (Finnish) 1.692e-4, Overall 1.032e-4 http://gnomad.broadinstitute.org/variant/9-136594942-G-A

    1. patients

      CaseDO2: Male, Italy, 1 day onset

      CasePresentingHPOs: HP:0001252, HP:0002045, HP:0002033, HP:0001958, HP:0001987, HP:0002151, HP:0001942, HP:0003648, HP:0001640, HP:0001644, HP:0001667, HP:0003324, HP:0001270, HP:0001510, HP:0001875, HP:0002098, HP:0001649, HP:0000969, HP:0001712, HP:0012666, HP:0003535, HP:0001397, HP:0001706 (Muscular hypotonia, Hypothermia, Poor suck, Nonketotic hypoglycemia, Hyperammonemia, Increased serum lactate, Metabolic acidosis, Lacticaciduria, Cardiomegaly, Dilated cardiomyopathy, Right ventricular hypertrophy, Generalized muscle weakness, Motor delay, Growth delay, Neutropenia, Respiratory distress, Tachycardia, Edema, Left ventricular hypertrophy, Severely reduced ejection fraction, 3-Methylglutaconic aciduria, Hepatic steatosis, Endocardial fibroelastosis)

      HPOsFreeText: N/A

      CaseNotHPOs: HP:0001875 (Neutropenia)

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CasePreviousTesting: Birth weight of 2830 g; Unremarkable family history; See "Results" for exact metabolic values

      CaseGenotypingMethod: Genomic DNA was isolated from whole blood and the TAZ gene was amplified and directly sequenced.

      Variant: NM_000116.4:c.541+1G>A

      CAID: CA415183775, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA415183775

      gnomAD: Not in gnomAD

    2. two

      CaseDO1: Male, Italy, 3 days onset

      CasePresentingHPOs: HP:0011968, HP:0001254, HP:0001252, HP:0002045, HP:0001640, HP:0012664, HP:0002119, HP:0001943, HP:0002910, HP:0003236, HP:0001942, HP:0002151, HP:0003542, HP:0100493, HP:0008315, HP:0011936, HP:0003648, HP:0003344, HP:0003535, HP:0001508, HP:0001270, HP:0001649, HP:0001875, HP:0001644, HP:0002375, HP:0001706, HP:0001397 (Poor feeding, Lethargy, Muscular hypotonia, Hypothermia, Cardiomegaly, Reduced ejection fraction, Ventriculomegaly, Hypoglycemia, Elevated hepatic transaminase, Elevated serum creatine kinase, Metabolic acidosis, Increased serum lactate, Increased serum pyruvate, Hypoammonemia, Decreased plasma free carnitine, Decreased plasma total carnitine, Lacticaciduria, 3-Methylglutaric aciduria, 3-Methylglutaconic aciduria, Failure to thrive, Motor delay, Tachycardia, Neutropenia, Dilated cardiomyopathy, Hypokinesia, Endocardial fibroelastosis, Hepatic steatosis)

      HPOsFreeText: N/A

      CaseNotHPOs: HP:0002240, HP:0002919 (Hepatomegaly, Ketonuria)

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CasePreviousTesting: Birth weight of 2780 g; Three maternal great-uncles and two maternal second cousins died in the first years of life; See "Results" for exact metabolic values;

      CaseGenotypingMethod: Genomic DNA was isolated from whole blood and the TAZ gene was amplified and directly sequenced.

      Variant: NM_000116.5(TAZ):c.589G>A (p.Gly197Arg)

      ClinVar: 11105, https://www.ncbi.nlm.nih.gov/clinvar/variation/11105/

      gnomAD: Not in gnomAD

    1. Patient 2

      Case2: Female, Iran, 18 mo (age at diagnosis)

      CasePresentingHPOs: HP:0003324, HP:0001254, HP:0004789, HP:0002039, HP:0002015, HP:0002098, HP:0001508, HP:0002360, HP:0001298 (generalized muscle weakness, lethargy, milk intolerance, anorexia, swallowing difficulty, breathing difficulties, failure to thrive, sleep disturbance, encephalopathy)

      HPOsFreeText: unspecified abnormalities in sitting and speech

      Case (Level 2)


      CasePreviousTesting: elevated propionylcarnitines (4.24 umol/L), Urine MMA (BT) 2200 umol/mmol creatinine, Urine MMA (AT) 40.0 umol/mmol creatinine

      CaseMethod1: same as group

      CaseGenotypingMethod: same as group


      Variant: NM_000255.3:c.2125-3C>G

      ClinVar: n/a

      CAID: CA913187295

      gnomAD: n/a


      CaseAddInfo: consanguineous parents. Treated for MMA with L-carnitine, biotin, and vitamin B12. Died at the age of 3.5 y. homozygous mutation.

    2. Patient 3

      Case3: Female, Iran, 3 d (age at diagnosis)

      CasePresentingHPOs: HP:0002883, HP:0001254, HP:0004789, HP:0002039, HP:0001290, HP:0001941, HP:0001508, HP:0001298, HP:0002019 (rapid breathing, lethargy, milk intolerance, anorexia, hypotonia, acidosis, failure to thrive, encephalopathy, constipation)

      Case (Level 2)


      CasePreviousTesting: elevated propionylcarnitine (61 umol/L), Urine MMA (BT) 1950 umol/mmol creatinine, Urine MMA (AT) 35.0 umol/mmol creatinine.

      CaseMethod1: same as group

      CaseGenotypingMethod: same as group


      Variant: NM_000255.3:c.2125-3C>G

      ClinVar: n/a

      CAID: CA913187295

      gnomAD: n/a


      CaseAddInfo: Consanguineous parents. Treated for MMA with L-carnitine, sodium benzoate, and vitamin B12. Currently 6 y, with moderately delayed development. Deceased infant sibling with similar symptoms, not genotyped. homozygous mutation.

    3. Three unrelated affected patients

      GroupPresentingHPOs: HP:0002013, HP:0001263 (vomiting, developmental delay)

      HPOsFreeText: increased urinary excretion of methylmalonate and methylcitric acids. Elevated propionylcarnitine.

      NumberMales: 0

      NumberFemales: 3

      CountryOrigin: Iran

      AgeRange: 3 d-22 mo (age at diagnosis)

      TotalNumber: 3

      FamilyInfo: 3

      NoFamily: 0

      GroupAddInfo: All probands are products of consanguineous marriages.

      Group (Level 2)


      VariantCount: 3

      NonVariant: 0

      OtherVariant: 0

      GroupPreviousTesting: urine organic acid analysis with urease treatment extraction with gas chromatography-mass spectrometry, after showing high levels of propionylcarnitine (umol/L) through tandem mass spectrometry

      GroupMethod1: PCR

      GroupGenotypingMethod: Genomic DNA was extracted from peripheral blood samples by the salting out method. MUT gene was analyzed by PCR and sequencing of both DNA strands of the entire coding region and highly-conserved exon-intron splice junctions. Reference sequence is NM_000255.3. Amplification was confirmed by electrophoresis, and products of the sequencing reaction were analyzed by DNA Sequencher 4.7. The phase of the mutation was confirmed by sequencing DNA from the patients parents.

    4. Patient 1

      Case1: Female, Iran, 22 mo (age at diagnosis)

      CasePresentingHPOs: HP:0001250, HP:0001290, HP:0001941, HP:0002019, HP:0002355, HP:0001344 (seizures, generalized hypotonia, acidosis, constipation, difficulty walking, absent speech)

      HPOsFreeText: congenital malformations

      Case (Level 2)


      CasePreviousTesting: elevation of propionylcarnitine (9.8 umol/L0, Urine MMA (BT) 2800 umol/mmol creatinine, Urine MMA (AT) 47.0 umol/mmol creatinine

      CaseMethod1: same as group

      CaseGenotypingMethod: same as group


      Variant: NM_000255.3:c.2125-3C>G

      ClinVar: n/a

      CAID: CA913187295

      gnomAD: n/a


      CaseAddInfo: consanguineous parents, treated for MMA with phenobarbital, L-carnitine, and vitamin B12. Died at 3 y of age. homozygous mutation.

    1. Case report

      Case1: Male, 3 months onset, China, Asian

      CasePresentingHPOs: HP:0011968, HP:0001290, HP:0001263, HP:0001508, HP:0000023, HP:0002793, HP:0004691, HP:0001999, HP:0000369, HP:0000218, HP:0000954, HP:0006802, HP:0100952, HP:0002079, HP:0002151, HP:0012736, HP:0002421 (Poor feeding, Generalized hypotonia, Psychomotor delay, Poor weight gain, Inguinal hernia, Abnormal pattern of respiration, 2-3 toe syndactyly, Dysmorphic facies, Low-set ears, High-arched palate, Transverse palmar crease, Abnormality of the anterior horn cells, Enlarged lateral sulcus, Thinning of the corpus callosum, Increased serum lactate, Profound global developmental delay, Poor head control)

      HPOsFreeText: 3 kg birth weight, Breath-holding spells, The parameters at 5 months were as follows: weight, 4 kg (<0.4th percentile); length, 58 cm (<0.4th percentile), head circumference, 36.5 cm (<0.4th percentile), Enlarged anterior portion of bilateral ventricles and thinning surrounding whiter, Abnormal infant EEG

      CaseNotHPOs: HP:0001946, HP:0003542, HP:0000364, HP:0003457 (Ketosis, Increased serum pyruvate, Hearing abnormality, EMG abnormality)

      NotHPOsFreeText: N/A

      CaseAddInfo: Parents are non-consanguineous, parental heterozygosity is confirmed, Both variants are predicted to destroy normal splicing sites and cause a null protein with Variant 1 skipping exon 4 and Variant 2 skipping exon 12

      CasePreviousTesting: Mild elevation of hydroxyl-C4-carnitine (0.79; reference: 0.03–0.70), Normal venous blood lactate at 3 months (1.1 mmol/L; reference 0.44–1.78 mmol/L) and elevated at 5 months (3.2 mmol/L; reference: 1.42–1.90 mmol/L), Ketone and pyruvate levels at 5 months were normal, Karyotype analysis was performed to confirm normality. Low-coverage massively parallel CNV sequencing was used to confirm any copy number variation, which showed normal results.

      CaseGenotypingMethod: Genomic DNA was extracted from lymphocytes and whole exome sequencing was performed. The identified variants were filtered for pathogenicity and confirmed via Sanger sequencing. cDNA sequence analysis was also performed to determine the effect of these variants on the protein.

      Variant1: NM_014362.3:c.304+3A>G (p.=)

      CAID: CA913203579 http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA913203579

      gnomAD: Not in gnomAD

      Variant2: NM_014362.3:c.1010_1011+3delTGGTA

      CAID: CA2027408 http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvsOrDescriptor=NM_014362.3%3Ac.1010_1011%2B3delTGGTA

      gnomAD: Not in gnomAD

    1. Table 2

      Case2: Male, Belgium

      CasePresentingHPOs: HP:0001290, HP:0003324, HP:0002093, HP:0011968, HP:0001283, HP:0002804, HP:0003798, HP:0001558, HP:0001623, HP:0000602 (Generalized hypotonia, Generalized muscle weakness, Respiratory insufficiency, Feeding difficulties, Bulbar weakness, Arthrogryposis, Decreased fetal movement, Breech presentation, Ophthalmoplegia)

      HPOsFreeText: N/A

      CaseNotHPOs: HP:0001627 (Cardiac abnormality)

      NotHPOsFreeText: N/A

      CaseAddInfo: Severe congenital myopathy, Deceased 10 months

      CasePreviousTesting: N/A

      CaseGenotypingMethod: After LMOD3 was identified as a potential causal gene, bidirectional Sanger sequencing was performed on DNA in genetically unresolved patients using PCR amplification covering 3 exons.

      Variant: NM_198271.4(LMOD3):c.138dup (p.Ser47Glnfs)

      ClinVar: 162215 https://www.ncbi.nlm.nih.gov/clinvar/variation/162215/

      gnomAD: European (Non-Finnish) 8.879e-6, Overall 8.049e-6 https://gnomad.broadinstitute.org/variant/3-69171399-T-TG

    2. Table 2

      Case4: Male, Japan, Asian

      CasePresentingHPOs: HP:0001290, HP:0003324, HP:0002093, HP:0011968, HP:0001283, HP:0003798 (Generalized hypotonia, Generalized muscle weakness, Respiratory insufficiency, Feeding difficulties, Bulbar weakness, Nemaline bodies)

      HPOsFreeText: Atrophic myofibers

      CaseNotHPOs: HP:0001627 (Cardiac abnormality)

      NotHPOsFreeText: N/A

      CaseAddInfo: Severe congenital myopathy, Alive at 4 months

      CasePreviousTesting: N/A

      CaseGenotypingMethod: After LMOD3 was identified as a potential causal gene, bidirectional Sanger sequencing was performed on DNA in genetically unresolved patients using PCR amplification covering 3 exons.

      Variant: NM_198271.4:c.231G>A (p.Trp77*)

      CAID: CA353478954 http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_198271.4%3Ac.231G%3EA

      gnomAD: Not in gnomAD

    3. Table 2

      Case13a: Male, Pakistan

      CasePresentingHPOs: HP:0001290, HP:0003324, HP:0002093, HP:0011968, HP:0001283, HP:0001623, HP:0001561, HP:0000602, HP:0002808 (Generalized hypotonia, Generalized muscle weakness, Respiratory insufficiency, Feeding difficulties, Bulbar weakness, Breech presentation, Polyhydramnios, Ophthalmoplegia, Kyphosis)

      HPOsFreeText: N/A

      CaseNotHPOs: HP:0001627 (Cardiac abnormality)

      NotHPOsFreeText: N/A

      CaseAddInfo: Severe congenital myopathy, Deceased in 3 months, Has a sibling with same genotype/phenotype

      CasePreviousTesting: N/A

      CaseGenotypingMethod: After LMOD3 was identified as a potential causal gene, bidirectional Sanger sequencing was performed on DNA in genetically unresolved patients using PCR amplification covering 3 exons.

      Variant: NM_198271.4:c.1099_1100delAA (p.Asn367Glnfs*11)

      ClinVar: 162218 https://www.ncbi.nlm.nih.gov/clinvar/variation/162218/

      gnomAD: South Asian 4.575e-4, Overall 5.625e-5 https://gnomad.broadinstitute.org/variant/3-69168405-GTT-G

    4. Table 2

      Case1a: Female, Algeria

      CasePresentingHPOs: HP:0001290, HP:0003324, HP:0002093, HP:0011968, HP:0001283, HP:0001561, HP:0001622, HP:0002804, HP:0003798 (Generalized hypotonia, Generalized muscle weakness, Respiratory insufficiency, Feeding difficulties, Bulbar weakness, Polyhydramnios, Preterm delivery, Arthrogryposis, Nemaline bodies)

      HPOsFreeText: Bilateral femoral fractures, Atrophic myofibers

      CaseNotHPOs: HP:0001627 (Cardiac abnormality)

      NotHPOsFreeText: N/A

      CaseAddInfo: Severe congenital myopathy, Deceased in neonatal period, Parents are consanguineous

      CasePreviousTesting: N/A

      CaseGenotypingMethod: Linkage analysis combined with homozygosity mapping was used to identify candidate chromosomal loci. Whole exome sequencing in this family revealed likely pathogenic mutations in LMOD3 which agreed with the aforementioned analysis and was consistent with autosomal recessive inheritance.

      Variant: NM_198271.4(LMOD3):c.138dup (p.Ser47Glnfs)

      ClinVar: 162215 https://www.ncbi.nlm.nih.gov/clinvar/variation/162215/

      gnomAD: European (Non-Finnish) 8.879e-6, Overall 8.049e-6 https://gnomad.broadinstitute.org/variant/3-69171399-T-TG

    5. Table 2

      Case7: Female, Japan, Asian

      CasePresentingHPOs: HP:0001290, HP:0003324, HP:0002093, HP:0011968, HP:0001283, HP:0003798, HP:0001561, HP:0001558, HP:0000602 (Generalized hypotonia, Generalized muscle weakness, Respiratory insufficiency, Feeding difficulties, Bulbar weakness, Nemaline bodies, Polyhydramnios, Decreased fetal movements, Ophthalmoplegia)

      HPOsFreeText: Atrophic myofibers

      CaseNotHPOs: HP:0001627 (Cardiac abnormality)

      NotHPOsFreeText: N/A

      CaseAddInfo: Severe congenital myopathy, Alive at 1 yr 7 months

      CasePreviousTesting: N/A

      CaseGenotypingMethod: After LMOD3 was identified as a potential causal gene, bidirectional Sanger sequencing was performed on DNA in genetically unresolved patients using PCR amplification covering 3 exons.

      Variant1: NM_198271.4:c.349C>T (p.Gln117*)

      CAID: CA353477271 http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_198271.4%3Ac.349C%3ET

      gnomAD: Not in gnomAD

      Variant2: NM_198271.4:c.1218delA (p.Lys406Asnfs*11)

      CAID: CA909806380 http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_198271.4%3Ac.1218delA

      gnomAD: Not in gnomAD

    6. Table 2

      Case11b: Male, Sweden

      CasePresentingHPOs: HP:0001290, HP:0003324, HP:0002093, HP:0011968, HP:0001283 (Generalized hypotonia, Generalized muscle weakness, Respiratory insufficiency, Feeding difficulties, Bulbar weakness)

      HPOsFreeText: N/A

      CaseNotHPOs: HP:0001627 (Cardiac abnormality)

      NotHPOsFreeText: N/A

      CaseAddInfo: Severe congenital myopathy, Deceased in neonatal period

      CasePreviousTesting: N/A

      CaseGenotypingMethod: After LMOD3 was identified as a potential causal gene, bidirectional Sanger sequencing was performed on DNA in genetically unresolved patients using PCR amplification covering 3 exons.

      Variant: NM_198271.4:c.1069G>T (p.Glu357Ter)

      ClinVar: 162219 https://www.ncbi.nlm.nih.gov/clinvar/variation/162219/

      gnomAD: Not in gnomAD

    7. Table 2

      Case1b: Female, Algeria

      CasePresentingHPOs: HP:0001290, HP:0003324, HP:0002093, HP:0011968, HP:0001283, HP:0001622 (Generalized hypotonia, Generalized muscle weakness, Respiratory insufficiency, Feeding difficulties, Bulbar weakness, Preterm delivery)

      HPOsFreeText: N/A

      CaseNotHPOs: HP:0001627 (Cardiac abnormality)

      NotHPOsFreeText: N/A

      CaseAddInfo: Severe congenital myopathy, Deceased in neonatal period, Parents are consanguineous

      CasePreviousTesting: N/A

      CaseGenotypingMethod: Linkage analysis combined with homozygosity mapping was used to identify candidate chromosomal loci. Whole exome sequencing in this family revealed likely pathogenic mutations in LMOD3 which agreed with the aforementioned analysis and was consistent with autosomal recessive inheritance.

      Variant: NM_198271.4(LMOD3):c.138dup (p.Ser47Glnfs)

      ClinVar: 162215 https://www.ncbi.nlm.nih.gov/clinvar/variation/162215/

      gnomAD: European (Non-Finnish) 8.879e-6, Overall 8.049e-6 https://gnomad.broadinstitute.org/variant/3-69171399-T-TG

    1. three

      CaseKLC: Male, 42 yrs death, Japan, Asian

      CasePresentingHPOs: HP:0001394, HP:0002078, HP:0000651, HP:0008353, HP:0003763, HP:0100785, HP:0001276, HP:0030904, HP:0030906, HP:0030903 (Cirrhosis, Truncal ataxia, Diplopia, Neutral hyperaminoaciduria, Bruxism, Insomnia, Hypertonia, Glabellar reflex, Suck reflex, Grasp reflex)

      HPOsFreeText: Monoamino-monocarboxylic aciduria, Transient stupor

      CaseNotHPOs: HP:0000992, HP:0011123, HP:0040129 (Cutaneous photosensitivity, Dermatitis, Abnormal nerve conduction velocity)

      NotHPOsFreeText: N/A

      CaseAddInfo: Parents are first-cousin consanguineous, Max LOD score is 2.1 for family

      CasePreviousTesting: Defects in the intestinal absorption of monoamino-monocarboxylic acids determined by oral loading; Urine analyses confirmed the absence of hyperaminoaciduria in the mother (III-4), father (III-5) and the younger brother (IV-3);

      CaseGenotypingMethod: DNA was isolated from peripheral blood samples and from liver samples collected at autopsy. A genome-wide screen with 343 different markers was carried out and linkage analysis performed using homozygosity mapping. Both SLC6A18 and SLC6A19 were investigated for possible pathogenicity, with SLC6A19's pattern of expression supporting it as a primary candidate. Intronic primers were used to bidirectionally sequence each exon and flanking intronic regions, locating a homozygous frameshift mutation that perfectly segregated with the phenotype.

      CasePMIDs: 2582682, 11394870

      Variant: NM_001003841.3(SLC6A19):c.882_883TG[1] (p.Val295fs)

      ClinVar: 2018 https://ww.ncbi.nlm.nih.gov/clinvar/variation/2018/

      gnomAD: 0.000008900, https://gnomad.broadinstitute.org/variant/5-1214174-CTG-C?dataset=gnomad_r2_1

    2. Japanese

      CaseKLD: Female, 6 yrs report, Japan, Asian

      CasePresentingHPOs: HP:0001047, HP:0002028, HP:0004325, HP:0004322, HP:0008353, HP:0001397, HP:0001249 (Atopic dermatitis, Chronic diarrhea, Decreased body weight, Short stature, Neutral hyperaminoaciduria, Hepatic steatosis, Intellectual disability)

      HPOsFreeText: Lowered concentrations of valine, methionine, isoleucine, tyrosine, phenylalanine, and tryptophan with generalized mild hypoaminoacidemia

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: Parents are first-cousin consanguineous, Max LOD score is 1.45 for family, Pedigree in Figure 1aD

      CasePreviousTesting: Oral loading tests demonstrated impaired absorption of tryptophan from the gut, while the absorption of proline was intact; Absence of hyperaminoaciduria was confirmed by urine analyses of the pedigree members

      CaseGenotypingMethod: DNA was isolated from peripheral blood samples and from liver samples collected at autopsy. A genome-wide screen with 343 different markers was carried out and linkage analysis performed using homozygosity mapping. Both SLC6A18 and SLC6A19 were investigated for possible pathogenicity, with SLC6A19's pattern of expression supporting it as a primary candidate. Intronic primers were used to bidirectionally sequence each exon and flanking intronic regions, locating a homozygous missense mutation that perfectly segregated with the phenotype.

      CasePMIDs: 2582682, 11394870

      Variant: NM_001003841.3:c.169C>T (p.Arg57Cys)

      CAID: CA3182581 http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA3182581

      gnomAD: 0.0002181, https://gnomad.broadinstitute.org/variant/5-1201934-C-T

    1. 5

      CaseCA5: Male, 9 months death

      CasePresentingHPOs: HP:0001644, HP:0001875, HP:0001508, HP:0003535, HP:0002014, HP:0008872, HP:0003146 (Dilated cardiomyopathy, Neutropenia, Failure to thrive, 3-Methylglutaconic aciduria, Diarrhea, Feeding difficulties in infancy, Hypocholesterolemia)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CasePreviousTesting: N/A

      CaseGenotypingMethod: The TAZ gene was PCR amplified in three fragments and directly sequenced in the mother and proband.

      Variant: NM_000116.4:c.629T>G (p.Leu210Arg)

      CAID: CA415184340, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA415184340

      gnomAD: Not in gnomAD

    2. 3

      CaseCA3: Male, 6 months diagnosis

      CasePresentingHPOs: HP:0001644, HP:0001875, HP:0001508, HP:0003535, HP:0003756, HP:0030319, HP:0003551 (Dilated cardiomyopathy, Neutropenia, Failure to thrive, 3-Methylglutaconic aciduria, Skeletal myopathy, Facial weakness, Difficulty climbing stairs)

      HPOsFreeText: N/A

      CaseNotHPOs: HP:0003107 (Abnormal circulating cholesterol concentration)

      NotHPOsFreeText: N/A

      CaseAddInfo: Cardiac transplant 11 months after presentation; Variant also found in mother and grandmother

      CasePreviousTesting: N/A

      CaseGenotypingMethod: The TAZ gene was PCR amplified in three fragments and directly sequenced in the mother and proband.

      Variant: NM_000116.5(TAZ):c.589G>A (p.Gly197Arg)

      ClinVar: 11105, https://www.ncbi.nlm.nih.gov/clinvar/variation/11105/

      gnomAD: Not in gnomAD

    1. CLINICAL REPORT

      CaseSK: Male, Pakistan, Birth onset

      CasePresentingHPOs: HP:0008846, HP:0001562, HP:0002987, HP:0012453, HP:0001623, HP:0001518, HP:0003561, HP:0002209, HP:0011359, HP:0000963, HP:0100678, HP:0000973, HP:0100679, HP:0000348, HP:0002007, HP:0005280, HP:0000463, HP:0003196, HP:0000430, HP:0000233, HP:0000490, HP:0007759, HP:0000218, HP:0000347, HP:0005328, HP:0002828, HP:0002098, HP:0009110, HP:0000883, HP:0011682, HP:0001655, HP:0100545, HP:0007727, HP:0002033, HP:0002015, HP:0001250, HP:0000023, HP:0001525 (Severe intrauterine growth retardation, Oligohydramnios, Elbow contracture, Bilateral wrist flexion contracture, Breech presentation, Small for gestational age, Birth length less than 3rd percentile, Sparse scalp hair, Dry hair, Thin skin, Wrinkled skin, Cutis laxa, Lack of skin elasticity, High forehead, Frontal bossing, Depressed nasal bridge, Anteverted nares, Short nose, Underdeveloped nasal alae, Thin vermilion border, Deeply set eye, Opacification of the corneal stroma, High-arched palate, Micrognathia, Progeroid facial appearance, Multiple joint contractures, Respiratory distress, Diaphragmatic eventration, Thin ribs, Perimembranous ventricular septal defect, Patent foramen ovale, Arterial stenosis, Opacification of the corneal epithelium, Poor suck, Dysphagia, Seizures, Inguinal hernia, Severe failure to thrive)

      HPOsFreeText: Clenched fists, Birth weight was 1.52 kg (<3rd centile), his length was 38 cm (<3rd centile) and his OFC was 29.5 cm (<3rd centile). His Apgar scores were six and nine at 1 and 5 min respectively, Parchment paper‐like textured skin, Prominent cheek jowls, Absent Bowman's membrane, Increased cellularity in the substantia propia, Decreased amount of elastin compared to controls, Less-deefined collagen fibers, Amounts of collagen type I and III were qualitatively decreased

      CaseNotHPOs: N/A

      NotHPOsFreeText: Normal lung parenchyma

      CaseAddInfo: Born to consanguineous first-cousin once removed parents

      CasePreviousTesting: Maternal TORCH analysis showed no signs of an acute infection; Amniocentesis showed a normal male karyotype (46,XY), and amniotic fluid virology studies showed no detectable virus; Fetal echocardiography was normal; Fibroblast analysis showed cell proliferation was severely diminished along with abnormally decreased collagen production; A heterozygous variant in PYCR1 was also found (c.329C > T) but is predicted benign and no functional expression alteration of PYCR1 was found.

      CaseGenotypingMethod: The exons and exon-intron boundaries of ALDH18A1 were subject to mutation screening via direct sequencing and PCR amplification. A homozygous canonical splice-site variant was found with both parents heterozygous for the same mutation. cDNA was applied to test for functional alteration of the transcript which yielded, rathert than the WT 706 bp protein, a shortened protein ranging from 492-583 bp. These two transcripts either lead to a large deletion of c.1757–1970 or a premature termination codon predicted to undergo NMD.

      Variant: NM_002860.4(ALDH18A1):c.1923+1G>A

      ClinVar: 29727 https://www.ncbi.nlm.nih.gov/clinvar/variation/29727/

      gnomAD: Not in gnomAD

    1. Patient 2

      Case2: Male, White, 18 yrs report

      CasePresentingHPOs: HP:0010864, HP:0000717, HP:0002019, HP:0002300, HP:0001250, HP:0012072 (Severe Intellectual disability, Autism, Constipation, Mutism, Seizures, Aciduria)

      HPOsFreeText: N/A

      CaseNotHPOs: HP:0001627, HP:0000175 (Abnormal heart morphology, Cleft palate)

      NotHPOsFreeText: N/A

      CaseAddInfo: Parents are non-consanguineous, Has 22q11.2 deletion so phenotypes other than urinary excretion may result from that

      CasePreviousTesting: Urine analysis at 25 years of age showed an increase of AAA (226 mmol/mol creatinine; ref <14) and KAA (68 mmol/mol creatinine; ref not detected)

      CaseGenotypingMethod: All 17 exons and flanking intronic sequences of DHTKD1 were Sanger sequenced. SSCP analysis confirmed the presence of the 22q11.2 deletion.

      Variant1: NM_018706.5(DHTKD1):c.2185G>A (p.Gly729Arg)

      ClinVar: 39564 https://www.ncbi.nlm.nih.gov/clinvar/variation/39564/

      gnomAD: 0.002748, https://gnomad.broadinstitute.org/variant/10-12154929-G-A

      Variant2: NM_018706.7(DHTKD1):c.2318C>T (p.Pro773Leu)

      ClinVar: 420289 https://www.ncbi.nlm.nih.gov/clinvar/variation/420289/

      gnomAD: 0.0001423, https://gnomad.broadinstitute.org/variant/10-12155062-C-T

    2. Patient 3

      Case3: Female, 5 yrs report

      CasePresentingHPOs: HP:0012072 (Aciduria)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo:

      CasePreviousTesting: Partial biotinidase deficiency (19%) was confirmed; Urine AAA (552 mmol/mol creatinine; ref <91) and KAA (251 mmol/mol creatinine) were clearly increased. At 5 years of age, urine AAA and KAA as well as plasma AAA were persistently elevated.

      CaseGenotypingMethod: All 17 exons and flanking intronic sequences of DHTKD1 were Sanger sequenced.

      Variant1: NM_018706.5(DHTKD1):c.2185G>A (p.Gly729Arg)

      ClinVar: 39564 https://www.ncbi.nlm.nih.gov/clinvar/variation/39564/

      gnomAD: 0.002748, https://gnomad.broadinstitute.org/variant/10-12154929-G-A

      Variant2: NM_018706.7(DHTKD1):c.1309G>T (p.Glu437Ter)

      ClinVar: 574714 https://www.ncbi.nlm.nih.gov/clinvar/variation/574714/

      gnomAD: 0.0001316, https://gnomad.broadinstitute.org/variant/10-12136221-G-T

    1. one new de novo dominant case

      CaseST: Female, 2 days onset

      CasePresentingHPOs: HP:0002521, HP:0010841, HP:0012000, HP:0032842, HP:0011468, HP:0007289, HP:0100704, HP:0000639, HP:0001601, HP:0012820, HP:0002835, HP:0001252, HP:0001257, HP:0001263, HP:0002079, HP:0011757, HP:0003429 (Hypsarrhythmia, Multifocal epileptiform discharges, EEG with generalized spikes, Generalized-onset epileptic spasm, Facial tics, Limb fasciculations, Cerebral visual impairment, Nystagmus, Laryngomalacia, Bilateral vocal cord paralysis, Aspiration, Muscular hypotonia, Spasticity, Global developmental delay, Hypoplasia of the corpus callosum, Posterior pituitary hypoplasia, CNS hypomyelination)

      HPOsFreeText: Lack of normal sleep or wake features on EEG

      CaseNotHPOs: HP:0002650 (Scoliosis)

      NotHPOsFreeText: N/A

      CaseAddInfo: Proband is confirmed de novo heterozygous

      CasePreviousTesting: Currently on vigabatrin, levetiracetam, Rufinamide and ketogenic diet, previously on phenobarbatol, ACTH, Cannabidiol oil and Prednisolone; MRS with small lactate peaks in the basal ganglia and supratentorial white matter

      CaseGenotypingMethod: Whole exome sequencing revealed a pathogenic heterozygous c.254T>C (p.Leu85Pro) variant in the SLC1A2 gene, which was classified as de novo using parental testing.

      Variant: NM_004171.4(SLC1A2):c.254T>C (p.Leu85Pro)

      ClinVar: 254266, https://www.ncbi.nlm.nih.gov/clinvar/variation/254266/

      gnomAD: Not in gnomAD

    1. AC007 II-1

      CaseAC007_II-1: Male, 5 yrs onset, Liberia, Black

      CasePresentingHPOs: HP:0001992, HP:0002373, HP:0010864, HP:0000729, HP:0000750, HP:0002539, HP:0002282 (Organic aciduria, Febrile seizure, Severe intellectual disability, Autistic behavior, Delayed speech and language development, Cortical dysplasia, Gray matter heterotopia)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: Parents are reportedly non-consanguineous, Proband is confirmed homozygous for this variant without parental confirmation via restriction fragment analysis

      CasePreviousTesting: Identified by the assessment of urinary organic acids by gas chromatography–mass spectrometry; Accumulation of N-acetylated amino acids was much less pronounced than in previously reported patients

      CaseGenotypingMethod: Genomic DNA was extracted either from peripheral blood or EBV-transformed lymphocytes. PCR-amplification and bidirectional sequencing of all exons and exon-intron boundaries of ACY1 was performed. Restriction digest analysis was performed to confirm homozygosity.

      Variant: NM_000666.3(ACY1):c.1156C>T (p.Arg386Cys)

      ClinVar: 712435, https://www.ncbi.nlm.nih.gov/clinvar/variation/712435/

      gnomAD: 0.01775 (3 homozygotes), https://gnomad.broadinstitute.org/variant/3-52023020-C-T

    2. AC014 II-1

      CaseAC014_II-1: Female, 3 yrs report, Lebanon

      CasePresentingHPOs: HP:0001992, HP:0025356 (Organic aciduria, Psychomotor retardation)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: Parents are consanguineous, Proband is confirmed homozygous for this variant via parental testing, Siblings are healthy

      CasePreviousTesting: Identified by the assessment of urinary organic acids by gas chromatography–mass spectrometry; Accumulation of N-acetylated amino acids was much less pronounced than in previously reported patients

      CaseGenotypingMethod: Genomic DNA was extracted either from peripheral blood or EBV-transformed lymphocytes. PCR-amplification and bidirectional sequencing of all exons and exon-intron boundaries of ACY1 was performed.

      Variant: NM_000666.3(ACY1):c.1132C>T (p.Arg378Trp)

      ClinVar: 493363, https://www.ncbi.nlm.nih.gov/clinvar/variation/493363/

      gnomAD: 0.00001499 in ExAC, https://gnomad.broadinstitute.org/variant/3-52022996-C-T?dataset=exac

    1. Patient II:1

      CasePAII-1: Female, 18 yrs onset

      CasePresentingHPOs: HP:0000147, HP:0040292, HP:0002083, HP:0003401, HP:0001251, HP:0000640, HP:0006855, HP:0006744 (Polycystic ovary disease, Left hemiplegia, Migraine without aura, Paresthesia, Ataxia, Gaze-evoked nystagmus, Cerebellar vermis atrophy, Adrenocortical carcinoma)

      HPOsFreeText: N/A

      CaseNotHPOs: HP:0000505 (Visual impairments)

      NotHPOsFreeText: N/A

      CaseAddInfo: Parents are consanguineous, Mother has similar symptoms but declined to be clinically examined

      CasePreviousTesting: Episodes triggered by menstruation but also by stress and preceded by a sensorimotor march; EEG and electroneurography were normal; Pathologic CAG expansions in CACNA1A and conventional mutations in CACNA1A, ATP1A2, and SCN1A were ruled out; Treatment with ACZ (250 mg twice daily) prevented hemiplegic spells and interictal GEN receded; MRS demonstrated low combined glutamate and glutamine peak that responded to ACZ treatment during an episode

      CaseGenotypingMethod: Targeted genotyping analysis was performed.

      Variant: NM_004172.5:c.379_383del (p.Tyr127Aspfs*60)

      CAID: CA1139532263, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA1139532263

      gnomAD: Not in gnomAD

    1. 25014 (F)

      Case25014: Female, 31 yrs onset, United States

      CasePresentingHPOs: HP:0002527, HP:0002064, HP:0002460, HP:0002395, HP:0007350, HP:0003487, HP:0000012, HP:0006938, HP:0100658, HP:0000518, HP:0002322, HP:0010784, HP:0012104, HP:0006913 (Falls, Spastic gait, Distal muscle weakness, Lower limb hyperreflexia, Hyperreflexia in upper limbs, Babinski sign, Urinary urgency, Impaired vibration sensation at ankles, Cellulitis, Cataract, Resting tremor, Uterine neoplasm, Parietal cortical atrophy, Frontal cortical atrophy)

      HPOsFreeText: 5/7 disability score, Chronic microvascular disease

      CaseNotHPOs: HP:0001317, HP:0002464, HP:0100543, HP:0000973 (Abnormal cerebellum morphology, Spastic dysarthria, Cognitive impairment, Cutis laxa)

      NotHPOsFreeText: N/A

      CaseGenotypingMethod: Exome sequencing data of 160 index patients with autosomal dominant spastic paraplegia and 275 index patients with autosomal recessive or sporadic spastic paraplegia was examined. 95 patients were screened through panel sequencing. Any determined ALDH18A1 mutations were confirmed by Sanger sequencing.

      CasePreviousTesting: N/A

      CaseAddInfo: Case is sporadic

      Variant: NM_002860.4(ALDH18A1):c.755G>A (p.Arg252Gln)

      ClinVar: 217117 https://www.ncbi.nlm.nih.gov/clinvar/variation/217117/

      gnomAD: Not in gnomAD

    2. GSHSP44 (F)

      CaseGSHSP44: Female, 44 yrs onset, Australia/UK

      CasePresentingHPOs: HP:0040083, HP:0002317, HP:0002064, HP:0002460, HP:0002395, HP:0007350, HP:0003487, HP:0000012, HP:0012104, HP:0006913, HP:0001761, HP:0031520, HP:0006827 (Toe walking, Unsteady gait, Spastic gait, Distal muscle weakness, Lower limb hyperreflexia, Hyperreflexia in upper limbs, Babinski sign, Urinary urgency, Parietal cortical atrophy, Frontal cortical atrophy, Pes cavus, Groin pain, Atrophy of the spinal cord)

      HPOsFreeText: 4/7 disability score, Hip replacement

      CaseNotHPOs: HP:0001317, HP:0002464, HP:0100543, HP:0000973, HP:0006938 (Abnormal cerebellum morphology, Spastic dysarthria, Cognitive impairment, Cutis laxa, Impaired vibration sensation at ankles)

      NotHPOsFreeText: N/A

      CaseGenotypingMethod: Exome sequencing data of 160 index patients with autosomal dominant spastic paraplegia and 275 index patients with autosomal recessive or sporadic spastic paraplegia was examined. 95 patients were screened through panel sequencing. Any determined ALDH18A1 mutations were confirmed by Sanger sequencing.

      CasePreviousTesting: N/A

      CaseAddInfo: Case is sporadic

      Variant reported as c.1949G>T which does not exist in current transcripts

      Variant: NM_002860.3:c.1955C>T (p.Ser652Phe)

      CAID: CA377700120 http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA377700120

      gnomAD: Not in gnomAD

    1. 53

      Case53: 4 mo (at biopsy), Arab/Turkish, female

      CaseNotHPOs: metabolic acidosis, homocystinuria (HP:0001942, HP:0002156)

      NotHPOsFreeText: normal synthesis of adenosylcobalamin and methylcobalmin (suggests patient does not have cblX disease).

      Case 53 (Level 2)


      CasePreviousTesting: same as group. found 1.0 nmol/mg protein/18 h propionate incorporation, 0.8 nmol/mg/protein/18 h propionate incorporation with hydroxocobalamin supplementation

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_005334.2:c.4475C>T (p.Pro1492Leu)

      ClinVar: n/a

      CAID: CA415114585

      gnomAD: n/a


      CaseAddInfo: Originally identified as mut0 type patient through somatic cell complementation. But NGS instead identified a novel heterozygous mutation in HCFC1, which is detailed above. Based on clinical presentation it was determined unlikely that the identified variant is related to the patients MMA.

    2. 52

      Case52: 3 wks (at biopsy), Irish/Italian

      CasePresentingHPOs: methylmalonic acidemia (HP:0002912)

      HPOsFreeText: SIDS, elevation in C3 carnitine (post mortem blood spot)

      Case 52 (Level 2)


      CasePreviousTesting: same as group. found 2.0 nmol/mg protein/18 h propionate incorporation, 2.3 nmol/mg/protein/18 h propionate incorporation with hydroxocobalamin supplementation

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_001177599.1:c.273A>T (p.Arg91Ser)

      ClinVar: n/a

      CAID: CA353555085

      gnomAD: n/a


      CaseAddInfo: Originally identified as mut0 type patient through somatic cell complementation. But NGS instead identified a novel heterozygous mutation in SUCLG2. Unknown relevance of variant to patient's phenotype.

    3. 51

      Case51: 3 wks (at biopsy), Irish/Italian

      CasePresentingHPOs: metabolic acidosis-severe, methylmalonic acidemia-mild, lactic acidosis, sensorineural hearing loss (HP:0001942, HP:0002912, HP:0003128, HP:0000407)

      Case 51 (Level 2)


      CasePreviousTesting: same as group. found 1.0 nmol/mg protein/18 h propionate incorporation, 0.9 nmol/mg/protein/18 h propionate incorporation with hydroxocobalamin supplementation

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_003849.3:c.433G>A (p.Glu145Lys)

      ClinVar: n/a

      CAID: CA347515756

      gnomAD: 0.00001761 (European non-Finnish)


      Variant2: NM_003849.3:c.511A>C (p.Asn171His)

      ClinVar: n/a

      CAID: CA347515593

      gnomAD: n/a


      CaseAddInfo: Originally identified as mut0 type patient through somatic cell complementation. But NGS instead identified two novel heterozygous mutations in the SUCLG1 gene (detailed above). Mutations are likely causative of patient's phenotype.

    4. 48

      Case48: 8 mo (at biopsy), Indian

      Case 48 (Level 2)


      CasePreviousTesting: same as group. found 1.1 nmol/mg protein/18 h propionate incorporation, 1.1 nmol/mg/protein/18 h propionate incorporation with hydroxocobalamin supplementation

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.2179C>T (p.Arg727Ter)

      ClinVar: 218998

      CAID: CA347913

      gnomAD: 0.0001504 (East Asian)


      CaseAddInfo: mut0 type, homozygous mutations.

    5. 47

      Case47: 2 y 7 mo (at biopsy), Barbadian

      Case 47 (Level 2)


      CasePreviousTesting: same as group. found 0.4 nmol/mg protein/18 h propionate incorporation, 1.3 nmol/mg/protein/18 h propionate incorporation with hydroxocobalamin supplementation

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.2150G>T (p.Gly717Val)

      ClinVar: 1881

      CAID: CA249729

      gnomAD: 0.0006810 (African)


      CaseAddInfo: mut- type, homozygous mutations. reportedly non-consanguineous

    6. 46

      Case46: 1 y (at biopsy), White

      Case 46 (Level 2)


      CasePreviousTesting: same as group. found 1.0 nmol/mg protein/18 h propionate incorporation, 0.9 nmol/mg/protein/18 h propionate incorporation with hydroxocobalamin supplementation

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.1962_1963delTC (p.Arg655Terfs)

      ClinVar: 552144

      CAID: CA658821515

      gnomAD: n/a


      CaseAddInfo: mut0 type, homozygous mutations.

    7. 44

      Case44: 13y (at biopsy), Arab

      Case 44 (Level 2)


      CasePreviousTesting: same as group. found 0.8 nmol/mg protein/18 h propionate incorporation, 1.1 nmol/mg/protein/18 h propionate incorporation with hydroxocobalamin supplementation

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.1871A>G (p.Gln624Arg)

      ClinVar: n/a

      CAID: CA3846720

      gnomAD: 0.00003266 (South Asian)


      CaseAddInfo: mut0 type, homozygous mutations.

    8. 43

      Case43: 20 y (at biopsy), Lebanese

      Case 43 (Level 2)


      CasePreviousTesting: same as group. found 1.4 nmol/mg protein/18 h propionate incorporation, 1.1 nmol/mg/protein/18 h propionate incorporation with hydroxocobalamin supplementation

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.1741C>T (p.Arg581Ter)

      ClinVar: 554675

      CAID: CA364395893

      gnomAD: n/a


      CaseAddInfo: mut0 type, homozygous mutations.

    9. 45

      Case45: no age or ethnicity recorded

      Case 45 (Level 2)


      CasePreviousTesting: same as group. found 1.5 nmol/mg protein/18 h propionate incorporation, 1.6 nmol/mg/protein/18 h propionate incorporation with hydroxocobalamin supplementation

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.1891delG (p.Ala631GlinfsTer17)

      ClinVar: n/a

      CAID: CA351288

      gnomAD: 0.00002896 (Latino)


      CaseAddInfo: mut0 type, homozygous mutations.

    10. 42

      Case42: 1 y 7 mo (at biopsy), Hmong

      Case 42 (Level 2)


      CasePreviousTesting: same as group. found 4.5 nmol/mg protein/18 h propionate incorporation, 9.0 nmol/mg/protein/18 h propionate incorporation with hydroxocobalamin supplementation

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.1663G>A (p.Ala555Thr)

      ClinVar: 203850

      CAID: CA312769

      gnomAD: 0.0003262 (East Asian)


      CaseAddInfo: mut- type, homozygous mutations. Additional heterozygous mutations in CUBN gene (Variant 1: NM_001081.3:c.3500G>T, CAID: CA376148913 , gnomAD: 0.00005014, East Asian ) (Variant 2: NM_001081.3:c.6211A>G, CAID: CA5423765 , gnomAD: 0.001003, East Asian )

    11. 41

      Case41: 6 mo (at biopsy), Pakistani

      Case 41 (Level 2)


      CasePreviousTesting: same as group. found 0.6 nmol/mg protein/18 h propionate incorporation, 0.6 nmol/mg/protein/18 h propionate incorporation with hydroxocobalamin supplementation

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.1560G>C (p.Lys520Asn)

      ClinVar: n/a

      CAID: CA364397073

      gnomAD: n/a


      CaseAddInfo: mut0 type, homozygous mutations.

    12. 40

      Case40: Middle Eastern

      Case 40 (Level 2)


      CasePreviousTesting: same as group. found 1.8 nmol/mg protein/18 h propionate incorporation, 1.6 nmol/mg/protein/18 h propionate incorporation with hydroxocobalamin supplementation

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.1420C>T (p.Arg474Ter)

      ClinVar: 554873

      CAID: CA138795916

      gnomAD: 0.00003267 (South Asian)


      CaseAddInfo: mut0 type, homozygous mutations. documented consanguinity.

    13. 39

      Case39: 1 y (at biopsy), Asian

      Case 39 (Level 2)


      CasePreviousTesting: same as group. found 1.4 nmol/mg protein/18 h propionate incorporation, 1.5 nmol/mg/protein/18 h propionate incorporation with hydroxocobalamin supplementation

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.1280G>A (p.Gly427Asp)

      ClinVar: 218990

      CAID: CA347873

      gnomAD: 0.0004011 (East Asian)


      CaseAddInfo: mut0 type, homozygous mutations. documented non-consanguinity.

    14. 38

      Case38: 9 y (at biopsy), German/Polish

      Case 38 (Level 2)


      CasePreviousTesting: same as group. found 0.5 nmol/mg protein/18 h propionate incorporation, 0.5 nmol/mg/protein/18 h propionate incorporation with hydroxocobalamin supplementation

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.1106G>A (p.Arg369His)

      ClinVar: 203846

      CAID: CA312764

      gnomAD: 0.0001504 (East Asian)


      CaseAddInfo: mut0 type, homozygous mutations.

    15. 37

      Case37: 18 mo (at biopsy), Moroccan

      Case 37 (Level 2)


      CasePreviousTesting: same as group. found 0.5 nmol/mg protein/18 h propionate incorporation, 0.5 nmol/mg/protein/18 h propionate incorporation with hydroxocobalamin supplementation

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.683G>A (p.Arg228Gln)

      ClinVar: n/a

      CAID: CA3847070

      gnomAD: 0.00002905 (Latino)


      CaseAddInfo: mut0 type, homozygous mutations.

    16. 36

      Case36: 14 mo (at biopsy), Hispanic

      Case 36 (Level 2)


      CasePreviousTesting: same as group. found 0.7 nmol/mg protein/18 h propionate incorporation, 0.8 nmol/mg/protein/18 h propionate incorporation with hydroxocobalamin supplementation

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.406G>T (p.Val136Phe)

      ClinVar: n/a

      CAID: CA364404792

      gnomAD: n/a


      CaseAddInfo: mut0 type, homozygous mutations. documented consanguinity.

    17. 35

      Case35: 5 y (at biopsy), Hispanic

      Case 35 (Level 2)


      CasePreviousTesting: same as group. found 0.5 nmol/mg protein/18 h propionate incorporation, 0.7 nmol/mg/protein/18 h propionate incorporation with hydroxocobalamin supplementation

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.322C>T (p.Arg108Cys)

      ClinVar: 1887

      CAID: CA249732

      gnomAD: 0.0008393 (Latino)


      CaseAddInfo: mut0 type, homozygous mutations.

    18. 33

      Case33: 9 mo (at biopsy), Hispanic

      Case 33 (Level 2)


      CasePreviousTesting: same as group. found 1.0 nmol/mg protein/18 h propionate incorporation, 1.3 nmol/mg/protein/18 h propionate incorporation with hydroxocobalamin supplementation

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.322C>T (p.Arg108Cys)

      ClinVar: 1887

      CAID: CA249732

      gnomAD: 0.0008393 (Latino)


      CaseAddInfo: mut0 type, homozygous mutations.

    19. 32

      Case32: 10 y (at biopsy), Arab

      Case 32 (Level 2)


      CasePreviousTesting: same as group. found 1.0 nmol/mg protein/18 h propionate incorporation, 1.0 nmol/mg/protein/18 h propionate incorporation with hydroxocobalamin supplementation

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.278G>A (p.Arg93His)

      ClinVar: 1880

      CAID: CA249728

      gnomAD: 0.0004777 (European- Finnish)


      CaseAddInfo: mut0 type, homozygous mutations. documented consanguinity.

    20. 34

      Case34: 3.5 wks (at biopsy), White/Hispanic

      Case 34 (Level 2)


      CasePreviousTesting: same as group. found 1.6 nmol/mg protein/18 h propionate incorporation, 1.8 nmol/mg/protein/18 h propionate incorporation with hydroxocobalamin supplementation

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.322C>T (p.Arg108Cys)

      ClinVar: 1887

      CAID: CA249732

      gnomAD: 0.0008393 (Latino)


      CaseAddInfo: mut0 type, homozygous mutations.

    1. cases

      CaseSA4P: Female, 12 months onset, European

      CasePresentingHPOs: HP:0001988, HP:0000825, HP:0001987, HP:0002167 (Recurrent hypoglycemia, Hyperinsulinemic hypoglycemia, Hyperammonemia, Neurological speech impairment)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: Has mother with confirmed variant and similar phenotypes

      CasePreviousTesting: Leucine load test showed leucine sensitivity; Protein/leucine restriction was effective at reducing symptoms

      CaseGenotypingMethod: Genomic DNA was prepared from all patients via peripheral blood leukocytes. The GLUD1 gene exons 1-13 and the flanking intronic regions were PCR-amplified and directly sequenced. All variants were confirmed via restriction enzyme analysis. Additionally, paternity testing was performed by HLA typing and by southern blot analysis of DNA fragments as well as PCR analysis of STRs.

      Variant: NM_005271.5(GLUD1):c.965G>A (p.Arg322His)

      ClinVar: 16129, https://www.ncbi.nlm.nih.gov/clinvar/variation/16129/

      gnomAD: Not in gnomAD

    1. B1

      CaseB1: United States, White

      CasePresentingHPOs: HP:0008353 (Neutral hyperaminoaciduria)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: Variants segregate with the disease, Has a brother (B2) also homozygous for variant and positive for amino acid profile

      CasePreviousTesting: Hartnup aminoaciduria profile was confirmed by ion exchange high performance liquid chromatography;

      CaseGenotypingMethod: All SLC6A19 exons and flanking introns were directly amplified and sequenced from genomic DNA.

      Variant: NM_001003841.3(SLC6A19):c.517G>A (p.Asp173Asn)

      ClinVar: 2019 https://www.ncbi.nlm.nih.gov/clinvar/variation/2019/

      gnomAD: 0.003016, https://gnomad.broadinstitute.org/variant/5-1212453-G-A

    2. AHN8.1

      CaseAHN8.1: Australia, White

      CasePresentingHPOs: HP:0008353 (Neutral hyperaminoaciduria)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: Variants segregate with the disease

      CasePreviousTesting: Hartnup aminoaciduria profile was confirmed by ion exchange high performance liquid chromatography;

      CaseGenotypingMethod: All SLC6A19 exons and flanking introns were directly amplified and sequenced from genomic DNA.

      Variant1: NM_001003841.3:c.277G>A (p.Gly93Arg)

      CAID: CA3182636 http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA3182636

      gnomAD: 0.0001195, https://gnomad.broadinstitute.org/variant/5-1208935-G-A

      Variant2: NM_001003841.3(SLC6A19):c.1173+2T>G

      ClinVar: 449553 https://www.ncbi.nlm.nih.gov/clinvar/variation/449553/

      gnomAD: 0.0006791, https://gnomad.broadinstitute.org/variant/5-1217062-T-G

    3. AHN6.3

      CaseAHN6.3: Australia, White

      CasePresentingHPOs: HP:0008353 (Neutral hyperaminoaciduria)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: Variants segregate with the disease

      CasePMIDs: 15286788

      CasePreviousTesting: Hartnup aminoaciduria profile was confirmed by ion exchange high performance liquid chromatography;

      CaseGenotypingMethod: All SLC6A19 exons and flanking introns were directly amplified and sequenced from genomic DNA.

      Variant1: NM_001003841.3(SLC6A19):c.517G>A (p.Asp173Asn)

      ClinVar: 2019 https://www.ncbi.nlm.nih.gov/clinvar/variation/2019/

      gnomAD: 0.003016, https://gnomad.broadinstitute.org/variant/5-1212453-G-A

      Variant2: NM_001003841.3:c.1550A>G (p.Asp517Gly)

      CAID: CA3183226, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA3183226

      gnomAD: 0.00004675, https://gnomad.broadinstitute.org/variant/5-1221277-A-G

    4. AHN15.1

      CaseAHN15.1: Australia, White

      CasePresentingHPOs: HP:0008353 (Neutral hyperaminoaciduria)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: Variants segregate with the disease

      CasePreviousTesting: Hartnup aminoaciduria profile was confirmed by ion exchange high performance liquid chromatography;

      CaseGenotypingMethod: All SLC6A19 exons and flanking introns were directly amplified and sequenced from genomic DNA.

      Variant1: NM_001003841.3(SLC6A19):c.517G>A (p.Asp173Asn)

      ClinVar: 2019 https://www.ncbi.nlm.nih.gov/clinvar/variation/2019/

      gnomAD: 0.003016, https://gnomad.broadinstitute.org/variant/5-1212453-G-A

      Variant2: NM_001003841.3:c.850G>A (p.Gly284Arg)

      CAID: CA3182918, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA3182918

      gnomAD: 0.00005440, https://gnomad.broadinstitute.org/variant/5-1214143-G-A

    1. Patient 2

      Patient2: Female, 5yo, Thai

      CasePresentingHPOs: HP:0011968, HP:0001254, HP:0100806, HP:0001876, HP:0001290, HP:0001942, HP:0001987, HP:0002342 (poor feeding, lethargy, sepsis, pancytopenia, hypotonia, metabolic acidosis, hyperammonemia, moderate mental retardation)

      HPOsFreeText: acute neonatal IVA, hemoglobin = 11g/dL, WBC = 3100/mm^3, platelets = 47,000/mm^3, sepsis treated with parenteral antibiotics and IV fluid, bicarbonate = 14mmol/L, anion gap = 18mmol/L, ammonia = 97µmol/L, began metabolic treatment at 14mo but was non-compliant, developmental quotient = 48, treated with low-protein diet and leucine-free formula (150–250mg/kg per day of l‐glycine, and 100mg/kg per day of l‐carnitine), urine isovalerylglycine = 153

      CaseNotHPOs:

      NotHPOsFreeText: ammo

      CaseAddInfo: non-consanguineous family, diagnose with sepsis at 14 days old, lost to follow up at 5yo

      CasePMIDs:

      CasePreviousTesting: urine organic acid analysis with GC/MS (PMID: 27082169)

      CaseMethod1: PCR

      CaseMethod2: Sequencing

      CaseGenotypingMethod: Genomic DNA extracted from peripheral blood, IVD coding exons and flanking introns amplified with PCR (primer in table 1), PCR products purified and sequenced with Big Dye Primer Cycle Sequencing Kit and ABI 210 Genetic Analyzer

      Variant1: c.457–3_2CA>GG / no ClinVar or CAID

      Variant2: NM_001354598.2:c.194C>G (p.Ala65Gly)

      CAID: CA391744802, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA391744802

      gnomAD: n/a

    1. an EA patient

      CaseIW: Female, 10 yrs report,

      CasePresentingHPOs: HP:0002078, HP:0000486, HP:0002080, HP:0001350 (Truncal ataxia, Strabismus, Intention tremor, Slurred speech)

      HPOsFreeText: Hypoperfusion of cerebellum and brainstem at 8 yrs

      CaseNotHPOs: HP:0001270 (Motor delay)

      NotHPOsFreeText: N/A

      CaseAddInfo: Parents are healthy and non-consanguineous and have no family history of neurological symptoms; Proband is confirmed de novo heterozygous via parental testing

      CasePreviousTesting: Treatment with acetazolamide helped with symptoms

      CaseGenotypingMethod: Genomic DNA was isolated from peripheral blood leukocytes and subject to whole exome sequencing. Variants were filtered according to likely pathogenicity and presence in previously reported causative genes associated with ataxia, cerebellar atrophy, and other neurodegenerative diseases.The SLC1A3 variant was confirmed via Sanger seuqencing in the proband and absent in her parents.

      Variant: NM_004172.5:c.383T>G (p.Met128Arg)

      CAID: CA359477326, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA359477326

      gnomAD: Not in gnomAD

    1. 2928 (F)

      Case2928: Female, 2 years diagnosis, Czech

      CasePresentingHPOs: HP:0001270, HP:0001263, HP:0003153, HP:0001250, HP:0002240, HP:0000980, HP:0000613, HP:0001744 (Motor delay, Psychomotor retardation, Cystathioninuria, Seizures, Hepatomegaly, Paleness, Photophobia, Splenomegaly)

      HPOsFreeText: Elevated total homocysteine (34.0 μM/l; reference 5.1–13.9), Elevated cystathionine (4.4 μM/l; reference 0.04–0.34), Normal total cysteine (250 μmol/l; reference 203–369), Responsive to B6 treatment, Birth weight was 3000 g

      CaseNotHPOs: HP:0000315, HP:0000939, HP:0000818, HP:0001977 (Ocular abnormality, Osteoporosis, Abnormality of the endocrine system, Abnormal thrombosis)

      NotHPOsFreeText: N/A

      CaseAddInfo: Patient is compound heterozygous for these mutations

      CasePreviousTesting: Cystathionine (Cysta), total cysteine (tCys), and total homocysteine (tHcy) panels

      CaseGenotypingMethod: PCR amplification of CTH coding regions and exon-intron boundaries was performed. These fragments were sequenced and aligned with a reference to find mutations. Those found were confirmed by restriction digest of 100 controls.

      Variant1: NM_001902.5:c.200C>T (p.Thr67Ile)

      ClinVar: 2939 https://www.ncbi.nlm.nih.gov/clinvar/variation/2939/

      gnomAD: Ashkenazi Jewish 9.934e-3, Overall 6.308e-3 https://gnomad.broadinstitute.org/variant/1-70881670-C-T

      Variant Too Long

      Variant2: NP_001893.2:p.Gly57_Gln196del

      ClinVar:

      gnomAD:

    1. OS-124 II-1

      CaseOS-124_II-1: Male, Birth onset, Turkey

      CasePresentingHPOs: HP:0001992, HP:0001263, HP:0002275, HP:0001252, HP:0002079, HP:0001320, HP:0002188, HP:0003396, (Organic aciduria, Global developmental delay, Poor motor coordination, Muscular hypotonia, Hypoplasia of the corpus callosum, Cerebellar vermis hypoplasia, Delayed CNS myelination, Syringomyelia,

      HPOsFreeText: Syringomyelia length of 3.5 cm

      CaseNotHPOs:

      NotHPOsFreeText:

      CaseAddInfo: Parents are consanguineous, Older sister are unaffected, This variant results in a splicing alteration in the acceptor site of Exon 6, skipping exon 6 (amino acid residues 121 to 146) and causing a premature stop codon; Proband is confirmed homozygous via parental testing

      CasePreviousTesting: GS-MS analysis identified urinary organic acids dominated by N-aceylated AAs, supported by NMR spectroscopy of urine samples with serum samples being negative; Values of excreted AAs are in Table 1; MRI of the head and spine was performed at age 3 mo

      CaseGenotypingMethod: Genomic DNA was extracted from blood samples or after EBV transformation of peripheral blood lymphocytes. Exons and exon-intron boundaries were amplified and bidirectionally sequenced.

      Variant: NM_000666.3(ACY1):c.360-1G>A

      ClinVar: 18112, https://www.ncbi.nlm.nih.gov/clinvar/variation/18112/

      gnomAD: 0.00001767, https://gnomad.broadinstitute.org/variant/3-52020270-G-A

    1. cblC individual

      CaseFamily1,III-1: male, Family 1

      HPOsFreeText: same as family

      CaseAddInfo: affected sibling with same variant (fetus with unknown gender)

      Case (Level 2)


      CasePreviousTesting: same as family

      CaseMethod1: same as family

      CaseGenotypingMethod: same as family


      Variant1: NM_015506.2(MMACHC):c.271dupA

      ClinVar: 1421

      CAID: CA090937

      gnomAD: .002800 (Ashkenazi Jewish)


      Variant2: NM_015506.2:c.468_469delCT

      ClinVar: n/a

      CAID: n/a

      gnomAD: n/a

      CaseAddInfo: Variant one said to be associated with early onset disease.

    1. T23159

      CaseT23159: Female, 2 days onset

      CasePresentingHPOs: HP:0200134, HP:0011167, HP:0010818, HP:0032667, HP:0031475, HP:0032816, HP:0010841, HP:0010845, HP:0006808, HP:0002079, HP:0012753, HP:0002059, HP:0007266, HP:0002273, HP:0011471, HP:0000121, HP:0000141, HP:0000696, HP:0001662, HP:0002045, HP:0000253, HP:0000341, HP:0001525, HP:0001007, HP:0002751, HP:0001371, HP:0001182 (Epileptic encephalopathy, Focal tonic seizure, Generalized tonic seizure, Myoclonic status epilepticus, Nonconvulsive status epilepticus, Neonatal multifocal myoclonic seizure, Multifocal epileptiform discharges, EEG with generalized slow activity, Cerebral hypomyelination, Hypoplasia of the corpus callosum, T2 hypointense basal ganglia, Cerebral atrophy, White matter dysmyelination/demyelination, Tetraparesis, Gastrostomy tube feeding in infancy, Nephrocalcinosis, Amenorrhea, Delayed eruption of permanent teeth, Bradycardia, Hypothermia, Progressive microcephaly, Narrow forehead, Severe failure to thrive, Hirsutism, Kyphoscoliosis, Flexion contracture, Tapered finger)

      HPOsFreeText: Thinning of cortical gray matter

      CaseNotHPOs: HP:0001272 (Cerebellar atrophy)

      NotHPOsFreeText: Hypomyelination of cerebellum and brain stem

      CaseAddInfo: Proband confirmed de novo heterozygous by parental sequencing

      CasePreviousTesting: Currently on carbamazepime, lamotrigine and lacosamide; previously on pyridoxine, clonazepam, acetazolamide, valproate, phenobarbitone, phenytoin, prednisolone, vigabatrin, topiramate and ketogenic diet

      CaseGenotypingMethod: About 10% of the original 290 genes where a single de novo variant had been identified was chosen for targeted sequencing in a new cohort. Most of these individuals had been tested for mutations of known and novel candidate genes as well as pathogenic copy-number variants. These genes were sequenced in the parents and proband to look for de novo variants.

      Variant: NM_004171.4(SLC1A2):c.254T>C (p.Leu85Pro)

      ClinVar: 254266, https://www.ncbi.nlm.nih.gov/clinvar/variation/254266/

      gnomAD: Not in gnomAD

    1. 43 patients

      GroupPresentingHPOs: HP:0001987, HP:0001942, HP:0003128, HP:0002912 (hyperammonemia, metabolic acidosis, lactic acidosis, methylmalonic acidemia)

      HPOsFreeText: elevated blood levels of propionylcarnitine (C3) (median 13.56 umol/L), and elevated C3 to acetylcarnitine (C2) ratio (median 0.85). elevated urine methylmalonate levels (median 598.96 mmol/mol creatinine). 28/73.7% displayed recurrent vomiting (HP:0002572). 28/73.7% displayed disturbances of consciousness (HP:0004372). 23/60.5% displayed feeding difficulties in infancy (HP:0008872), 20/52.6% displayed respiratory distress (HP:0002098), 20/52.6% displayed failure to thrive (HP:0001508), 20/52.6% displayed dystonia (HP:0001332), 14/36.8% displayed mental retardation, 12/31.6% displayed convulsions.

      GroupNotHPOs: normal plasma total homocysteine

      NotHPOsFreeText:

      NumberMales: 27

      NumberFemales: 16

      CountryOrigin: China

      Ethnicity: Chinese

      AgeRange: 33d- 10.3 y at last follow up

      TotalNumber 43

      FamilyInfo: 43

      NoFamily: 0

      GroupAddInfo: 9 identified by NBS, 34 recruited after being suspected of inherited metabolism disorders. 42 families from 14 provinces of the Mainland of China. 8 died during acute metabolic crisis, 7 lost to follow up, 28 alive at end of study.

      Group (Level 2)


      VariantCount: 43 (35 had two mutant alleles)

      NonVariant: 0

      OtherVariant: 0

      GroupPreviousTesting: tandem mass spectrometry for blood levels, gas chromatography-mass spectrometry for urine,

      GroupMethod1: PCR

      GroupGenotypingMethod: genomic DNA extracted from peripheral blood leukocytes from patients and their parents. Exonic and flanking intronic regions of the MUT gene were amplified through PCR. PCR products were sequenced directly using forward and reverse primers on ABI 3700 sequencer. Mutation analysis using MUT reference NM_000255.3. Nucleotide numbering reflects cDNA numbering (initiation codon= codon1). All detected mutations were confirmed in the patients' parents. Novel variants were screened in 100 alleles from 50 control children. Novel variants were considered pathogenic when predicted to be deleterious by two algorithms.

    2. P1

      Case1: Male, Chinese, 11 mo (at end of study)

      Case1HPOs: HP:0012736 (profound psychomotor retardation)

      HPOsFreeText: 10 mo at onset, poor neurological outcome

      NotHPOsFreeText: not responsive to vitamin B12


      Case1 (Level 2)

      CasePreviousTesting: same as group

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant: NM_000255.3(MMUT):c.323G>A (p.Arg108His)

      ClinVar: 100707

      CAID: CA235522

      gnomAD: 0.00006152 (African)


      CaseAddInfo: homozygous mutations

    3. P4

      Case4: Male, Chinese, 2.8 y (end of study)

      HPOsFreeText: poor neurologic outcome, neonatal onset

      NotHPOsFreeText: not responsive to vitamin B12


      Case4 (Level 2):

      CasePreviousTesting: NBS

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant: NM_000255.3:c.729_730insTT (p.Asp244LeufsTer?)

      ClinVar: 552079

      CAID: CA3847064

      gnomAD: 0.0002008 (East Asian)


      CaseAddInfo: homozygous mutations

    1. Patient 1

      CaseAL1: Male, 14 yrs report

      CasePresentingHPOs: HP:0012120 (Methylmalonic aciduria)

      HPOsFreeText: Malonic acidemia/uria

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: Born to non-consanguineous Ashkenazi Jewish parents; Proband is confirmed homozygous via parental testing

      CasePreviousTesting: Newborn screening identified these probands, with subsequent urine organic acid analysis by gas chromatography mass spectroscopy confirming CMAMMA; Initial urine MMA level was 891 μmol/mmol creatinine; Confirmatory testing showed a urine MMA of 745 μmol/mmol creatinine (normal <25) and MA of 60 μmol/mmol creatinine (normal <6); Plasma MMA level was 18 μmol/l (normal <0.5); No other organic acid abnormality was detected. Carnitine levels, acylcarnitine profiles, plasma amino acids, ammonia, blood gas values, total homocysteine, folate and vitamin B12 levels were all within reference ranges, and the mothers were not vitamin B12 deficient; MCD activity in fibroblasts were within the reference range

      CaseGenotypingMethod: Genomic DNA was isolated from fibroblasts and all exons and flanking introns of MLYCD, along with ACSF3, were subject to Sanger sequencing.

      Variant: NM_001243279.3:c.1411C>T (p.Arg471Trp)

      ClinVar: 31137, https://www.ncbi.nlm.nih.gov/clinvar/variation/31137

      gnomAD: 0.007046, https://gnomad.broadinstitute.org/variant/16-89211719-C-T

    1. CaseWG2098: 3 yrs onset

      CasePresentingHPOs: HP:0001251, HP:0004302, HP:0001260, HP:0002313, HP:0012120 (Ataxia, Functional motor deficit, Dysarthria, Spastic paraparesis, Methylmalonic aciduria)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: Proband has normal 14C-propionate incorporation, suggesting normal MCEE protein activity level; The high gnomAD frequency and homozygotes suggests this is likely a benign polymorphism

      CasePreviousTesting: Normal MRI; Propionate Incorporation w/o hydroxycobalamin at 7.0 nmols/mg protein/18hr; Propionate Incorporation with hydroxycobalamin at 8.2 nmols/mg protein/18hr; Adenosylcobalamin synthesis percentage at 12.7%; Elevated methylmalonic values of 621 µmol/mmol creatinine (reference 0.8-5.2 µmol/mmol creatinine)

      CaseGenotypingMethod: Genomic DNA was extracted from patient fibroblasts, sequenced, and the three MCEE/thirteen MUT exons were analyzed and amplified. Any reported mutations were resequenced from fresh PCR product.

      Variant: NM_032601.4(MCEE):c.178A>C (p.Lys60Gln)

      ClinVar: 203812, https://www.ncbi.nlm.nih.gov/clinvar/variation/203812/

      gnomAD: 0.01463 (10 homozygotes), https://gnomad.broadinstitute.org/variant/2-71351536-T-G

    1. III-3

      CaseDOIII-3: Female, 12 yrs report, White

      CasePresentingHPOs: HP:0001531, HP:0002020, HP:0001942, HP:0001944, HP:0002789, HP:0002013, HP:0002014, HP:0002919, HP:0012120 (Failure to thrive in infancy, Gastroesophageal reflux, Metabolic acidosis, Dehydration, Tachypnea, Vomiting, Diarrhea, Ketonuria, Methylmalonic aciduria)

      HPOsFreeText: Elevated methylcitric acid

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: Parents are first-cousin consanguineous, Son is healthy but second daughter shares phenotypes with the proband and shows clear methylmalonic aciduria, Proband and her sister are confirmed homozygous for this variant via parental testing

      CasePreviousTesting: Serum methylmalonic acid was 1314 ng/ml (normal < 32); Vitamin B12 levels were normal (927 pg/ml, normal 200–1100); Vitamin B12 injections improved patient condition; At 12.5 yrs carnitine, plasma AAs, blood counts, and basic metabolic panels are normal but methylmalonic acid remains high at 180–1456 mmol/mol creatinine; Fibroblasts showed normal AdoCbl synthesis, contrary to expected from MMAA or MMAB variants; MUT and MMAB were sequenced with no variation found

      CaseGenotypingMethod: Genomic DNA was isolated and PCR-amplified before directly sequencing all exons and flanking intronic sequences of the MCEE gene. Restriction enzyme digest confirmed the phase of the variant in the proband and the parents.

      Variant: NM_032601.4(MCEE):c.139C>T (p.Arg47Ter)

      ClinVar: 2343, https://www.ncbi.nlm.nih.gov/clinvar/variation/2343/

      gnomAD: 0.0004884, https://gnomad.broadinstitute.org/variant/2-71351575-G-A

    1. Subject A

      CaseGuA: Male, 6 weeks onset

      CasePresentingHPOs: HP:0200134, HP:0020217, HP:0002069, HP:0010852, HP:0012012, HP:0012017, HP:0012018, HP:0010841, HP:0025152, HP:0030211, HP:0008936, HP:0002061, HP:0006986, HP:0002187, HP:0011344, HP:0001344, HP:0012448, HP:0002283, HP:0002079, HP:0012696, HP:0002500, HP:0012751 (Epileptic encephalopathy, Focal aware motor seizure, Bilateral tonic-clonic seizure, EEG with parietal focal spike waves, EEG with parietal focal spikes, EEG with temporal focal spikes, Multifocal epileptiform discharges, Poor visual behavior for age, Slow pupillary light response, Muscular hypotonia of the trunk, Lower limb spasticity, Upper limb spasticity, Profound intellectual disability, Severe global developmental delay, Absent speech, Delayed myelination, Global brain atrophy, Thin corpus callosum, Abnormal thalamic MRI signal intensity, White matter abnormalities, Abnormal basal ganglia MRI signal intensity)

      HPOsFreeText: Dyskinetic movements of arms, In ability to sit unsupported, Abnormal MRI signal in putamen and caudate

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: Variant is confirmed heterozygous de novo

      CasePreviousTesting: Investigations include electroencephalography (EEG), head MRI, neurometabolic testing, and chromosome microarray; Individuals with self-limiting benign electroclinical syndromes, such as childhood absence epilepsy (onset > 4 years), were excluded; Capture of right arm jerks and chin twitching showed no EEG correlate; Head circumference was 45.1 cm at 8 months (50%), 52 cm at 5 years (50th percentile); Partial response to phenobarbital, levetiracetam, and clobazam; Longest seizure-free period was 16 months

      CaseGenotypingMethod: Variants within co-expressed candidate genes in Table S1 were extracted from exome sequencing data. Variants were annotated and were verified with Sanger sequencing of the proband and parents.

      Variant: NM_004171.4(SLC1A2):c.244G>A (p.Gly82Arg)

      ClinVar: 438736, https://www.ncbi.nlm.nih.gov/clinvar/variation/438736/

      gnomAD: Not in gnomAD