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    1. a case

      PatientID: None

      KindredID: 1

      Case: M, Age Unknown, Ethnicity Unknown

      DiseaseAssertion: VHL

      FamilyInfo: The patient’s aunt died of a cerebellar tumor of unknown pathology at 30Y. The patient’s father presented with giant pheochromocytoma at age 46, meningothelial meningioma and capillary hemangioblastoma at age 66, and died from cerebral infarctions and RCC at age 69.

      CasePresentingHPOs: HP:0006880 (Cerebellar hemangioblastoma)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.L158V(c.472C>G)

      LegacyVariant: p.L158V(c.685C>G)

      ClinVarID: 567944, https://www.ncbi.nlm.nih.gov/clinvar/variation/567944/

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant;transversion

      CivicName: L158V(c.472C>G)

      MultipleGeneVariants: N/A

    1. Genetic screening and management The patient was investigated to determine if there was a genetic cause for her phaeochromocytoma. Neurofibromatosis type 1 was excluded on clinical grounds as she had none of the cutaneous features. Mutational analysis of the RET proto-oncogene was normal, making MEN2 unlikely. Sequencing of exons 1–3 of the VHL gene revealed a novel single base pair substitution (A268C). This replaces asparagine with histidine at codon 90 of VHL (N90H) and was not present in either parent. Another mutation at the same amino acid residue (N90I) has previously been reported in an individual with vHL disease,1 and in vitro studies indicate that this alters vHL function. Therefore, N90H is highly likely to be pathogenic.

      ArticleReferenceSequence: Not specified – Assumption: variants assumed to have been documented by the author under reference sequence NM_000551.3

      GenotypingMethod: Sequencing of exons 1–3 of the VHL gene revealed a novel single base pair substitution (A268C). Unclear of exact methods.

      SamplingMethod: Unclear - investigated conducted to determine if there was a genetic cause.

    1. PMID: 7977367

      Tissue analysis from 61 VHL patients, 30 sporadic renal cell carcinoma (RCC) tumor samples, and 6 sporadic RCC cell lines revealed 22 variants within VHL patients, 10 variants in tumor samples and variants in all cell lines. All mutations cluster to the 3’ end of the VHL gene open reading frame, implicating this region as important for the tumor-suppressor function of the VHL protein. Northern blot, SSCP and RT-PCR analysis from normal tissue found a germline p.76delF (c.227_229delTTC) mutation, stated in the paper as c.437_439delF due to an older transcript. It was seen in two families: [pedigree No] 17 and 20, with an unknown number of members described as ‘VHL-affected’ with RCC. Other manifestations are possible but not clear.

    1. 353T→C Ts Exon 2 118 CTC L L118P

      A study of 103 patients with VHL retinal manifestations and 108 patients without VHL retinal manifestations extracted from the French VHL database revealed that the number of hemangioblastomas appeared higher in patients who had a substitution when compared with patients with a truncated protein. Detected by PCR and SSCP, this missense mutation (p.L118P (c.353T>C)) was found in a VHL patient with retinal hemangioblastomas. Other manifestations are not clearly stated. No family information was provided. This is possibly previously published in PMID: 15300849

    2. 353T→C Ts Exon 2 118 CTC L L118P

      GroupID: 28

      Case: Age unknown, Sex unknown, French

      DiseaseAssertion: VHL

      FamilyInfo: None - one member documented here

      CasePresentingHPOs: HP:0009711 (retinal capillary hemangioma)

      CaseHPOFreeText: other manifestations are not clearly stated.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: Possibly published in PMID:15300849

      SupplementalData: N/A

      Variant: p.L118P (c.353T>C)

      CaseProblemVariantFreeText: N/A

      LegacyVariant: N/A

      ClinVarID: 428807 https://www.ncbi.nlm.nih.gov/clinvar/variation/428807/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant; transition

      CivicName: L118P (c.353T>C)

      MultipleGeneVariants: N/A

    3. 211insT Fs Exon 1 71 CCC R Stop131

      GroupID: 7

      Case: Age unknown, Sex unknown, French

      DiseaseAssertion: VHL

      FamilyInfo: None - one member documented here

      CasePresentingHPOs: N/A

      CaseHPOFreeText: other manifestations are not clearly stated.

      CaseNotHPOs: HP:0009711 (retinal capillary hemangioma)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: Possibly published in PMID:15300849

      SupplementalData: N/A

      Variant: p.P71Lfs*61 (c.211_212insT)

      CaseProblemVariantFreeText: N/A

      LegacyVariant: N/A

      ClinVarID: N/A

      CAID: CA2501268513 http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA2501268513

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: plus_1_frameshift

      CivicName: P71fs (c.211insT)

      MultipleGeneVariants: N/A

    4. 499C→T Ts Exon 3 167 CGG R R167W

      GroupID: 47

      DiseaseAssertion: VHL

      GroupSize: 15

      GroupNumberMales: N/A

      GroupNumberFemales: N/A

      GroupEthnicity: French

      GroupAgeRange: N/A

      GroupInfo: 15 patients are listed with this mutationt; any relation is unknown.

      GroupPresentingHPOs: HP:0009711 (retinal capillary hemangioma)

      GroupHPOFreeText: 5 patients were said to have retinal HBs. Other manifestations are not clearly stated.

      GroupNotHPOs: N/A

      GroupNotHPOFreeText: the other 10 members are said to not have retinal HBs

      GroupPreviousTesting: N/A

      PreviouslyPublished: some are possibly published in PMID:15300849

      SupplementalData: N/A

      Variant: p.R167W (c.499C>T)

      CaseProblemVariantFreeText: N.A

      LegacyVariant: N/A

      ClinVarID: 2218 https://www.ncbi.nlm.nih.gov/clinvar/variation/2218/

      CAID: N/A

      gnomAD: 0.000007954 https://gnomad.broadinstitute.org/variant/3-10191506-C-T

      VariantEvidence: N/A

      MutationType: missense_variant; transition

      CivicName: R167W (c.499C>T)

      MultipleGeneVariants: N/A

    1. Meanwhile, it was also found that the guanine replaced the 559th cytosine on one patient and two carriers from the third family, which made the 116th leucine replaced by valine.

      PatientID: III-2

      KindredID: 3

      Case: F, Age Unknown (deceased), Chinese

      DiseaseAssertion: CNS Hemangioblastoma

      FamilyInfo: The transition mutation was found and confirmed in 1 patient (II-3) and 2 carriers (III-7, IV-2). 5 members, including III-2, had hemangioblastomas of the CNS, but had all passed away before genetic testing. Could be assumed and deduced the genetics due to pedigree showing future linear relations of this mutation.

      CasePresentingHPOs: HP:0010797 (hemangioblastoma)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.L116V (c.346C>G) [assumed]

      LegacyVariant: p.L116V (c.559C>G) [assumed]

      CaseProblemVariantFreeText: N/A

      ClinVarID: N/A

      CAID: CA351753642 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvsOrDescriptor=NM_000551.3%3Ac.346C%3EG

      gnomAD: N/A

      VariantEvidence: No genetic testing was done prior to death, however family history and presentation leads to this deduction

      MutationType: missense_variant;transversion

      CivicName: L116V (c.346C>G)

      MultipleGeneVariants: N/A

    2. Meanwhile, it was also found that the guanine replaced the 559th cytosine on one patient and two carriers from the third family, which made the 116th leucine replaced by valine.

      PatientID: III-3

      KindredID: 3

      Case: M, Age Unknown (deceased), Chinese

      DiseaseAssertion: CNS Hemangioblastoma

      FamilyInfo: The transition mutation was found and confirmed in 1 patient (II-3) and 2 carriers (III-7, IV-2). 5 members, including III-3, had hemangioblastomas of the CNS, but had all passed away before genetic testing. Could be assumed and deduced the genetics due to pedigree showing future linear relations of this mutation.

      CasePresentingHPOs: HP:0010797 (hemangioblastoma)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.L116V (c.346C>G) [assumed]

      LegacyVariant: p.L116V (c.559C>G) [assumed]

      CaseProblemVariantFreeText: N/A

      ClinVarID: N/A

      CAID: CA351753642 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvsOrDescriptor=NM_000551.3%3Ac.346C%3EG

      gnomAD: N/A

      VariantEvidence: No genetic testing was done prior to death, however family history and presentation leads to this deduction

      MutationType: missense_variant;transversion

      CivicName: L116V (c.346C>G)

      MultipleGeneVariants: N/A

    1. GroupID/ KindredID: VHL 56

      DiseaseAssertion: assumed VHL

      GroupSize: 2

      GroupNumberMales: N/A

      GroupNumberFemales: N/A

      GroupEthnicity: German

      GroupAgeRange: N/A

      GroupInfo: 2 patients with the given mutation belonging to VHL family 56

      GroupPresentingHPOs: HP:0009711; HP:0010797 (retinal capillary hemangioma, hemangioblastoma)

      GroupHPOFreeText: both (2) patients have retinal angioma and hemangioblastomas

      GroupNotHPOs: N/A

      GroupNotHPOFreeText: N/A

      GroupPreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.Q195* (c.583C>T)

      CaseProblemVariantFreeText: N/A

      LegacyVariant: p.Q195* (c.796C>T)

      ClinVarID: 428794 https://www.ncbi.nlm.nih.gov/clinvar/variation/428794/

      CAID: CA70052558 http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvsOrDescriptor=NM_000551.3%3Ac.583C%3ET

      gnomAD: N/A

      VariantEvidence: allele-specific oligonucleotide (ASO) probes and hybridization conditions confirmed

      MutationType: missense_variant; transition

      CivicName: Q195* (c.583C>T)

      MultipleGeneVariants: N/A

    1. c.472 C>Gap.L158V

      GroupID: 20A

      Case: Sex, Age, Ethnicity unknown

      DiseaseAssertion: VHL

      FamilyInfo: None. The patient with the given mutation in this study was a VHL patient with pancreatic ICTs.

      CasePresentingHPOs: HP:0030405 (pancreatic endocrine tumor)

      CaseHPOFreeText: Patient has islet cell tumors (ICTs), or listed as pancreatic endocrine tumor.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.L158V (c.472C>G)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 567944 https://www.ncbi.nlm.nih.gov/clinvar/variation/567944/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant; transversion

      CivicName: L158V (c.472C>G)

      MultipleGeneVariants: N/A

    2. c.357 C>Gap.F119L

      53 patients with a molecularly confirmed VHL mutation (by PCR through EDTA-anticoagulated blood) and a pancreatic neuroendocrine tumor (ICT) were collected from the German NET-Registry and the German VHL-registry. An additional 296 patients were stated in this paper with a VHL associated germline mutation, but without pancreatic neuroendocrine tumors. 4 patients were found to have the above mutation (c.357C>G). 2 were VHL patients with ICTs (pancreatic neuroendocrine tumors) taken from the VHL-registry. The other 2 patients were stated to be in this study with the given mutation, however no ICT. Other clinical manifestations outside of a pancreatic neuroendocrine tumor are possible, but were not discussed. ACMG evidence codes: 'PP2' because they observe a missense variant in a gene where missense variants are a common mechanism of disease.

    3. c.266 T/Cap.L89P

      53 patients with a molecularly confirmed VHL mutation (by PCR through EDTA-anticoagulated blood) and a pancreatic neuroendocrine tumor (ICT) were collected from the German NET-Registry and the German VHL-registry. An additional 296 patients were stated in this paper with a VHL associated germline mutation, but without pancreatic neuroendocrine tumors. 8 patients were found to have the above mutation (c.266T>C). 1 was a VHL patient with an ICT (pancreatic neuroendocrine tumor) taken from the VHL-registry. The other 7 patients were stated to be in this study with the given mutation, however no ICT. Other clinical manifestations outside of a pancreatic neuroendocrine tumor are possible, but were not discussed. ACMG evidence codes: 'PP2' because they observe a missense variant in a gene where missense variants are a common mechanism of disease.

    4. c.340 G>Aap.G114S

      GroupID: 8B

      Case: Sex, Age, Ethnicity unknown

      DiseaseAssertion: Unknown. Patient was pulled from either the VHL-Registry or NET- Registry and recorded with the given mutation. Symptoms or manifestations are not clear.

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: HP:0030405 (pancreatic endocrine tumor)

      CasePreviousTesting: Patient was negatively tested for islet cell tumors (ICTs), or listed as pancreatic endocrine tumor.

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.G114S (c.340G>A)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 583094 https://www.ncbi.nlm.nih.gov/clinvar/variation/583094/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant; transition

      CivicName: G114S (c.340G>A)

      MultipleGeneVariants: N/A

    5. c.467 A>Gap.Y156C

      GroupID: 19A

      Case: Sex, Age, Ethnicity unknown

      DiseaseAssertion: VHL

      FamilyInfo: None. The patient with the given mutation in this study was a VHL patient with pancreatic ICTs.

      CasePresentingHPOs: HP:0030405 (pancreatic endocrine tumor)

      CaseHPOFreeText: Patient has islet cell tumors (ICTs), or listed as pancreatic endocrine tumor.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.Y156C (c.467A>G)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 43600 https://www.ncbi.nlm.nih.gov/clinvar/variation/43600/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant; transition

      CivicName: Y156C (c.467A>G)

      MultipleGeneVariants: N/A

    1. 26m417.6n19.4↑553 G/A–6.7

      PatientID: 26

      KindredID: 26

      Case: M, 41Y0M, Ethnicity Unknown

      DiseaseAssertion: Assumed VHL

      FamilyInfo: No details on family information.

      CasePresentingHPOs: HP:0010797 (hemangioblastoma)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.G114S (c.340G>A)

      LegacyVariant: c.553G>A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 583094, https://www.ncbi.nlm.nih.gov/clinvar/variation/583094/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant; transition

      CivicName: G114S (c.340G>A)

      MultipleGeneVariants: N/A

    1. A female patient presented with VHL disease at age 16, when a symptomatic left adrenal pheochromocytoma was diagnosed and removed laparoscopically. At age 28, a cystic cerebellar hemangioblastoma was removed. Molecular genetic testing revealed the mutation VHL c.500 G > A (p. R167Q).In 2010, she was admitted to the Freiburg Preventive Medicine Center. Baseline MRI detected multiple intraspinal hemangioblastomas associated with tumor cysts. Abdominal MRI also showed a 5.6 × 5.4 cm solid tumor in the pancreatic tail that was richly vascularized

      PatientID: 3

      KindredID: 3

      Case: F, 28Y0M, German

      DiseaseAssertion: VHL

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0006748, HP:0006880, HP:0009713, HP:0030405, HP:0010302 (Adrenal pheochromocytoma, cerebellar hemangioblastoma, spinal hemangioblastoma, pancreatic endocrine tumour, spinal cord tumor)

      CaseHPOFreeText: At age 16 she presented with a left adrenal pheochromocytoma which was removed laparoscopically. At age 28, a cystic cerebellar hemangioblastoma was removed. In 2010, she was admitted to the Freiburg Preventive Medicine Center. Baseline MRI detected multiple intraspinal hemangioblastomas associated with tumor cysts. Abdominal MRI also showed a 5.6 × 5.4 cm solid tumor in the pancreatic tail that was richly vascularized. Three of eleven lymph nodes showed metastases.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.R167Q (c.500G>A)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVar: 2216 https://www.ncbi.nlm.nih.gov/clinvar/variation/2216/

      CAID: N/A

      gnomAD: 0.000003977 https://gnomad.broadinstitute.org/variant/3-10191507-G-A

      VariantEvidence: N/A

      MutationType: missense_variant;transition

      CivicName: R167Q (c.500G>A)

      MultipleGeneVariants: N/A

    1. PatientID: VII-3

      KindredID: 1

      Case: F, Age Unknown, Ethnicity Unknown

      DiseaseAssertion: VHL (Asymptomatic)

      FamilyInfo: Family’s roots were traced to the German town of Leipzig in Saxony, from whence the original 11 siblings had immigrated to America around 1670. The following report is a 2011 updated pedigree on the previously reported Tisherman kindred. At the time of this study, 43/49 patients have undergone mutational analysis revealing the VHL familial mutation (Y112H) and 35/49 patients have clinical VHL manifestations. Phenotypic cumulative lifetime risk was 71% for Pheo/PGL, 15% for hemangioblastoma, 33% for retinal angioma, 3% for renal cell carcinoma, and 3% for pancreatic cysts. 6 members of the family (all deceased; 4 males, 2 females) had suspected VHL and 2 (males) of these were suspected to have had Pheo/PGL.

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: HP:0005584; HP:0009711; HP:0002666; HP:0002668 (Renal cell carcinoma, Retinal capillary hemangioma, Pheochromocytoma, Paraganglioma)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: 9201016; 8239848 (no genetic information; only phenotypes)

      SupplementalData: N/A

      Variant: p.Y112H (c.334T>C)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 2222, https://www.ncbi.nlm.nih.gov/clinvar/variation/2222/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant;transition

      CivicName: Y112H (c.334T>C)

      MultipleGeneVariants: N/A

    2. PatientID: III-6

      KindredID: 1

      Case: M, Age Unknown, Ethnicity Unknown

      DiseaseAssertion: VHL

      FamilyInfo: Family’s roots were traced to the German town of Leipzig in Saxony, from whence the original 11 siblings had immigrated to America around 1670. The following report is a 2011 updated pedigree on the previously reported Tisherman kindred. At the time of this study, 43/49 patients have undergone mutational analysis revealing the VHL familial mutation (Y112H) and 35/49 patients have clinical VHL manifestations. Phenotypic cumulative lifetime risk was 71% for Pheo/PGL, 15% for hemangioblastoma, 33% for retinal angioma, 3% for renal cell carcinoma, and 3% for pancreatic cysts. 6 members of the family (all deceased; 4 males, 2 females) had suspected VHL and 2 (males) of these were suspected to have had Pheo/PGL.

      CasePresentingHPOs: HP:0002666; HP:0002668; HP:0009711 (Pheochromocytoma, Paraganglioma, Retinal capillary hemangioma)

      CaseHPOFreeText: Phenotype noted as: Pheo/PGL (unclear which of the two or if both apply to this patient). Deceased.

      CaseNotHPOs: HP:0005584 (Renal cell carcinoma)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: 9201016; 8239848 (no genetic information; only phenotypes)

      SupplementalData: N/A

      Variant: p.Y112H (c.334T>C)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 2222, https://www.ncbi.nlm.nih.gov/clinvar/variation/2222/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant;transition

      CivicName: Y112H (c.334T>C)

      MultipleGeneVariants: N/A

    3. PatientID: V-7

      KindredID: 1

      Case: F, Age Unknown, Ethnicity Unknown

      DiseaseAssertion: VHL

      FamilyInfo: Family’s roots were traced to the German town of Leipzig in Saxony, from whence the original 11 siblings had immigrated to America around 1670. The following report is a 2011 updated pedigree on the previously reported Tisherman kindred. At the time of this study, 43/49 patients have undergone mutational analysis revealing the VHL familial mutation (Y112H) and 35/49 patients have clinical VHL manifestations. Phenotypic cumulative lifetime risk was 71% for Pheo/PGL, 15% for hemangioblastoma, 33% for retinal angioma, 3% for renal cell carcinoma, and 3% for pancreatic cysts. 6 members of the family (all deceased; 4 males, 2 females) had suspected VHL and 2 (males) of these were suspected to have had Pheo/PGL.

      CasePresentingHPOs: HP:0009711 (Retinal capillary hemangioma)

      CaseHPOFreeText: N/A

      CaseNotHPOs: HP:0005584; HP:0002666; HP:0002668 (Renal cell carcinoma, Pheochromocytoma, Paraganglioma)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: 9201016; 8239848 (no genetic information; only phenotypes)

      SupplementalData: N/A

      Variant: p.Y112H (c.334T>C)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 2222, https://www.ncbi.nlm.nih.gov/clinvar/variation/2222/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant;transition

      CivicName: Y112H (c.334T>C)

      MultipleGeneVariants: N/A

    1. NM_000551.3:c.95A>G(p.Glu32Gly)

      This abstract presented the case of a 37-year-old caucasian male with a right adrenal pheochromocytoma. Genetic testing revealed NM_000551.3:c.95A>G(p.Glu32Gly) mutation in the VHL gene. The patient also had significant family history in grandmother who had an adrenalctomy and his son diagnosed with hypertension. Genetic testing for family member was not reported in the abstract.

    1. GroupID: 1

      DiseaseAssertion: VHL

      GroupSize:14

      GroupNumberMales: N/A

      GroupNumberFemales: N/A

      GroupEthnicity: French

      GroupAgeRange: N/A

      GroupInfo: 14 members of this family presented with the c.499C>T germline variant of the VHL gene. Members 296, 419, 295 and 414 had no renal involvement. Members 427, 318, 403 and 406 had unknown renal involvement. Members 402, 322, 403 and 1 had mild renal disease (RCC). Members 401 and 404 had moderate renal disease (RCC). Families were recruited from the French VHL Registry. Enrolment in the study required identification of the germline VHL mutation (currently 85% of the families included in the French VHL Registry) and available data regarding renal phenotype. A total of 126 families fulfilled these criteria.

      GroupPresentingHPOs: HP:0009726; HP:0005584 (Renal neoplasm, Renal cell carcinoma)

      GroupHPOFreeText: Mild renal disease (simple renal cyst, multicystic kidney[s], small lesion [less than 10 mm in size] of unknown significance, or small solid tumor without indication for surgical removal [less than 30 mm in size]). Moderate renal disease (less than five solid lesions requiring surgical treatment, either unilateral or bilateral).

      GroupNotHPOs: N/A

      GroupNotHPOFreeText: N/A

      GroupPreviousTesting: N/A

      PreviouslyPublished: Paper states that this family is previously reported in PMID 12202531 and/or 9829912, where 15 individuals and 3 families respectively with this mutation are reported. It is unclear if one or both of these previously reported groups are the same as the current family. These previously reported individuals/families could alternatively correspond to family 23 or 50.

      SupplementalData: Phenotype and genotype information can be found in Supplementary Table S1.

      Variant: p.R167W (c.499C>T)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 2218, https://www.ncbi.nlm.nih.gov/clinvar/variation/2218/

      CAID: N/A

      gnomAD: 0.000007954, https://gnomad.broadinstitute.org/variant/3-10191506-C-T?dataset=gnomad_r2_1

      VariantEvidence: N/A

      MutationType: missense_variant;transition

      CivicName: R167W (c.499C>T)

      MultipleGeneVariants: N/A

    2. PatientID: 9799

      KindredID: 416

      Case: Sex Unknown, Age Unknown, French

      DiseaseAssertion: VHL

      FamilyInfo: N/A

      CohortInfo: Families were recruited from the French VHL Registry. Enrolment in the study required identification of the germline VHL mutation (currently 85% of the families included in the French VHL Registry) and available data regarding renal phenotype. A total of 126 families fulfilled these criteria.

      CasePresentingHPOs: HP:0005584 (Renal cell carcinoma)

      CaseHPOFreeText: Moderate renal disease (less than five solid lesions requiring surgical treatment, either unilateral or bilateral). Individual RCC phenotype is noted as positive.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: Phenotype and genotype information can be found in Supplementary Table S1.

      Variant: p.S43_E47del (c.123_137del)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: N/A

      CAID: CA039321, https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvsOrDescriptor=NM_000551.3%3Ac.123_137del

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: inframe_deletion; deletion

      CivicName: S43_E47del (c.123_137del)

      MultipleGeneVariants: N/A

    3. GroupID: 87

      DiseaseAssertion: VHL

      GroupSize: 3

      GroupNumberMales: N/A

      GroupNumberFemales: N/A

      GroupEthnicity: French

      GroupAgeRange: N/A

      GroupInfo: 3 members of this family were found to harbor the c.466T>G germline variant of the VHL gene. Member 4587 presented with severe renal disease (RCC). Members 4588 and 5177 had unknown renal involvement. Families were recruited from the French VHL Registry. Enrolment in the study required identification of the germline VHL mutation (currently 85% of the families included in the French VHL Registry) and available data regarding renal phenotype. A total of 126 families fulfilled these criteria.

      GroupPresentingHPOs: HP:0005584 (Renal cell carcinoma)

      GroupHPOFreeText: Severe renal disease (any solid lesion before 25 years of age, five or more solid lesions within one or two kidneys, or metastasis of renal cell carcinoma).

      GroupNotHPOs: N/A

      GroupNotHPOFreeText: N/A

      GroupPreviousTesting: N/A

      PreviouslyPublished: Paper states that this family is previously reported in PMID 12202531 and/or 9829912, where 1 and 1 individuals respectively with this mutation are reported. It is unclear if one or both of these previously reported groups are the same as the current family.

      SupplementalData: Phenotype and genotype information can be found in Supplementary Table S1.

      Variant: p.Y156D (c.466T>G)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: N/A

      CAID: CA351756043, https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvsOrDescriptor=NM_000551.3%3Ac.466T%3EG

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant;transversion

      CivicName: Y156D (c.466T>G)

      MultipleGeneVariants: N/A

    4. PatientID: 2178

      KindredID: 113

      Case: Sex Unknown, Age Unknown, French

      DiseaseAssertion: VHL

      FamilyInfo: N/A

      CohortInfo: Families were recruited from the French VHL Registry. Enrolment in the study required identification of the germline VHL mutation (currently 85% of the families included in the French VHL Registry) and available data regarding renal phenotype. A total of 126 families fulfilled these criteria.

      CasePresentingHPOs: HP:0005584 (Renal cell carcinoma)

      CaseHPOFreeText: Moderate renal disease (less than five solid lesions requiring surgical treatment, either unilateral or bilateral). Individual RCC phenotype is noted as positive.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: Phenotype and genotype information can be found in Supplementary Table S1.

      Variant: p.V87A (c.260T>C)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: N/A

      CAID: CA351750654, https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvsOrDescriptor=NM_000551.3%3Ac.260T%3EC

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant;transition

      CivicName: V87A (c.260T>C)

      MultipleGeneVariants: N/A

    5. Molecular and clinical analysis of 126 French VHL families tested for renal involvement revealed 92 different mutations. 90 of these families had renal involvement. The p.R161Q (c.482G>A) germline variant of the VHL gene was detected in a family (ID 60). Member 1603 presented with mild renal disease. Member 1601 presented with severe renal disease (RCC). An individual from another family (ID 6270, Family 279) was also found with this variant and presented with renal cell carcinoma. The paper states that these families are previously reported in PMID 12202531 and/or 9829912.

    1. PatientID: 218

      KindredID: 218

      Case: Sex Unknown, 17Y0M, Ethnicity Unknown

      DiseaseAssertion: VHL

      FamilyInfo: Positive VHL family history.

      CasePresentingHPOs: HP:0010797 (hemangioblastoma )

      CaseHPOFreeText: N/A

      CaseNotHPOs: HP:0009711, HP:0001737, HP:0002666, HP:0000107, HP:0006770 (retinal capillary hemangioma, pancreatic cyst, pheochromocytoma, renal cyst, clear cell renal cell carcinoma)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: Table S1, S2, S3.

      Variant: p.R161* (c.481C>T)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 2217 https://www.ncbi.nlm.nih.gov/clinvar/variation/2217/

      CAID: CA020408 http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvsOrDescriptor=NM_000551.3%3Ac.481C%3ET

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: stop_gained

      CivicName: R161*(c.481C>T)

      MultipleGeneVariants: N/A

    2. PatientID: 384

      KindredID: 384

      Case: Sex Unknown, 40Y0M, Ethnicity Unknown

      DiseaseAssertion: VHL

      FamilyInfo: Family history is positive but no details provided.

      CasePresentingHPOs: HP:0001732; HP:0006770 (Abnormality of the pancreas, Clear cell renal cell carcinoma)

      CaseHPOFreeText: Clear cell renal cell carcinoma and pancreatic cyst or tumor.

      CaseNotHPOs: HP:0010797; HP:0002666; HP:0000107; HP:0009711 (Hemangioblastoma, Pheochromocytoma, Renal cyst, Retinal capillary hemangioma)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished:N/A

      SupplementalData: Table S1, S2 and S3

      Variant: Complete Deletion

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: N/A

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: deletion

      CivicName: Null (Complete deletion)

      MultipleGeneVariants: N/A

    3. PatientID: 378

      KindredID: 378

      Case: Sex Unknown, 52Y0M, Ethnicity Unknown

      DiseaseAssertion: VHL

      FamilyInfo: Family history is positive but no details are provided.

      CasePresentingHPOs: HP:0010797 (Hemangioblastoma)

      CaseHPOFreeText: CNS hemangioblastoma.

      CaseNotHPOs: HP:0002666; HP:0006770; HP:0001732; HP:0000107; HP:0009711 (Pheochromocytoma, Clear cell renal cell carcinoma, Abnormality of the pancreas, Renal cyst, Retinal capillary hemangioma)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished:N/A

      SupplementalData: Table S1, S2 and S3

      Variant: Exon 1-2 Deletion (c.1-?_463+?del)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: N/A

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: exon_loss_variant; deletion

      CivicName: Exon 1-2 Deletion

      MultipleGeneVariants: N/A

    1. Genomic DNA was extracted from peripheral blood leukocytes using DNA isolation kit for mammalian blood (Roche Diagnostics GmbH). Mutation analysis of splice sites and exons 1, 2, and 3 of the VHL gene was performed by using direct sequencing of DNA samples amplified by PCR. PCR amplifications were carried out using modified oligonucleotide primers (24), which covered the exon–intron boundaries. Sequence analysis was performed by direct cycle sequencing using the SequiTherm Excel II DNA Sequencing Kit-LC (Epicentre Technologies, Madison, WI, USA) and an automated Li-COR IR2 sequencer (Li-COR Inc., Lincoln, NE, USA) or by direct cycle sequencing using the Big Dye Terminator Cycle Sequencing kit v3.1 (Applied Biosystems, Foster City, CA, USA), and run on an automated sequencer 310 Genetic Analyzer from Applied Biosystems.In cases when direct sequencing failed to show VHL gene mutations, DNA samples were analyzed for germline deletion of the VHL gene. A nonsequence-specific real-time detection of PCR products was performed by using the DNA binding dye SYBR Green I, as described by Ponchel et al.

      ArticleReferenceSequence: Not specified- Assumption: Nucleotide change is not specified in the paper, only protein coding change is. cDNA variant was inferred based on protein coding change, and reported based on VHL reference sequence NM_000551.3

      GenotypingMethod: DNA samples amplified by PCR underwent direct sequencing using SequiTherm Excel II DNA Sequencing Kit-LC (Epicentre Technologies, Madison, WI, USA) and an automated Li-COR IR2 sequencer (Li-COR Inc., Lincoln, NE, USA) or by direct cycle sequencing using the Big Dye Terminator Cycle Sequencing kit v3.1 (Applied Biosystems, Foster City, CA, USA), and run on an automated sequencer 310 Genetic Analyzer from Applied Biosystems. In cases where direct sequencing failed to detect any VHL mutations, patients also underwent nonsequence-specific real-time detection of PCR products using the DNA binding dye SYBR Green I.

      SamplingMethod: peripheral blood

    1. Medical records of 26 patients with germline mutations of the VHL gene who had been diagnosed with VHL disease in Severance Hospital (Seoul, Republic of Korea) and Samsung Medical Center (Seoul, Republic of Korea) between 2003 and 2012 were respectively reviewed. Peripheral blood leukocytes were isolated and directly sequenced. Patient 29, 47Y female, and her daughter presented with multiple and/or bilateral pheochromocytoma. The proband also presented with CNS and retinal hemangioblastomas. Both family members had the c.361G>A (p.D121N) germline VHL variant. The probands phenotypes were revised from a previous report in PMID 16142346 and was previously reported by Yang et al., in 2005 (reference 20 in the current paper). The proband was diagnosed with VHL Type 2A and her daughter with VHL Type 2C.

    2. PatientID: 10

      KindredID: 10

      Case: F, 41Y0M, Korean

      DiseaseAssertion: VHL

      FamilyInfo: No family history of VHL.

      CohortInfo: 26 Korean patients with more than one HAB in the CNS or eye, a single HAB in the CNS or retina plus a visceral manifestation (multiple renal, pancreatic or hepatic cysts, pheochromocytoma and RCC) and positive family history plus any one of the above manifestations.

      CasePresentingHPOs: HP:0010797 (Hemangioblastoma)

      CaseHPOFreeText: CNS hemangioblastoma. Diagnosed with VHL Type 1.

      CaseNotHPOs: HP:0002666; HP:0009711; HP:0005584 (Pheochromocytoma, Retinal capillary hemangioma, Renal cell carcinoma)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.E70K (c.208G>A)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 43598, https://www.ncbi.nlm.nih.gov/clinvar/variation/43598/

      CAID: N/A

      gnomAD: 0.000004365, https://gnomad.broadinstitute.org/variant/3-10183739-G-A

      VariantEvidence: N/A

      MutationType: missense_variant;transition

      CivicName: E70K (c.208G>A)

      MultipleGeneVariants: N/A

    3. PatientID: 3

      KindredID: 3

      Case: M, 55Y0M, Korean

      DiseaseAssertion: VHL

      FamilyInfo: No family history of VHL.

      CohortInfo: 26 Korean patients with more than one HAB in the CNS or eye, a single HAB in the CNS or retina plus a visceral manifestation (multiple renal, pancreatic or hepatic cysts, pheochromocytoma and RCC) and positive family history plus any one of the above manifestations.

      CasePresentingHPOs: HP:0010797 (Hemangioblastoma)

      CaseHPOFreeText: Multiple or bilateral CNS hemangioblastoma. Diagnosed with VHL Type 1. Phenotypes revised from previous reports (see “PreviouslyPublished” section below for PMID).

      CaseNotHPOs: HP:0002666; HP:0009711; HP:0005584 (Pheochromocytoma, Retinal capillary hemangioma, Renal cell carcinoma)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: 19270817

      SupplementalData: N/A

      Variant: p.E70K (c.208G>A)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 43598, https://www.ncbi.nlm.nih.gov/clinvar/variation/43598/

      CAID: N/A

      gnomAD: 0.000004365, https://gnomad.broadinstitute.org/variant/3-10183739-G-A

      VariantEvidence: N/A

      MutationType: missense_variant;transition

      CivicName: E70K (c.208G>A)

      MultipleGeneVariants: N/A

    4. PatientID: 31

      KindredID: 31

      Case: F, 42Y0M, Korean

      DiseaseAssertion: VHL

      FamilyInfo: No family history of VHL.

      CohortInfo: 26 Korean patients with more than one HAB in the CNS or eye, a single HAB in the CNS or retina plus a visceral manifestation (multiple renal, pancreatic or hepatic cysts, pheochromocytoma and RCC) and positive family history plus any one of the above manifestations.

      CasePresentingHPOs: HP:0010797; HP:0005584 (Hemangioblastoma, Renal cell carcinoma)

      CaseHPOFreeText: CNS hemangioblastoma. Other phenotypes presented but not specified (one or more of: pancreatic cyst or tumor, renal or hepatic cyst). Diagnosed with VHL Type 1.

      CaseNotHPOs: HP:0002666; HP:0009711 (Pheochromocytoma, Retinal capillary hemangioma)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.L128P (c.383T>C)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 1208816, https://www.ncbi.nlm.nih.gov/clinvar/variation/1208816/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant;transition

      CivicName: L128P (c.383T>C)

      MultipleGeneVariants: N/A

    1. One hundred and sixteen unrelated VHL disease patients have been investigated by molecular genetic analysis. Twenty-two of these were previously shown to have germline deletions on Southern analysis, and in the present study the remaining 94 patients were screened for intragenic mutations via SSCP and heteroduplex analysis of 855 bp of the VHL coding sequence and 800 bp of the 3' UTR. An intragenic mutation was identified in 55 (59%) out of 94 patients without germline deletions on Southern analysis. In all patients with multiple affected family members the missense mutation segregated with the disease. Large deletions or intragenic mutations predicted to cause a truncated protein were found in 36 of 53 families without pheochromocytoma (VHL type 1) and 2 of 12 families with pheochromocytoma (VHL type 2). This study also investigated the frequency of different mutation classes between kindreds with and without pheochromocytoma. The p.E94 (c.280G>T) missense mutation (noted as p.E165 (c.493G>T) in the paper due to a difference in reference transcript used) was found in at least one patient in kindred 51. Pheochromocytoma was not observed in any members of this kindred (implying the affected patient(s) had VHL disease type 1). No other familial phenotypic information could be inferred from the paper.

    2. KindredID: 99

      GroupID: 30

      GroupSize: Unknown

      GroupNumberMales: Unknown

      GroupNumberFemales: Unknown

      GroupEthnicity: Unknown

      GroupAgeRange: Unknown

      DiseaseAssertion: VHL

      GroupInfo: Kindred no. 99 describes a family where at least one member (unspecified how many) had this mutation in the VHL gene. No phenotypic information is listed for this kindred.

      GroupPresentingHPOs: N/A

      GroupHPOFreeText: No phenotypic information is listed for this kindred.

      GroupNotHPOs: N/A

      GroupNotHPOFreeText: N/A

      GroupPreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: L153Cfs*6 (c.457del)

      LegacyVariant: p.224fs (c.670delC)

      CaseProblemVariantFreeText: N/A

      ClinVarID: N/A

      CAID: CA432421920

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: minus_1_frameshift_variant

      CivicName: L153fs (c.457delC)

      MultipleGeneVariants: N/A

    1. D121Y (32) 

      301 were enrolled in a prospective clinical protocol to evaluate the natural history of vHL-associated pancreatic lesions (NCT00062166). Of these, 69 patients with pancreatic manifestations of vHL disease and missense VHL mutations were included in the current study. Individual patient phenotype was not described, but overall of the 60 patients, 57 had RCC, 41 had CNS hemangioblastomas, 28 had retinal hemangioblastoma, 23 had pheochromocytoma. 36/69 patients were female and the mean age was 50.5 years old. All patients underwent genetic testing using Sanger sequencing and Southern Blotting. One patient was listed with this missense mutation, c.361G>T.

    2. P86S (26) 4 

      GroupID: None

      DiseaseAssertion: VHL

      GroupSize: 4

      GroupNumberMales:N/A

      GroupNumberFemales:N/A

      GroupEthnicity: N/A

      GroupAgeRange: ≥12

      GroupInfo: The four patients were grouped by mutation.

      GroupPresentingHPOs: HP:0001732 (abnormality of the pancreas)

      GroupHPOFreeText: N/A

      GroupNotHPOs:N/A

      GroupNotHPOFreeText: N/A

      GroupPreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.P86S (c.256C>T)

      LegacyVariant:N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 178692 https://www.ncbi.nlm.nih.gov/clinvar/variation/178692/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence:N/A

      MutationType: missense_variant;transition

      CivicName: P86S (c.256C>T)

      MultipleGeneVariants: N/A

    1. c.269A > T p.Asn90Ile (group 8)

      GroupID: 8

      DiseaseAssertion: assumed VHL

      GroupSize: 15

      GroupNumberMales: N/A

      GroupNumberFemales: N/A

      GroupEthnicity: Chinese

      GroupAgeRange: 36.9Y +/- 15.6Y

      GroupInfo: Clinical characteristics of 258 patients from 80 unrelated Chinese families were reported in this study. Grouped by the 21 mutations found, 3 families with 15 members total were described, and phenotypic information was given for this group.

      GroupPresentingHPOs: HP:0010797; HP:0009711; HP:0005584; HP:0001737; HP:0002666 (hemangioblastoma, retinal capillary hemangioma, renal cell carcinoma, pancreatic cysts, pheochromocytoma)

      GroupHPOFreeText: 10 of the 15 members presented with CNS hemangioblastoma (mean age of 29.9Y), 2/15 had retinal capillary hemangiomas at 23Y and 30Y, renal cell carcinoma in 4 members (at a mean age of 41.5Y), pancreatic cysts in 5 members (with a mean age of onset of 41.4Y), and 1 member with pheochromocytoma at 38Y

      GroupNotHPOs: HP:0009715 (papillary cystadenoma of the epididymis)

      GroupNotHPOFreeText: No patients were given with papillary cystadenoma of the epididymis

      GroupPreviousTesting: N/A

      PreviouslyPublished: 29330336; 28388566

      SupplementalData: N/A

      Variant: p.N90I (c.269A>T)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 223172 https://www.ncbi.nlm.nih.gov/clinvar/variation/223172/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant;transition

      CivicName: N90I (c.269A>T)

      MultipleGeneVariants: N/A

    2. c.263G > C p.Trp88Ser

      GroupID: 6B

      DiseaseAssertion: assumed VHL

      GroupSize: 9

      GroupNumberMales: N/A

      GroupNumberFemales: N/A

      GroupEthnicity: Chinese

      GroupAgeRange: 33.8Y +/- 17.6Y

      GroupInfo: Clinical characteristics of 258 patients from 80 unrelated Chinese families were reported in this study. Grouped by the 21 mutations found, 3 families with 13 members total were described. it is unclear how many distinct families are reported in group 6B. 9 individuals were described. Phenotypic information was given for this mutation.

      GroupPresentingHPOs: HP:0010797; HP:0009711; HP:0005584; HP:0001737; HP:0009715 (hemangioblastoma, retinal capillary hemangioma, renal cell carcinoma, pancreatic cysts, papillary cystadenoma of the epididymis)

      GroupHPOFreeText: 7 of the 9 members presented with CNS hemangioblastoma (mean age of 29.9Y), 2/9 had retinal angiomas at 25Y and 35Y, 1 had renal cell carcinoma (at 30Y), pancreatic cysts in 2 members (with an age of onset of 30 and 31Y), and 1 member with a genital system tumor (epididymis or broad ligament) at 24Y

      GroupNotHPOs: HP:0002666 (pheochromocytoma)

      GroupNotHPOFreeText: No patients were given with pheochromocytoma

      GroupPreviousTesting: N/A

      PreviouslyPublished: 29330336; 28388566

      SupplementalData: N/A

      Variant: p.W88S (c.263G>C)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 2220, https://www.ncbi.nlm.nih.gov/clinvar/variation/2220/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant;transversion

      CivicName: W88S (c.263G>C)

      MultipleGeneVariants: N/A

    3. 337

      GroupID: 10

      DiseaseAssertion: assumed VHL

      GroupSize: 6

      GroupNumberMales: N/A

      GroupNumberFemales: N/A

      GroupEthnicity: Chinese

      GroupAgeRange: 47.0Y +/- 18.4Y

      GroupInfo: Clinical characteristics of 258 patients from 80 unrelated Chinese families were reported in this study. Grouped by the 21 mutations found, 2 families with 6 members total were described, and phenotypic information was given for this group.

      GroupPresentingHPOs: HP:0010797; HP:0009711; HP:0005584; HP:0001737; HP:0009715 (hemangioblastoma, retinal capillary hemangioma, renal cell carcinoma, pancreatic cysts, papillary cystadenoma of the epididymis)

      GroupHPOFreeText: 3 of the 6 members presented with CNS hemangioblastoma (mean age of 40.0Y), 3/6 had retinal capillary hemangiomas (at a mean age of 23Y), renal cell carcinoma in 3 members (at a mean age of 35.3Y), pancreatic cysts in 2 members (with age of onsets of 26 and 27Y), and 1 with a papillary cystadenoma of the epididymis genital system tumor (epididymis or broad ligament) (at age 18Y).

      GroupNotHPOs: HP:0002666 (pheochromocytoma)

      GroupNotHPOFreeText: no members were found with pheochromocytomas

      GroupPreviousTesting: N/A

      PreviouslyPublished: 29330336

      SupplementalData: N/A

      Variant: p.R113* (c.337C>T)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 220414 https://www.ncbi.nlm.nih.gov/clinvar/variation/220414/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: stop_gained

      CivicName: R113* (c.337C>T)

      MultipleGeneVariants: N/A

    4. Six major VHL-related lesions (CHB, RA, RCC, PCT, PHEO, and GS) were observed in the c.194C > T p.Ser65Leu mutational subgroup

      540 patients from 187 unrelated Chinese VHL families at the Peking University First Hospital were all screened for VHL clinical features and germline mutations. Of these, clinical characteristics were observed in 258 patients from 80 unrelated Chinese families. These were reported in this study, grouped by the 21 mutations found. PCR and MLPA on peripheral blood detected the VHL mutations. Possessing the p.S65L (c.194C>T) mutation, 24 members total from an unknown number of families were described, and phenotypic information was given for this group. With ages ranging from 15-65Y, hemangioblastomas were observed in 15/24 members, retinal capillary hemangioma in 2, renal cell carcinoma in 9, pancreatic cysts in 11, pheochromocytoma in 1, and a genital system tumor (epididymis or broad ligament) in 4 members. This cohort has been previously published in PMID 29330336; 28388566.

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    1. In family 4, the proband was a female who had a bilateral pheochromocytoma at the age of 46 years that recurred locally with liver metastases a few years later. Her brother had a monolateral benign pheochromocytoma. The proband also had a melanoma and bilateral renal cysts. A VHL sequence variant IVS2 +43 A>G was found in this case and also in one other unrelated sporadic pheochromocytoma. Their VHL mRNA integrity is currently being assessed. The proband had no cerebellar or spinal NMR finding or retinal alterations. Molecular analysis showed the following sequence variants: VHL IVS2 +43 A>G, RET c.2071 G>A p.G691S, SDHD c.34 G>A p.G12S, IVS2-29 A>G, c.204 C>T p.S68S, and IVS3-32 T>C.

      PatientID: 4 (proband)

      KindredID: 4

      Case: F, 46Y0M, Ethnicity Unknown

      DiseaseAssertion: assumed VHL

      FamilyInfo: Positive family history with her brother having a monolateral benign pheochromocytoma

      CasePresentingHPOs: HP:0002666; HP:0002861; HP:0000107 (pheochromocytoma; melaonoma; renal cyst)

      CaseHPOFreeText: Bilateral pheochromocytoma at the age of 46Y with a local reccurance a few years later. She also presented with liver metastases from the pheochromocytoma, as well as melanoma and bilateral renal cysts

      CaseNotHPOs: (HP:0006880; HP0009713; HP:0009711)

      CaseNotHPOFreeText: She had no cerebellar or spinal hemangiostaomasm nor retinal alterations

      CasePreviousTesting: RET/SDHB/SDHC/SDHD/EGLN3

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: c.463+43A>G

      LegacyVariant: IVS1+43A>G

      CaseProblemVariantFreeText: N/A

      ClinVarID: 1244574 https://www.ncbi.nlm.nih.gov/clinvar/variation/1244574/

      CAID: N/A

      gnomAD: 0.01186 https://gnomad.broadinstitute.org/variant/3-10188363-A-G

      VariantEvidence: this intronic sequence variant may have a role in VHLd because it was also detected in this study in a case of sporadic pheochromocytoma. However, this variant’s large allele frequency means this is likely non disease causing (not deleterious; polymorphism).

      MutationType: splice_site_variant; intron_variant

      CivicName: c.463+43A>G

      MultipleGeneVariants: Germline, RET, c.2071G>A (p.Gly691Ser); Germline, SDHD, c.34G>A (p.Gly12Ser); SDHD, (IVS2-29A>G); SDHD c.204C>T (p.Ser68Ser); SDHD (IVS3-32T>C)

    1. Germline mutations were identified in 300/469 (63%) of the families tested; 137 distinct intragenic germline mutations were detected.

      Germline mutational data on VHL was gathered from various countries to assess variation in germline mutations that produce disease within different populations. Families were grouped according to three possible outcomes of disease: renal cell carcinoma without pheochromocytoma, renal cell carcinoma with pheochromocytoma, or pheochromocytoma alone. SSCP and denaturing gradient gel electrophoresis identified mutations in 300/469 (63%) of families affected with VHL. This germline familial VHL mutation (L135* (c.404T>A)) was taken from the National Cancer Institute database, and the Bristol Myers Squibb database. It had an unknown number of members belonging to Family ID 3710NCI, reported in Table 3, as being found in VHL families without pheochromocytoma, and with renal cell carcinoma. Additionally, it was reported in table 5, specified as families without detailed clinical information, under family ID 8BMS. It was reported in the paper as c.617T>A due to a difference in transcript reference.

    2. Germline mutations were identified in 300/469 (63%) of the families tested; 137 distinct intragenic germline mutations were detected.

      Germline mutational data on VHL was gathered from various countries to assess variation in germline mutations that produce disease within different populations. Families were grouped according to three possible outcomes of disease: renal cell carcinoma without pheochromocytoma, renal cell carcinoma with pheochromocytoma, or pheochromocytoma alone. SSCP and denaturing gradient gel electrophoresis identified mutations in 300/469 (63%) of families affected with VHL. This germline familial VHL mutation (N78S (c.233A>G)) was taken from multiple databases including: the Department of Uroglogy, Yokohama database, the Munich, university of Freiburg and Institute of Pathology database, the National Cancer Institute database, and the Cambridge, Department of Pathology database, with an unknown number of members belonging to Family IDs 9YO, 51CE, 4327NCI, 160CA. It was reported in the paper as c.446A>G due to a difference in transcript reference. As reported in Table 3, this mutation is found in VHL families without pheochromocytoma, and with renal cell carcinoma.

    3. Germline mutations were identified in 300/469 (63%) of the families tested; 137 distinct intragenic germline mutations were detected.

      GroupID/ KindredID: 46YO, 19CA, 27F

      DiseaseAssertion: VHL

      GroupSize: N/A

      GroupNumberMales: N/A

      GroupNumberFemales: N/A

      GroupEthnicity: N/A

      GroupAgeRange: N/A

      GroupInfo: This germline familial VHL mutation was taken from multiple databases including: the Department of Uroglogy, Yokohama database, the Cambridge, Department of Pathology database, and the Neuro Olcologie database in Paris, with an unknown number of members belonging to Family IDs 46YO, 19CA, 27F. Table 3 lists all ID and mutations associated with individuals possessing renal carcinoma, without pheochromocytoma.

      GroupPresentingHPOs: HP:0005548 (renal cell carcinoma)

      GroupHPOFreeText: Described as a VHL family with RCC, without pheochromocytoma. Other phenotypes are likely, however not detailed in this publication

      GroupNotHPOs: HP:0002666 (pheochromocytoma)

      GroupNotHPOFreeText: N/A

      GroupPreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.L118P (c.353T>C)

      LegacyVariant: p.L118P (c.566T>C)

      CaseProblemVariantFreeText: N/A

      ClinVarID: 428807 https://www.ncbi.nlm.nih.gov/clinvar/variation/428807/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant; transition

      CivicName: L118P (c.353T>C)

      MultipleGeneVariants: N/A

    4. Germline mutations were identified in 300/469 (63%) of the families tested; 137 distinct intragenic germline mutations were detected.

      Germline mutational data on VHL was gathered from various countries to assess variation in germline mutations that produce disease within different populations. Families were grouped according to three possible outcomes of disease: renal cell carcinoma without pheochromocytoma, renal cell carcinoma with pheochromocytoma, or pheochromocytoma alone. SSCP and denaturing gradient gel electrophoresis identified mutations in 300/469 (63%) of families affected with VHL. This germline familial VHL mutation (Y112* (c.336C>A)) was taken from the National Cancer Institute database, with an unknown number of members belonging to Family IDs 3759NCI and 3760NCI. It was reported in the paper as c.549C>A due to a difference in transcript reference. As reported in Table 3, this mutation is found in VHL families without pheochromocytoma, and with renal cell carcinoma. Later publications reference this cohort as being reported in PMID: 7728151.

    5. Germline mutations were identified in 300/469 (63%) of the families tested; 137 distinct intragenic germline mutations were detected.

      GroupID/ KindredID: 4783NCI

      DiseaseAssertion: VHL

      GroupSize: N/A

      GroupNumberMales: N/A

      GroupNumberFemales: N/A

      GroupEthnicity: N/A

      GroupAgeRange: N/A

      GroupInfo: Two germline familial VHL mutations were associated with this family. They were: c.382C>T and c.381G>T and this data was taken from the National Cancer Institute database. It is unclear how many members belonging to Family ID 4783NCI had both mutations. Table 4 lists all ID and mutations associated with individuals with pheochromocytoma.

      GroupPresentingHPOs: HP:0002666 (pheochromocytoma)

      GroupHPOFreeText: Described as a VHL family with pheochromocytoma. Other phenotypes are likely, including renal cell carcinoma, however not detailed here.

      GroupNotHPOs: N/A

      GroupNotHPOFreeText: N/A

      GroupPreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.G127G (c.381G>T)

      LegacyVariant: p.G127G (c.594G>T)

      CaseProblemVariantFreeText: N/A

      ClinVarID: N/A

      CAID: CA432421824 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvsOrDescriptor=NM_000551.3%3Ac.381G>T

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant; transversion; synonymous_variant

      CivicName: G127G (c.381G>T)

      MultipleGeneVariants: Germline, VHL, c.382C>T (p.Leu128Phe)

    1. The patient was heterozygous for the novel c.163 G > T (p.55GluX) amber nonsense mutation

      PatientID: 1

      KindredID: 1 (A)

      Case: M, 15Y0M, Hungarian

      DiseaseAssertion: VHL

      FamilyInfo: Both parents were healthy with no display of any mutations in the VHL gene, indicating a de novo mutation.

      CasePresentingHPOs: HP:0006770; HP:0009711 (clear cell renal cell carcinoma, retinal capillary hemangioma)

      CaseHPOFreeText: Patient developed bilateral retinal angioma (retinal capillary hemangioma) and had serious retinal detachment.

      CaseNotHPOs: HP:0010797; HP:0002666 (hemangioblastoma, pheochromocytoma)

      CaseNotHPOFreeText: MRI of the craniospinal axis could not detect any alterations. No deviation from normal values was observed in the laboratory test.

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.E55* (c.163G>T)

      CaseProblemVariantFreeText: N/A

      LegacyVariant: N/A

      ClinVar: N/A

      CAID: CA351748495 http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvsOrDescriptor=NM_000551.3%3Ac.163G%3ET

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant; transversion

      CivicName: E55* (c.163G>T)

      MultipleGeneVariants: N/A

    1. Eighteen VHL patients who underwent pancreatectomy for one or several endocrine tumors at Beaujon hospital from 1997 to 2008 were retrieved from the file of VHL patients (Table 1).

      PatientID: 7

      KindredID: 7

      Case: M, 26Y0M, Ethnicity unknown

      DiseaseAssertion: pancreatic endocrine tumor

      FamilyInfo: None

      CasePresentingHPOs: HP:0030405 (pancreatic endocrine tumor)

      CaseHPOFreeText: See Table 1 for more information

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: N/A; Null (large rearrangement)

      CaseProblemVariantFreeText: N/A

      LegacyVariant: N/A

      ClinVarID: N/A

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: rearrangement_region

      CivicName: Rearrangement

      MultipleGeneVariants: N/A

    1. 2. Materials and methods2.1. PatientThe 32-year-old male patient was admitted to Xiangya Hospital in 2006 and presented with progressive back and neck pain, and numbness and weakness of both legs which had continued for 1 month followed by fecal and urinary retention for 5 days. The MRI (1.5 Tesla) of the brain and entire spinal cord showed multiple lesions in the cerebellum, brain stem, and spinal cord, which were obviously enhanced and highly suggestive of hemangioblastomas (Fig. 1a–e). Subsequent evaluation, by MRI, of the abdomen revealed a solid kidney tumor (Fig. 1f). He underwent surgical resection for hemangioblastomas of T10 and T12 of the spinal cord, which appeared bright red at surgery. The pathological examination of the tissues showed many small blood vessels, most of which were a capillary plexus. Vascular endothelial cells were flat and distributed within a large number of stromal cells. Some of the vascular endothelial cells formed solid masses and cords. Between the capillary plexus, various forms of stromal cells were found, including nest-like or sheet arrangements with hyperchromatic nuclei, rich cytoplasm, rich lipid vacuoles and rare or no mitoses. Some foam cells and adipose-like cells were also found. Immunohistochemistry of the biopsied tissues from the lesions in the spinal cord were negative on immunostaining (–) for glial fibrillary acidic protein (GFAP), CD68, cytokinin (CK)-pan and epithelial membrane antigen (EMA), but stained positive (+) for factor 8 related antigen (F8RAg). Vascular endothelial cells were F8RAg(+) but stromal cells were F8RAg(–). Vascular endothelial cells and stromal cells were all immunonegative for GFAP, EMA, CK-pan, and CD68 (Fig. 1g, h). The patients’ symptoms resolved after surgery. At 5-year follow-up his condition did not recur or deteriorate, but active surveillance was continued.12Download : Download high-res image (1MB)Download : Download full-size imageFig. 1. Main clinical manifestations of von Hippel-Lindau (VHL) disease. (a) Sagittal T1-weighted MRI of the thoracic spinal cord showing two brightly enhancing nodular lesions with clear boundaries at T10 and T12 (arrows). (b) Sagittal T1-weighted MRI of the cervical spinal cord showing two brightly enhancing nodular lesions with clear boundaries at C5 and C6 (arrows). (c) Sagittal T1-weighted MRI of the cervical spinal cord showing a brightly enhancing nodular lesion with a clear boundary at C2 (arrow). (d) Sagittal T1-weighted MRI of the cranial–cervical region showing three brightly enhancing round lesions with clear boundaries at the posterior of the medulla oblongata, superior spinal cord and basilar part of the pons (arrows). (e) Axial T1-weighted MRI of the brain showing two brightly enhancing nodular lesions with clear boundaries at the posterior of the medulla oblongata and the right cerebellar hemisphere (arrows). (f) Sagittal T1-weighted MRI of the kidney showing the small (1.2 cm × 0.6 cm) enhancing nodular lesion (arrow). (g) Histopathological examination of the lesions at T10 and T12 in the spinal cord of the patient with VHL (hematoxylin and eosin stain, ×400). (h) Immunohistochemistry of the biopsied tissue from the lesions at T10 and T12 in the spinal cord of the patient with VHL (factor 8 related antigen stain, ×400).After genetic counseling, all family members of the patient (his parents, sister, son, sister’s son, brother, and brother’s son) were recruited into this study. His 66-year-old father and 63-year-old mother were both in good health without clinical symptoms of VHL. They did not undergo a whole-body examination, but all other family members underwent clinical examination, including ophthalmoscopy, MRI of the CNS, and ultrasonography of the abdomen, to exclude the disease. Informed consent was obtained from all individuals before their participation in the study.

      PatientID: 1

      KindredID: 1

      Case: M, 39Y0M, Ethnicity Unknown

      DiseaseAssertion: VHL

      FamilyInfo: No family history. All 7 of his other family members (his parents, sister, son, sister’s son, brother, and brother’s son) were sequenced and no mutation were found. Additionally, all were healthy members. Suggestive of de novo due to no abnormal changes in the VHL gene of either parent.

      CasePresentingHPOs: HP:0010797; HP:0009713; HP:0006880; HP:0009726 (hemangioblastoma, spinal hemangioblastoma, cerebellar hemangioblastoma, renal neoplasm)

      CaseHPOFreeText: At 32Y this patient presented with progressive back and neck pain and numbness. Patient developed multiple CNS hemangioblastomas (multiple lesions in the cerebellum, brain stem, and spinal cord). Subsequent evaluation of the abdomen revealed a solid kidney tumor (visceral tumor).

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.F76del (c.227_229delTCT)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: N/A

      CAID: CA357012 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvsOrDescriptor=NM_000551.3%3Ac.227_229delTCT

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: inframe_deletion

      CivicName: F76del (c.227_229delTCT)

      MultipleGeneVariants: N/A

    2. 2.2. DNA sequencingGenomic DNA was extracted from peripheral blood leukocytes by standard extraction methods.2 Genomic DNA (50–100 ng) was amplified by polymerase chain reaction (PCR) in a standard PCR buffer containing 200 mM of each deoxyribonucleotide triphosphate (dNTP), 1.5 mM MgCl2, 0.25 units of Ex Taq™ DNA polymerase (TaKaRa, Dalian, China) and 0.2 mM of each primer. The PCR conditions were as follows: 95 °C for 5 min; 35 cycles of 95 °C for 30 s, 62 °C for 45 s and 72 °C for 1 min; and 72 °C for 10 min. PCR products were purified and sequenced with an automated DNA sequencer (ABI PRISM®3100, Applied Biosystems, Carlsbad, CA, USA). Exon 1 was amplified using two primer sets. Exons 2 and 3 were each amplified using one primer set. The primer pairs used for the amplification of the three exons and their flanking introns of the VHL gene are shown (Table 1).

      ArticleReferenceSequence: Not specified – Assumption: variants assumed to have been documented by the author under reference sequence NM_000551.3

      GenotypingMethod: Genomic DNA (50–100 ng) was amplified by polymerase chain reaction (PCR) in a standard PCR buffer containing 200 mM of each deoxyribonucleotide triphosphate (dNTP), 1.5 mM MgCl2, 0.25 units of Ex Taq™ DNA polymerase (TaKaRa, Dalian, China) and 0.2 mM of each primer. Any partial or complete VHL gene deletions were detected by real-time quantitative PCR (RQ-PCR).

      SamplingMethod: peripheral blood leukocytes

    1. PatientID: 12

      KindredID: N/A

      Case: Sex Unknown, Age Unknown, Ethnicity Unknown

      DiseaseAssertion: VHL

      FamilyInfo: N/A

      CohortInfo: The authors evaluated 64 VHL patients (32 women and 32 men) with renal involvement of whom 54/64 had undergone renal surgery or a radiofrequency thermal ablation procedure for RCC. In 10/64 VHL patients, at least one or more RCC were diagnosed, however at the time of diagnosis an indication for treatment was not yet present. For all patients several CT/MRI scans existed for retrospective description of tumour growth kinetics.

      CasePresentingHPOs: HP:0005584 (Renal cell carcinoma)

      CaseHPOFreeText: This is a tumor resolution study (VHL patients were investigated based on the presence of renal tumors.) No other phenotypic information is available.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: Supplementary Table S1 describes 19 patients with missense mutations, including this patient.

      Variant: p.H115R(c.344A>G)

      LegacyVariant: c.557A>G

      CaseProblemVariantFreeText: N/A

      ClinVarID: 664415, https://www.ncbi.nlm.nih.gov/clinvar/variation/664415/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant;transition

      CivicName: H115R (c.344A>G)

      MultipleGeneVariants: N/A

    2. The authors described the growth kinetics of 96 renal tumours in 64 VHL patients (32 males, 32 females). All patients had VHL disease with renal involvement. 54/64 had undergone renal surgery or a radiofrequency thermal ablation procedure for RCC. In 10/64 patients, at least one or more RCC was diagnosed. However, at the time of diagnosis, an indication for treatment was not yet present. For all patients, several CT/MRI scans existed for retrospective description of tumour growth kinetics. 10-ml EDTA anticoagulated blood samples were available from each patient for mutation screening of all exons of the VHL gene. Genomic DNA from blood samples was extracted using standard methods. Small deletions/insertions or point mutations were identified by DNA sequencing followed by complete mutation screening using PCR/single-strand conformation polymorphism and denaturing high-performance liquid chromatography. A germline missense variant p.W88R(c.262T>A) was identified in two patients: patient #43 and patient #46. This mutation was noted as c.475T>A in the paper due to a difference in reference transcript used (see Table S1). No family information is available for either patient, and there is no indication these patients are related.

    1. p.*214G

      17 patients with genetic variants in SDHB, VHL, EPAS1, or RET with pheochromocytoma were identified retroactively for this study. 5 pathogenic germline variants were confirmed in patients with clinical criteria of von Hippel Lindau syndrome. Next generation sequencing (NGS) re-confirmed these germline mutations. One of which was a p.*214G (c.640T>G) mutation in patient 6, a 46Y male with pheochromocytoma. No further manifestation details were provided, nor family information.

    1. Germline mutations in 45 unrelated Japanese VHL patients were determined from blood samples using PCR-SSCP or Southern blot analyses. The authors reported a nucleotide deletion (i.e. 571insAC) which coincides with legacy variant nomenclature (AF010238.1) and was mapped to c.358_359insAC (NM_000551.3). PCR-SSCP or Southern blot analyses of the DNA from family members showed that mutations were segregated with disease phenotype in VHL families, although this data was not shown. Data on the presence of retinal angioma, CNS hemangioblastoma (Hb) renal cell carcinoma (RCC), and pheochromocytoma was available. Case 14 had p.Arg120fs ( c.358insAC) mutation. 2 members were affected with renal cell carcinoma. Other demographics of the members were not described.

    1. The genotype and phenotype in the large Chinese family with VHL disease. a The pedigree of the family 6 with 18 affected patients. b DNA sequence analysis showing a A–G transition at nucleotide 446. The change results in the mutation from Asn to Ser in codon78.

      PatientID: IV-14

      GroupID/ KindredID: 6

      Case: 46Y0M, F, Chinese

      DiseaseAssertion: hemangioblastoma

      FamilyInfo: Positive - 22 family members were recorded with the given mutation. 18 had VHL manifestations while 4 were asymptomatic carriers. See pedigree (Fig 3.), or follow GroupID/KindredID: 6

      CasePresentingHPOs: HP:0010797 (hemangioblastoma)

      CaseHPOFreeText: N/A

      CaseNotHPOs: HP:0001732; HP:0005584; HP:0002666; HP:0009711 (abnormality of the pancreas, Renal cell carcinoma, pheochromocytoma, retinal capillary hemangioma)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.N78S (c.233A>G)

      CaseProblemVariantFreeText: N/A

      LegacyVariant: p.N78S (c.446A>G)

      ClinVarID: 93326 https://www.ncbi.nlm.nih.gov/clinvar/variation/93326/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant; transition

      CivicName: N78S (c.233A>G)

      MultipleGeneVariants: N/A

    2. The genotype and phenotype in the large Chinese family with VHL disease. a The pedigree of the family 6 with 18 affected patients. b DNA sequence analysis showing a A–G transition at nucleotide 446. The change results in the mutation from Asn to Ser in codon78

      PatientID: II-4

      GroupID/ KindredID: 6

      Case: Age unknown (deceased), M, Chinese

      DiseaseAssertion: assumed VHL

      FamilyInfo: Positive - 22 family members were recorded with the given mutation. 18 had VHL manifestations while 4 were asymptomatic carriers. See pedigree (Fig 3.), or follow GroupID/KindredID: 6

      CasePresentingHPOs: HP:0005584; HP:0010797 (Renal cell carcinoma, hemangioblastoma)

      CaseHPOFreeText: N/A

      CaseNotHPOs: HP:0009711; HP:0001732; HP:0002666 (retinal capillary hemangioma, abnormality of the pancreas, pheochromocytoma)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.N78S (c.233A>G)

      CaseProblemVariantFreeText: No VHL gene test was conducted but due to substantial family pedigree history, can assumed with confidence this mutation

      LegacyVariant: p.N78S (c.446A>G)

      ClinVarID: 93326 https://www.ncbi.nlm.nih.gov/clinvar/variation/93326/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant; transition

      CivicName: N78S (c.233A>G)

      MultipleGeneVariants: N/A

    1. 41 non-related patients with retinal capillary hemangioma presenting in the Benjamin Franklin University Eye Clinic between 1988 to 1999 Germany were evaluated for the presence of other VHL lesions. VHL disease was diagnosed in 33 patients based on the presence of other severe VHL lesions (spinal hemangioblastoma, cerebellar hemangioblastoma, renal cysts, pancreatic cyst, renal carcinoma, and pheochromocytoma), molecular genetic testing, and/or family history. VHL germline mutations were identified in 27 out of 29 VHL families screened with molecular genetics. Blood samples were genetically tested using PCR-SSCP sequencing. One patient with VHL-related retinal angiomatosis was found to have germline nonsense (c.280G>T) mutation in the VHL gene. 1 other affected relative was also evaluated and found to have this mutation but no phenotype information was provided. This variant was reported as c.493G>T (AF010238.1) and mapped to p.E94* (c.280G>T) (NM_000551.3). It's unclear which other VHL-related lesions were identified in these patients.

    1. PatientID: ccRCC-132

      KindredID: 132

      Case: M, 59Y0M, Ethnicity Unknown

      DiseaseAssertion: Clear Cell Renal Cell Carcinoma

      FamilyInfo: N/A

      CohortInfo: 240 ccRCC specimens.

      CasePresentingHPOs: HP:0006770 (clear cell renal cell carcinoma)

      CaseHPOFreeText:He was diagnosed with ccRCC at age 54.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: Supplementary table 1.

      Variant: c.464-1G>T

      CaseProblemVariantFreeText: N/A

      LegacyVariant: N/A

      ClinVarID: 223221 https://www.ncbi.nlm.nih.gov/clinvar/variation/223221/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: splice_site_variant

      CivicName: Splice Site (c.464-1G>T)

      MultipleGeneVariants: N/A

    1. VHL mutation c. 232A>T; p. Asn78Tyr in this patient. The same point mutation of VHL was identified in three family members including one sister

      PatientID: N/A (proband's sister)

      KindredID: 2

      Case: F, 40Y0M, Ethnicity Unknown

      DiseaseAssertion: assumed VHL

      FamilyInfo: The same point mutation of VHL (c. 232A>T; p.Asn78Tyr) was identified in three family members including one sister, one brother and one nephew. Her sister was found with adrenal pheochromocytoma, cerebellar hemangioblastoma, and her brother and nephew refused for further examinations for VHL-related lesions. Her mother died of stroke at early of 50 years.

      CasePresentingHPOs: HP:0030405 (pancreatic endocrine tumour)

      CaseHPOFreeText: patient died of the hemorrhagic stroke at age of 40 years.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.N78Y (c.232A>T)

      LegacyVariant: N/A

      ClinVar: 223167 https://www.ncbi.nlm.nih.gov/clinvar/variation/223167/

      CAID: CA357056 http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvsOrDescriptor=NM_000551.3%3Ac.232A%3ET

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant; transversion

      CivicName: N78Y (c.232A>T)

      MultipleGeneVariants: N/A

    1. PatientID: None

      KindredID: 12

      Case: F, 20Y0M, Chinese

      DiseaseAssertion: asymptomatic

      FamilyInfo: Patient 12's 20 year old niece (this patient) was identified as a carrier of the same mutation as patient 12. Patient 12 was noted to not have a family history of VHL or other lesions associated with VHL disease.

      CasePresentingHPOs: N/A

      CaseHPOFreeText: The 20-year-old niece of patient 12 was identified as a carrier of the same mutation by genetic screening (no evidence of VHL disease.)

      CaseNotHPOs:None

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.P86L (c.257C>T)

      LegacyVariant: c.470C>T

      CaseProblemVariant Free Text: N/A

      ClinVar: 182977, https://www.ncbi.nlm.nih.gov/clinvar/variation/182977/

      CAID: CA020186

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_transition

      CivicName: P86L (c.257C>T)

      MultipleGeneVariants: N/A

    1. PatientID: 47

      KindredID: 47

      Case: Sex Unknown, Age Unknown, Ethnicity Unknown

      DiseaseAssertion: Assumed VHL

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0002666 (Pheochromocytoma)

      CaseHPOFreeText: Bilateral pheochromocytoma.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: Patient information pulled from Supplemental Table 1b.

      Variant: p.Y156S (c.467A>C)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: N/A

      CAID: CA351756049

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant;transversion

      CivicName: Y156S (c.467A>C)

      MultipleGeneVariants: N/A

    1. PatientID: 8 (Mother)

      KindredID: 3

      Case: F, 43Y0M, Ethnicity Unknown

      DiseaseAssertion: VHL

      FamilyInfo: 3 members of this family were genetically confirmed to be carriers of a germline partial deletion of exon 2 of the VHL gene. ID 2 presented with retinal angioma and pancreatic abnormality. ID 1 was asymptomatic. ID 16 presented with a retinal angioma (33Y), CNS hemangioblastoma at (32Y) and died at age 42. ID 16 was stated as having the germline variant but this was inferred from family/personal history and was not genetically confirmed.

      CasePresentingHPOs: HP:0010797 (Hemangioblastoma)

      CaseHPOFreeText: The patient presented with CNS hemangioblastoma (26Y and 40Y).

      CaseNotHPOs: HP:0005584; HP:0001732; HP:0000077; HP:0002666; HP:0009711 (Renal cell carcinoma, Abnormality of the pancreas, Abnormality of the kidney, Pheochromocytoma, Retinal capillary hemangioma)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: Supplementary Table 1.

      Variant: Exon 2 Partial Deletion

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: N/A

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: deletion

      CivicName: Null (Partial deletion of Exon 2)

      MultipleGeneVariants: N/A

    1. 1 (25)

      GroupID: 29b

      Case: Sex Unknown, Age Unknown, Ethnicity Unknown

      DiseaseAssertion: VHL CohortInfo: a retrospective cohort study from an eye centre in Germany involved 148 VHL patients and their genetic data involved in retinal capillary hemangiomas.

      CasePresentingHPOs: N/A

      CaseHPOFreeText: This was 1 of 4 patients discussed with this mutation. The individual did NOT have retinal hemangiomas; Other VHL manifestations were discussed but not per- variant.

      CaseNotHPOs: HP:0009711 (retinal capillary hemangioma)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: Yes - Supplementary Table S1

      Variant: p.R107G (c.319C>G)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 43599 https://www.ncbi.nlm.nih.gov/clinvar/variation/43599/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant; transversion

      CivicName: R107G (c.319C>G)

      MultipleGeneVariants: N/A

    2. c.220del p.Val74Leufs*85

      216 patients with clinically expected VHL disease due to family history or presence of VHL typical tumours were routinely examined in an eye centre in Germany between January 2019 and January 2020, majority of which were of European descent (~95%). Since data on the genotype–phenotype correlation of the onset of Retinal Hemangioblastoma (RH) is scarce in relation to VHL disease, this study wanted to inversitage the relationship between VHL gene variants (truncating vs single amino acid substitutions) and the ocular phenotype of the disease. 42 different rare VHL gene variants in 148 patients were detected - some of whom had RH and some who did not. Although date of onset of RH, as well as data on central nervous system haemangioblastomas (CNSH), pheochromocytoma/paraganglioma (PPGL), clear cell renal cell carcinoma (ccRCC) and pancreatic neuroendocrine neoplasm (PNEN) were collected, it was not reported on a per patient basis and therefore could not be discussed per variant. There were 2 patients reported with the p.V74Sfs*85 (c.220del) mutation. Both members presented with retinal hemangiomas, while no other clinical manifestations were discussed. Additionally, no family information was provided.

    1. PMID: 20567917

      PatientID: 2

      KindredID: 2

      Case: F, 29Y0M, Brazilian

      DiseaseAssertion: VHL

      FamilyInfo: VHL type 1. Genetic testing has been performed in her parents and brother with negative results. Her only child has not undergone predictive testing yet.

      CasePresentingHPOs: HP:0030393; HP:0009711; HP:0010797; HP:0000107; HP:0001737; HP:0001407 (endolymphatic sac tumor; retinal capillary hemangioma; hemangioblastoma; renal cysts; pancreatic cysts; hepatic cysts)

      CaseHPOFreeText: endolymphatic sac tumor diagnosed at 11Y, retinal angiomas at 16Y; hemangioblastoma, renal, pancreatic, and hepatic cysts at 29Y

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: Yes

      Variant: p.Q73* (c.217C>T)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 223164 https://www.ncbi.nlm.nih.gov/clinvar/variation/223164/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: stop_gained

      CivicName: Q73* (c.217C>T)

      MultipleGeneVariants: N/A

    1. F6, II.1c.492G>T/c.340+574A>T*VHL p.Gln164His/SA2014/6 moM15.6496.91167Splenomegaly—

      PatientID: II.1

      KindredID: F6

      Case: M, 0Y6M, Ethnicity Unknown

      DiseaseAssertion: Splenomegaly

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001744 (Splenomegaly)

      CaseHPOFreeText: Diagnosed with splenomegaly at age 6 months (DOB: 2014).

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.Q164H (c.492G>T)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 456566, https://www.ncbi.nlm.nih.gov/clinvar/variation/456566/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: Variants are heterozygous.

      MutationType: missense_variant;transversion

      CivicName: Q164H (c.492G>T) and c.340+574A>T

      MultipleGeneVariants: Germline, VHL, c.340+574A>T

    2. F10

      PatientID: I.1

      KindredID: F10

      Case: M, Age Unknown, Ethnicity Unknown

      DiseaseAssertion: Asymptomatic

      FamilyInfo: This patient’s partner and two children were all carriers of the D143= (c.429C>T) germline VHL variant. Their son was diagnosed with splenomegaly and polycythemia and was homozygous for the variant. All other family members were asymptomatic.

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.D143= (c.429C>T)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 416990, https://www.ncbi.nlm.nih.gov/clinvar/variation/416990/

      CAID: N/A

      gnomAD: 0.000007953, https://gnomad.broadinstitute.org/variant/3-10188286-C-T?dataset=gnomad_r2_1

      VariantEvidence: N/A

      MutationType: missense_variant;transition; synonymous_variant

      CivicName: D143= (c.429C>T)

      MultipleGeneVariants: N/A

    1. PatientID: N/A

      KindredID: 10

      Case: Sex, Age, Ethnicity Unknown

      DiseaseAssertion: pheochromocytoma

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0002666 (pheochromocytoma)

      CaseHPOFreeText: Nonsyndromic pheochromocytoma.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: RET, SDHB, SDHD

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.F119L (c.357C>G)

      CaseProblemVariantFreeText: N/A

      LegacyVariant: p.F119L (c.570C>G)

      ClinVarID: 625240 https://www.ncbi.nlm.nih.gov/clinvar/variation/625240/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant; transversion

      CivicName: F119L (c.357C>G)

      MultipleGeneVariants: N/A

    1. PatientID: 218

      KindredID: 81

      Case: M, 26Y0M, Chinese

      DiseaseAssertion: VHL

      FamilyInfo: The patient's sister (the proband) had the same germline mutation, and presented with a CNS hemangioblastoma at 24, renal cell carcinoma at 32, and multiple pancreatic cysts/tumors at 33. The proband's mother had a CNS hemangioblastoma at 35, however no genotyping information is available for her.

      CasePresentingHPOs: HP:0010797; HP:0002666 (Hemangioblastoma, Pheochromocytoma)

      CaseHPOFreeText: The patient presented with a CNS hemangioblastoma at age 20, and a pheochromocytoma at age 26.

      CaseNotHPOs: HP:0009711; HP:0005584; HP:0001737; HP:0001732 (Retinal capillary hemangioma, Renal cell carcinoma, Pancreatic cysts, Abnormality of the pancreas)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: This cohort was also published in a later paper by Wang et al., 2018 (PMID: 29330336).

      SupplementalData: Patient and family genotype-phenotype information is listed in Supplementary Table 1.

      Variant: p.R167Q (c.500G>A)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 2216, https://www.ncbi.nlm.nih.gov/clinvar/variation/2216/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant;transition

      CivicName: R167Q (c.500G>A)

      MultipleGeneVariants: N/A

    2. PatientID: 2

      KindredID: 2

      Case: M, 48Y0M, Chinese

      DiseaseAssertion: VHL

      FamilyInfo: The proband's son also had this mutation, and presented with a CNS hemangioblastoma at age 22. The proband's mother presented with a CNS hemangioblastoma at age 61, and his brother presented with a CNS hemangioblastoma at age 33. His mother passed away before diagnosis, and there was no DNA sample available for his brother.

      CasePresentingHPOs: HP:0005584; HP:0001732; HP:0001737 (Renal cell carcinoma, Abnormality of the pancreas, Pancreatic cysts)

      CaseHPOFreeText: The proband presented with renal cell carcinoma and pancreatic cysts at the age of 48.

      CaseNotHPOs: HP:0010797; HP:0009711; HP:0002666 (Hemangioblastoma, Retinal Capillary Hemangioma, Pheochromocytoma)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: This cohort was also published in a later paper by Wang et al., 2018 (PMID: 29330336).

      SupplementalData: Patient and family genotype-phenotype information is listed in Supplementary Table 1.

      Variant: p.S65W (c.194C>G)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 43597, https://www.ncbi.nlm.nih.gov/clinvar/variation/43597/

      CAID:

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant;transversion

      CivicName: S65W (c.194C>G)

      MultipleGeneVariants: N/A

    1. The tests revealed that the same missense mutation in the VHL gene [c.500G>A (p.Arg167Gln)] was found in the patient and his two sons,

      PatientID: III-7

      KindredID: 3

      Case: M, Age Unknown, Chinese

      DiseaseAssertion: Asymptomatic

      FamilyInfo: The patient's father, the proband (II-4) carried the VHL mutation and presented with clear cell renal cell carcinoma, pancreatic cysts, spinal hemangioblastoma, and renal cysts. The patient's brother (III-6) carried the mutation but was asymptomatic. The patient's grandmother (I-2) died as a result of pancreatic cancer. His paternal aunt (II-1) underwent surgery for a brain tumor and had pancreatic and renal cysts. Another paternal aunt (II-2) underwent surgery for breast cancer. See Figure 3 for family pedigree.

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: Abdominal ultrasound examination of the patient revealed no abnormality.

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.R167Q (c.500G>A)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 2216 https://www.ncbi.nlm.nih.gov/clinvar/variation/2216/

      CAID: CA020454 http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvsOrDescriptor=NM_000551.3%3Ac.500G%3EA

      gnomAD: 0.000003977 https://gnomad.broadinstitute.org/variant/3-10191507-G-A

      VariantEvidence: N/A

      MutationType: missense_variant;transition

      CivicName: R167Q (c.500G>A)

      MultipleGeneVariants: N/A

    1. PatientID: None

      KindredID: 14482

      Case: Age unknown, Sex unknown, Belgian

      DiseaseAssertion: VHL

      FamilyInfo: Paper states: Belgian family; Germline mutation

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: Yes

      Variant: p.R167Q (c.500G>A)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 2216 https://www.ncbi.nlm.nih.gov/clinvar/variation/2216/

      CAID: N/A

      gnomAD: 0.000003977 https://gnomad.broadinstitute.org/variant/3-10191507-G-A

      VariantEvidence: N/A

      MutationType: missense_variant;transition

      CivicName: R167Q (c.500G>A)

      MultipleGeneVariants: N/A

    1. All family members underwent clinical, laboratory, imaging, and genetic evaluation.

      PatientID: IV-28 [written in Table 2 as IV-24 - typo]

      KindredID: 1

      Case: F, 33Y0M, Iranian

      DiseaseAssertion: assumed VHL

      FamilyInfo: Familial history was positive. See Fig 1. A total of 43 members of the kindred, 24 males and 19 females, aged 2-77 years were reached for evaluation. It is stated in the paper that all affected subjects (13) were positive for the same mutation (c.500G>A). Additionally, gene sequencing revealed that 4 asymptomatic members of the kindred also harbored the pathogenic mutation, one of which was this patient who proved to be symptomatic. Phenotypes include pheochromocytoma, hemangioblastoma, and retinal HB.

      CasePresentingHPOs: HP:0011732; HP:0006880; HP:0010302 (abnormality of adrenal morphology, cerebellar hemangioblastoma, spinal cord tumor)

      CaseHPOFreeText: Originally thought to be an asymptomatic carrier, however after follow-up was found to be symptomatic: brain MRI revealed multiple tutors, including a frontal mass (cerebellar tumor) with multiple spinal lesions, and an abdominal CT showed a 1.6x1.7 right adrenal mass. Additionally, this patient was pregnant at the time, to which was terminated at the 38th week of gestation with a caesarian section. She has two other children already.

      CaseNotHPOs: HP:0000077 (abnormality of the kidney)

      CaseNotHPOFreeText: There was no case of kidney tumors among the kindred.

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.R167Q (c.500G>A)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 2216, https://www.ncbi.nlm.nih.gov/clinvar/variation/2216/

      CAID: N/A

      gnomAD: 0.000003977, https://gnomad.broadinstitute.org/variant/3-10191507-G-A

      VariantEvidence: N/A

      MutationType: missense_variant; transition

      CivicName: R167Q (c.500G>A)

      MultipleGeneVariants: N/A

    1. Family 1+1C.292T > A, p.Tyr98AsnNo135373937––

      PatientID: None

      KindredID: 1

      Case: Sex Unknown, 39Y0M, Chinese

      DiseaseAssertion: VHL

      FamilyInfo: Positive. Patient's mother did not undergo genetic testing but had a hemangioblastoma at age 50 and a pancreatic cyst or tumour at age 62. The patient's sister also had this mutation but was asymptomatic. Another one of the patient's sisters presented with hemangioblastoma (age 40), renal cell carcinoma (age 43), and pancreatic cysts or tumours (age 43). This patient died before diagnosis. The proband's brother also died before diagnosis and presented with hemangioblastoma and retinal angioma at age 27.

      CasePresentingHPOs: HP:0010797, HP:0005584, HP:0001732, HP:0009711 (hemangioblastoma, renal cell carcinoma, abnormality of the pancreas, retinal capillary hemangioma)

      CaseHPOFreeText: The patient presented with hemangioblastoma at age 35. At age 37 she presented with retinal angioma and pancreatic cysts or tumours. At age 39 she presented with renal cell carcinoma.

      CaseNotHPOs: HP:0002666, HP:0009715 (pheochromocytoma, Papillary cystadenoma of the epididymis)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: 29330336

      SupplementalData: N/A

      Variant: p.Y98N (c.292T>A)

      CaseProblemVariantFreeText: N/A

      LegacyVariant: N/A

      ClinVarID: N/A

      CAID: CA351750883 http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvsOrDescriptor=NM_000551.3%3Ac.292T%3EA

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant; transversion

      CivicName: Y98N (c.292T>A)

      MultipleGeneVariants: N/A

    1. Ninety-eight individuals were tested for VHL mutations--23 symptomatic and 75 asymptomatic individuals belonging to 16 families. Seven of the families had definite clinical criteria of VHL disease, five had sporadic hemangioblastoma, and four had CNS hemangioblastoma combined with minor visceral signs. Molecular genetic testing identified five germline mutations in six of the definite VHL families (sensitivity 85%), but none in the possible VHL and sporadic hemangioblastoma cases; four of these mutations had been previously described and one is a novel mutation present in two unrelated families. After patients carrying the mutation were identified, they underwent clinical screening and asymptomatic VHL-related lesions were identified in 43%.

      PatientID: 19

      KindredID: C

      Case: Sex Unknown, 30Y0M, Mexican (Latino/Admixed American)

      DiseaseAssertion: assumed VHL

      FamilyInfo: At least 13 members in this family presented with the mutation. 5 were asymptomatic (ages 9, 12, 13, 17, and 29Y). Other family manifestations include: cerebellar, spinal, retinal HBs, pancreatic, hepatic, suprarenal and kidney cysts, epididymal cystadenoma, and RCC. Fig 1 displays family pedigree.

      CasePresentingHPOs: HP:0009713 (spinal hemangioblastoma)

      CaseHPOFreeText: Patient had 2 spinal HBs. They however appeared absent of clinical manifestations of VHL disease prior to clinical and imaging scrutiny.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: 20064270 (Here, the family cohort is given with a reportedly different variant of: p.G34Rfs*98 (c.99_100insA). Unclear of why this is or which most correctly corresponds to the family).

      SupplementalData: N/A

      Variant: p.T100Nfs*32 (c.298dupA)

      LegacyVariant: c.1012_1013insA

      CaseProblemVariantFreeText: The ‘1012_1013insA’ mutation is out-of-frame, leading to a modification of 31 amino acids downstream and a premature stop codon at nucleotides 5441-5443 (amino acid residue 131).

      ClinVarID: N/A

      CAID: CA2573129737 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvsOrDescriptor=NM_000551.3%3Ac.298dupA

      gnomAD: N/A

      VariantEvidence: The modified amino acids are located in a domain common to all pVHL isoforms, the highly conserved cctbinding domain of the protein, involved in the formation of the pVHL elongin complex that is crucial for tumor suppression. Furthermore, the mutant protein is prematurely truncated and lacks the C-terminal half of exon 2 and exon 3 completely, which includes the nuclear export signal and the elongin C binding site of pVHL. Thus, this truncated protein would affect the two functional isoforms of pVHL: the major isoform pVHL30 and pVHL19, but not isoform 2, which lacks exon 2 but is not functional

      MutationType: plus_1_frameshift_variant; duplication

      CivicName: T100Nfs*32 (c.298dupA)

      MultipleGeneVariants: N/A

    2. Ninety-eight individuals were tested for VHL mutations--23 symptomatic and 75 asymptomatic individuals belonging to 16 families. Seven of the families had definite clinical criteria of VHL disease, five had sporadic hemangioblastoma, and four had CNS hemangioblastoma combined with minor visceral signs. Molecular genetic testing identified five germline mutations in six of the definite VHL families (sensitivity 85%), but none in the possible VHL and sporadic hemangioblastoma cases; four of these mutations had been previously described and one is a novel mutation present in two unrelated families. After patients carrying the mutation were identified, they underwent clinical screening and asymptomatic VHL-related lesions were identified in 43%.

      PatientID: 3

      KindredID: A

      Case: Sex Unknown, 35Y0M, Mexican (Latino/Admixed American)

      DiseaseAssertion: assumed VHL

      FamilyInfo: two other symptomatic and one asymptomatic members of family A had this mutation. The symptomatic individuals had cerebellar hemangioblastomas, as well as spinal hemangioblastomas snd renal cysts.

      CasePresentingHPOs: HP:0006880 (cerebellar hemangioblastoma)

      CaseHPOFreeText: Symptomatic before 29Y, clinically manifested as >3 cerebellar hemangioblastomas

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: 20064270

      SupplementalData: N/A

      Variant: p.F76del (c.227_229del)

      CaseProblemVariantFreeText: N/A

      LegacyVariant: N/A

      ClinVarID: N/A

      CAID: CA357012 http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvsOrDescriptor=NM_000551.3%3Ac.226_228delTTC

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: inframe_deletion

      CivicName: F76del (c.227_229del)

      MultipleGeneVariants: N/A

      
      
    3. Ninety-eight individuals were tested for VHL mutations--23 symptomatic and 75 asymptomatic individuals belonging to 16 families. Seven of the families had definite clinical criteria of VHL disease, five had sporadic hemangioblastoma, and four had CNS hemangioblastoma combined with minor visceral signs. Molecular genetic testing identified five germline mutations in six of the definite VHL families (sensitivity 85%), but none in the possible VHL and sporadic hemangioblastoma cases; four of these mutations had been previously described and one is a novel mutation present in two unrelated families. After patients carrying the mutation were identified, they underwent clinical screening and asymptomatic VHL-related lesions were identified in 43%.

      PatientID: 13

      KindredID: C

      Case: Sex Unknown, 17Y0M, Mexican (Latino/Admixed American)

      DiseaseAssertion: asymptomatic

      FamilyInfo: At least 13 members in this family presented with the mutation. 5 were asymptomatic (ages 9, 12, 13, 17, and 29Y). Other family manifestations include: cerebellar, spinal, retinal HBs, pancreatic, hepatic, suprarenal and kidney cysts, epididymal cystadenoma, and RCC. Fig 1 displays family pedigree.

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Patient was asymptomatic at the time, likely due to young age

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: 20064270 (Here, the family cohort is given with a reportedly different variant of: p.G34Rfs*98 (c.99_100insA). Unclear of why this is or which most correctly corresponds to the family).

      SupplementalData: N/A

      Variant: p.G34Rfs*98 (c.99_100insA)

      LegacyVariant: c.1012_1013insA

      CaseProblemVariantFreeText: The ‘1012_1013insA’ mutation is out-of-frame, leading to a modification of 31 amino acids downstream and a premature stop codon at nucleotides 5441-5443 (amino acid residue 131).

      ClinVarID: N/A

      CAID: CA2018007671 http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA2018007671

      gnomAD: N/A

      VariantEvidence: The modified amino acids are located in a domain common to all pVHL isoforms, the highly conserved cctbinding domain of the protein, involved in the formation of the pVHL elongin complex that is crucial for tumor suppression. Furthermore, the mutant protein is prematurely truncated and lacks the C-terminal half of exon 2 and exon 3 completely, which includes the nuclear export signal and the elongin C binding site of pVHL. Thus, this truncated protein would affect the two functional isoforms of pVHL: the major isoform pVHL30 and pVHL19, but not isoform 2, which lacks exon 2 but is not functional

      MutationType: plus_1_frameshift_variant

      CivicName: G34Rfs (c.99_100insA)

      MultipleGeneVariants: N/A

    1. 2,3Deletion

      PatientID: I:1

      KindredID: 1

      Case: M, 50Y0M, Chinese

      DiseaseAssertion: VHL

      FamilyInfo: the patient’s son was observed to be affected with CNS hemangioblastoma diagnosed at 37Y, retinal capillary hemangioma at 31Y, and epididymal/ovarian cystadenoma at 16Y

      CasePresentingHPOs: HP:0010797 (hemangioblastoma)

      CaseHPOFreeText: patient had hemangioblastomas at 50Y

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: exon 2,3 deletion

      CaseProblemVariantFreeText: N/A

      LegacyVariant: N/A

      ClinVarID: N/A

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: exon_loss_variant

      CivicName: exon 2-3 deletion

      MultipleGeneVariants: N/A

    2. c.269A>T p.Asn90Ile

      PatientID: II:3 (proband 4)

      KindredID: 4

      Case: M, 38Y0M, Chinese

      DiseaseAssertion: VHL

      FamilyInfo: Patient’s mother (I:1) was found with the same mutation and RCC at 63Y. The proband’s brother (II:1) died before diagnosis; thus no DNA sample available. He presented with hemangioblastoma at 19Y

      CasePresentingHPOs: HP:0010797; HP:0009711 (hemangioblastoma, retinal capillary hemangioma)

      CaseHPOFreeText: patient had hemangioblastoma at 22Y and retinal capillary hemangioma at 32Y

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.N90I (c.269A>T)

      CaseProblemVariantFreeText: N/A

      LegacyVariant: N/A

      ClinVarID: 223172 https://www.ncbi.nlm.nih.gov/clinvar/variation/223172/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant; transversion

      CivicName: N90I (c.269A>T)

      MultipleGeneVariants: N/A

    1. PatientID: Carrier 12 (sister to proband 7)

      KindredID: 3

      Case: M, Age Unknown, Chinese

      DiseaseAssertion: Asymptomatic

      FamilyInfo: Father, mother and sister (all relative to proband 7) had this variant. Both father and sister were asymptomatic. Proband and mother presented with unilateral PCC.

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.P138Afs*6 (c.410dup)

      LegacyVariant: 623insTTTGTtG

      CaseProblemVariantFreeText: N/A

      ClinVarID: N/A

      CAID: CA432421860, https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvsOrDescriptor=NM_000551.3%3Ac.410dup

      gnomAD: N/A

      VariantEvidence: The VHL NM_000551.3 reference sequence surrounding nucleotide 410 is a TTTGTG sequence, where the 4th T is at position 410, which converts to nucleotide 623 in the legacy reference sequence (AF010238.1). Therefore it is assumed that the authors reported their insertion variant in the legacy nomenclature and this was mapped to p.Pro138Alafs*6 (c.410dup) in NM_000551.3.

      MutationType: insertion; plus_1_frameshift_variant

      CivicName: P138fs (c.410dup)

      MultipleGeneVariants: N/A

    2. PatientID: Carrier 7 (niece to proband 3)

      KindredID: 1

      Case: M, Age Unknown, Chinese

      DiseaseAssertion: Asymptomatic

      FamilyInfo: The family with PCCs includes 56 members of 4 generations, and is from Gansu Province. Among them, 7 extended over 3 generations were diagnosed as PCCs. One died before admission and another died due to a cardiovascular incident. Five were initially evaluated; evaluation included medical history, physical examination, abdominal ultrasonography, CT or MRI and laboratory tests. All 5 probands of this family underwent surgical resection. The tumors were benign under pathological examinations. There were no recurrence and malignant transformation over the period of up to 23-year follow-up. Twenty members, including 5 live patients and 15 direct relatives, accepted genetic examination.

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.H125P (c.374A>C)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 223201, https://www.ncbi.nlm.nih.gov/clinvar/variation/223201/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant;transversion

      CivicName: H125P (c.374A>C)

      MultipleGeneVariants: N/A

    1. PMID: 30853203

      The 10 year old female patient presented with sustained hypertension, headaches, and vomiting for several weeks. She had no signs of hypertensive retinopathy or papilledema. However, in the right eye, a small, white-yellowish nodular lesion in the retinal periphery was found. Luoresceinangiography showed early and late leakage and marked hyperfluorescence compatible with retinal hemangioblastoma. A heterozygous mutation 488T>A (Leu163His) in exon 3 of the VHL gene was identified (methods unspecified). Subsequently, bilateral pheochromocytomas were found. After surgical resection of the pheochromocytomas the patient was asymptomatic. No family history was mentioned.

    1. c.533T > Cp.Leu178Pro

      43 Italian patients were molecularly analyzed for Von Hippel-Lindau disease based on clinical suspicion. 1 (patient VHL-2) of the 43 patients was found to have the Leu178Pro (c.533T>C) germline mutation of the VHL gene. Genotyping was performed on peripheral blood executed via direct sequencing on an automatic sequencer and real time quantitative PCR. Clinical manifestations associated with this mutation include: CNS hemangioblastoma, pancreatic cysts, renal cysts, pheochromocytomas, and retinal hemangioblastoma. ACMG evidence codes: 'PP2' because they observe a missense variant in gene where missense variants are common mechanism of disease.

    1. nt 393 del G, codon 137, exon 1, stop

      PatientID: 6

      KindredID: 6

      Case: F, 42Y0M, Ethnicity unknown

      DiseaseAssertion: VHL

      FamilyInfo: Familial association - patient was selected from the group of familial VHL patients. This VHL germline mutation was detected in a close relative.

      CasePresentingHPOs: HP:0001737; HP:0010797; HP:0030405 (pancreatic cysts; hemangioblastoma; pancreatic endocrine tumour)

      CaseHPOFreeText: 2 single benign cysts, 6 macroscopic (and 1 microscopic) microcystic adenomas

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.Val62Cysfs*5 (c.180delG)

      LegacyVariant: p.V137Cfs*5 (c.393delG)

      ClinVarID: 182986 https://www.ncbi.nlm.nih.gov/clinvar/variation/182986/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: minus_1_frameshift_variant

      CivicName: V62fs (c.180delG)

      MultipleGeneVariants: N/A

    1. NS 21 35 M ? - ? ? ? - - Exon 3 del – a, distal b

      PatientID: 21

      KindredID: NS

      Case: M, 35Y0M, Indian

      DiseaseAssertion: VHL

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0009711; HP:0010797; HP:0005584 (Retinal capillary hemangioma, Hemangioblastoma, Renal cell carcinoma)

      CaseHPOFreeText: RCC, retinal angioma and CNS hemangioblastoma.

      CaseNotHPOs: HP:0001737; HP:0030393; HP:0002666 (Pancreatic cysts, Endolymphatic sac tumor, Pheochromocytoma)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: Exon 3 Deletion (c.464-?_642+?del)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: N/A

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: exon_loss_variant

      CivicName: Exon 3 Deletion

      MultipleGeneVariants: N/A

    1. GroupID: 4577

      DiseaseAssertion: VHL

      GroupSize: 3

      GroupNumberMales: N/A

      GroupNumberFemales: N/A

      GroupEthnicity: N/A

      GroupAgeRange: N/A

      GroupInfo: Each group represents a family.

      GroupPresentingHPOs: HP:0009711; HP:0010797; HP:0002666; HP:0005584 (Retinal capillary hemangioma, Hemangioblastoma, Pheochromocytoma, Renal cell carcinoma)

      GroupHPOFreeText: 2/3 members with pheochromocytoma, 1/3 members with CNS hemangioblastoma, 1/3 members with retinal angioma and 1/3 members with RCC. Diagnosed as a VHL Type 2B family.

      GroupNotHPOs: N/A

      GroupNotHPOFreeText: N/A

      GroupPreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.F119L (c.357C>G)

      LegacyVariant: c.570C>G

      CaseProblemVariantFreeText: N/A

      ClinVarID: 625240, https://www.ncbi.nlm.nih.gov/clinvar/variation/625240/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: Variant reported as 570, C to G (Phe to Leu), assumed to be reported in legacy nomenclature (AF010238.1) and mapped to c.357C>G, p.Phe119Leu (NM_000551.3).

      MutationType: missense_variant;transversion

      CivicName: F119L (c.357C>G)

      MultipleGeneVariants: N/A

    1. A 3 year-old girl was admitted in the Department of Pediatric Oncology following several months history of febrile episodes, sweating and irritability. Symptoms were first interpreted as being of infectious causes, and that is why she received repeated antibiotic therapies. There was no improvement, and that is why more investigations were performed. An abdominal ultrasound performed in a pediatric hospital revealed a right adrenal tumor mass that prompted the transfer to our unit.Family history: the patient’s mother aged 38 was diagnosed with bilateral pheochromocytoma resected when she was the age of 18 years. She presented several relapses, the most recent one at the age of 32, when she was also diagnosed with cerebral angioma. Genetic testing revealed the presence of the VHL c 244 C>G (p. Arg 82 Gly) heterozygote mutation, while the tests for RET, SDHB, SDHC and SDHD were negative.The clinical examination of our patient revealed: pallor, paroxysmal febrile episodes with irritability and sweating, tachycardia (130/min), hypertension (170/126 mmHg). There was no palpable abdominal mass.Abdominal ultrasound: well delimited tumor of the right adrenal gland, 37/34/35 mm in diameter, irregular with transonic inclusions.Magnetic resonance imaging (MRI): right adrenal tumor, 35/42/43 mm in diameter, well delimited, irregular, with marked heterogenous contrast intake, presenting cystic and necrotic areas (Figure 1).Open in a separate windowFigure 1Right adrenal tumor.Serum markers: urinary vanillylmandelic acid (VMA) 31.1 mg/24 h (normal <6.6), neuron specific enolase (NSE) 59.79 ng/ml (normal <17), ferritin 306.6 ng/ml (normal range 6–67), lactic dehydrogenase (LDH) 333 IU/L (normal range 125–300).Genetic examination: VHL c 244 C>G (p. Arg 82 Gly) heterozygotic mutation.Management: Complete surgical resection was performed with special precautions, but it was uneventful and blood pressure instantly dropped to normal.Go to:PathologyMacroscopic encapsuled 40/40/30 mm tumor, delimited by a bright yellow rim. The tumor is nodular with small hemorrhagic and necrotic areas.Microscopy: adrenal gland is compressed by a well delimited tumor made by cell nests of variable dimensions, separated by a reduced vascular connective stroma (Zellballen), with relatively numerous mitoses (8/10 High Power Field - HPF), most of them typical, very few atypical, extensive necrosis and vascular invasion. The aspect is suggestive for a malignant pheochromocytoma with Pheochromocytoma of the Adrenal gland Scaled Score (PASS) score 7: vascular invasion (1), necrosis (2), mitoses (2) (Figure 2).Open in a separate windowFigure 2Example of light microscopy image of sections from the excised tumor showing characteristics of malignant pheochromocytoma (Zellballen with central necrosis), hematoxylin eosin (HE) stain (10X).Go to:OutcomeAfter 6 months of follow-up, the patient is without any clinical symptoms, with normal blood pressure, no tumor markers, no evidence of tumor on cerebral and abdominal MRI and a normal ophthalmoscopy.

      PatientID: None

      KindredID: 1

      Case: F, 3Y0M, Ethnicity Unknown

      DiseaseAssertion: VHL

      FamilyInfo: Mother aged 38 was diagnosed with bilateral pheochromocytoma resected when she was the age of 18 years. She presented several relapses, the most recent one at the age of 32, when she was also diagnosed with cerebral angioma. Genetic testing revealed the presence of the VHL c 244 C>G (p. Arg 82 Gly) heterozygote mutation, while the tests for RET, SDHB, SDHC and SDHD were negative.

      CasePresentingHPOs: HP:0001954; HP:0000980; HP:0001649; HP:0000822; HP:0002666; HP:0006748 (Recurrent fever, Pallor, Tachycardia, Hypertension, Pheochromocytoma, Adrenal pheochromocytoma)

      CaseHPOFreeText: Several months history of febrile episodes, sweating and irritability. An abdominal ultrasound performed in a pediatric hospital revealed a right adrenal tumor mass. The clinical examination of our patient revealed: pallor, paroxysmal febrile episodes with irritability and sweating, tachycardia, hypertension. There was no palpable abdominal mass. Abdominal ultrasound showed a tumor of the right adrenal gland. MRI showed a right adrenal tumor confirmed by pathology to be a malignant pheochromocytoma. After 6 months from the complete resection of the tumor, the daughter is without any clinical symptoms, with normal blood pressure, normal ophthalmoscopy, no tumor markers and no evidence of tumor on cerebral or abdominal MRI.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.R82G (c.244C>G)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 1297059, https://www.ncbi.nlm.nih.gov/clinvar/variation/1297059/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant;transversion

      CivicName: R82G (c.244C>G)

      MultipleGeneVariants: N/A

    1. Complete deletion

      GroupID/ KindredID: 28

      PatientID: I

      Case: 27Y0M, Sex unknown, Polish

      DiseaseAssertion: VHL

      FamilyInfo: Family 28 consisted of 4 members; one relative (age 24Y) diagnosed with a single cerebellar HAB, another (40Y) diagnosed at 30Y with multiple cerebellar HABs, and multiple spinal HABs, and a final relative (62Y), diagnosed with a single HAB.

      CasePresentingHPOs: HP:0009713; HP:0006880 (spinal hemangioblastoma, cerebellar hemangioblastoma)

      CaseHPOFreeText: Patient was found with multiple cerebellar HABs at 25Y, and multiple spinal HABs

      GroupNotHPOs: HP:0009711; HP:0005584 (retinal capillary hemangioma; renal cell carcinoma)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: complete deletion of VHL gene

      CaseProblemVariantFreeText: N/A

      LegacyVariant: N/A

      ClinVarID: N/A

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: Haplotype analysis information in Table 3

      MutationType: deletion

      CivicName: deletion

      MultipleGeneVariants: N/A

    2. 226_228delTTC

      GroupID/ KindredID: 7

      DiseaseAssertion: VHL

      GroupSize: 2

      GroupNumberMales: N/A

      GroupNumberFemales: N/A

      GroupEthnicity: Polish

      GroupAgeRange: N/A

      GroupInfo: Familial VHL stated; 2 family members recorded with this mutation.

      GroupPresentingHPOs: HP:0009711; HP:0010797 (retinal capillary hemangioma, hemangioblastoma)

      GroupHPOFreeText: 1 patient was tallied with a retinal capillary hemangioma and both (2) with cHemangioblastomas.

      GroupNotHPOs: HP:0005584 (renal cell carcinoma)

      GroupNotHPOFreeText: None of the patients were recorded to have RCC

      GroupPreviousTesting: N/A

      PreviouslyPublished: 32179488

      SupplementalData: N/A

      Variant: p.F76del (c.226_228delTTC)

      CaseProblemVariantFreeText: NM_000551.3:c.226_228delTTC automaps to updated c.227_229delTCT

      LegacyVariant: N/A

      ClinVarID: N/A

      CAID: CA357012 http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvsOrDescriptor=NM_000551.3%3Ac.226_228delTTC

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: inframe_deletion

      CivicName: F76del (c.227_229del)

      MultipleGeneVariants: N/A

    3. The VHL gene product (pVHL) has two macromolecular sites, α and β domains, which can bind different proteins. pVHL bound to elongin B, C/cullin/Rbx1 acts as an E3 ubiquitin ligase and targets proteins for degradation.22 Similarly, hypoxia inducible proteins are regulated by complex pVHL/elongin B and C that requires direct binding of hypoxia inducible factor (HIF) to the β domain and targets HIF for ubiquitination catalysed by the α domain.23 The VHL protein also plays a role in extracellular matrix formation and is necessary for cell cycle exit.24,25 Germline VHL mutations cause different protein defects that result in the clinical heterogeneity of VHL disease. VHL type 1 disease (without phaeochromocytoma) is associated with mutations predicted to cause complete unravelling of protein structure (missense mutations mapping to VHL protein hydrophobic core, protein truncating mutations, and partial gene deletions). VHL type 2 (with phaeochromocytoma) is caused by missense mutations which map to protein binding sites of pVHL and are predicted to cause local protein defects.22 Specific phaeochromocytoma associated missense mutations confer different risks of HAB and RCC, being responsible for the occurrence of subcategories VHL type 2A (VHL without RCC), 2B (VHL with RCC), and 2C (phaeochromocytoma only).15 Phenotypic expression of VHL disease is also influenced by genetic modifiers.26
    1. One of his two children (III/3) also developed the disease.

      PatientID: III/3

      KindredID: 2

      Case: F, Age Unknown, Italian

      DiseaseAssertion: VHL

      FamilyInfo: Case II/3 (patient III/3's father) had retina angioma with renal carcinoma. Case II/2 (her uncle) also had the mutation and presented with renal carcinoma, central nervous system haemangioblastoma, pheochromacytoma and pancreatic cysts. Case I/1 (her grandfather) also had the mutation and presented with haemangioblastom. Pedigree: see Figure 2.

      CasePresentingHPOs: N/A

      CaseHPOFreeText: This patient has developed VHL disease as mentioned in the paper, however, specific clinical presentations of the disease are not outlined.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.R167W (c.499C>T)

      LegacyVariant: R167W (8702C->T)

      ClinVar: 2218 https://www.ncbi.nlm.nih.gov/clinvar/variation/2218/

      CAID: CA020450 http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvsOrDescriptor=NM_000551.3%3Ac.499C%3ET

      gnomAD: 0.000007954 https://gnomad.broadinstitute.org/variant/3-10191506-C-T

      VariantEvidence: N/A

      MutationType: missense_variant;transition

      CivicName: R167W (c.499C>T)

      MultipleGeneVariants: N/A

    1. Total cellular RNA was extracted from peripheral blood cells (PBLs) from each patient following the clinical trial, using a Nucleo Spin RNA kit (Macherey-Nagel, Düren, Germany). One microgram of total RNA was reverse-transcribed in a final volume of 20 μl with the First Strand cDNA Synthesis Kit (Roche, Mannheim, Germany) using random primers. The SYBR Green PCR system (BioRad, Hercules, CA, USA) was used to perform real-time PCR with an iQ5 system (Biorad, Spain)

      ArticleReferenceSequence: Not specified – Assumption: variants assumed to have been documented by the author under reference sequence NM_000551.3

      GenotypingMethod: polymerase chain reaction (PCR)

      SamplingMethod: peripheral blood using Nucleo Spin RNA kit (Macherey-Nagel, Düren, Germany)

    1. In 1996, we described a 3 generation VHL 2A kindred with 11 mutation carriers. We aim to share our experience regarding the long-term follow-up of this family

      PatientID: 3

      KindredID: 1

      Case: M, 55Y0M, Ethnicity Unknown

      DiseaseAssertion: VHL

      FamilyInfo: This patient was a member of family 1, where 14/32 total patients were diagnosed with VHL. One of which (I-32) was a mutational carrier with down syndrome. The other 13 patients had varying phenotypes, including adrenal pheochromocytoma, pancreatic endocrine tumors, liver and bone metastases, paraganglioma, cerebellar, spinal, and retinal hemangioblastomas, polycythemia, and chondrosarcoma. See Fig. 1 for family pedigree.

      CasePresentingHPOs: HP:0006748; HP:0002668; HP:0030405; HP:0009713; HP:0006880; HP:0001901 (adrenal pheochromocytoma; paraganglioma; pancreatic endocrine tumor; spinal hemagnioblastoma, cerebellar hemagnioblastoma; polycythemia)

      CaseHPOFreeText: Patient presented with his initial VHL-related clinical manifestations at 7Y0M. He was found to have adrenal pheochromocytoma; paraganglioma, pancreatic endocrine tumor, spinal and cerebellar hemagnioblastoma, and polycythemia (see table 1). Patient was diagnosed with VHL subtype 2A at 54Y0M.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: 8550742

      SupplementalData: N/A

      Variant: p.V166F (c.496G>T)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 2224, https://www.ncbi.nlm.nih.gov/clinvar/variation/2224/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant; transversion

      CivicName: V166F (c.496G>T)

      MultipleGeneVariants: N/A

    1. Nine patients were diagnosed with pheochromocytoma. Lumbal spinal hemangioblastoma and pancreatic neuroendocrine tumor without pheochromocytoma were detected in one patient. In patients with pheochromocytoma, additional tumors, such as retinal angioma, renal cell carcinoma, pancreatic serous cystadenoma, and pancreatic neuroendocrine tumors were detected. All patients were diagnosed as VHL syndrome type 2B.

      PatientID: III-10

      KindredID: 1

      Case: F, 27Y0M, Turkish

      DiseaseAssertion: VHL

      FamilyInfo: 17 family members from three generations were examined with the c.445G>T mutation and diagnosed with VHL type 2B. 11 individuals had clinical manifestations and 6 were asymptomatic carriers. One additional member (II-9) had passed before testing however were likely a carrier of the mutation. This patient’s mother, brother, and more, had the mutation. See Fig. 1 for full family pedigree.

      CasePresentingHPOs: HP:0006748; HP:0005584 (adrenal pheochromocytoma; renal cell carcinoma)

      CaseHPOFreeText: bilateral adrenal pheochromocytoma, right RCC

      CaseNotHPOs: HP:0030393; HP:0009715 (endolymphatic sac tumor, papillary cystadenoma of the epididymis) 

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.A149S (c.445G>T)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 127829 https://www.ncbi.nlm.nih.gov/clinvar/variation/127829/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant;transversion

      CivicName: A149S (c.445G>T)

      MultipleGeneVariants: N/A

    1. GroupID/ KindredID: F54

      Case: Sex unknown, 31Y0M, Spanish

      DiseaseAssertion: assumed VHL

      FamilyInfo: None.

      CasePresentingHPOs: HP:0006880; HP:0000107; HP:0001737 (cerebellar hemangioblastoma, renal cysts, pancreatic cysts)

      CaseHPOFreeText: Age of onset is 31Y0M.

      CaseNotHPOs: HP:0006770; HP:0002666; HP:0009711 (clear cell renal cell carcinoma, pheochromocytoma, retinal capillary hemangioma)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.F76del (c.227_229del)

      LegacyVariant: g.941_943delTCT

      CaseProblemVariantFreeText: Patient was reported with the g. (genomic) coding positions. The g.941_943delTCT variant worked out to correspond with c.227_229delTCT.

      ClinVarID: N/A

      CAID: CA357012 http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvsOrDescriptor=NM_000551.3%3Ac.227_229del

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: inframe_deletion

      CivicName: F76del (c.227_229del)

      MultipleGeneVariants: N/A

    1. GroupID: 22

      DiseaseAssertion: assumed VHL

      GroupSize: 3

      GroupNumberMales: N/A

      GroupNumberFemales: N/A

      GroupEthnicity: N/A

      GroupAgeRange: N/A

      GroupInfo: 3 of the 573 patients discussed in this paper were found to have the following mutation belonging to 1 family. 

      GroupPresentingHPOs: HP:0006880; HP:0009711; HP:0005584 (cerebellar hemangioblastoma, retinal capillary hemangioma; renal cell carcinoma)

      GroupHPOFreeText: 1 patient had retinal angiomas diagnosed at the age of 15Y, 1 had cerebellar hemangioblastomas diagnosed at 20Y, and 1 member had RCC diagnosed at 38Y.

      GroupNotHPOs: HP:0002666 (pheochromocytoma)

      GroupNotHPOFreeText: N/A

      GroupPreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: Supplementary Table S1.

      Variant: p.H125Qfs*7 (c.374dupA)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: N/A

      CAID: CA2499307153 http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA2499307153

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: duplication

      CivicName: H125fs (c.374insA) 

      MultipleGeneVariants: N/A

    2. Genotype-phenotype correlations of 573 VHL patients from 200 kindreds were analyzed. Higher risk of pheochromocytoma was associated with missense mutations that result in substitution of a surface amino acid (p<=0.004) than for patients with missense mutations that disrupt the structural integrity of the VHL gene product (pVHL) or other loss of function mutations (either germline deletions or truncating mutations). This missense mutation (c.533T>C), affecting residue on the surface of pVHL, was found in a VHL family of 3. All family members had retinal hemangioblastomas and cerebellar hemangioblastomas. Two had renal cell carcinoma. Another family in this study was observed with a L178R (c.533T>G) mutation. ACMG codes as follows: Supporting evidence of pathogenicity because Missense variant in a gene that has a low rate of benign missense variation and where missense variants are a common mechanism of disease (PP2).

    1. M198434NoCentral nervous system Hb, two RCC3Yesc.490C>T p.(Gln164*)3.33.5Tissue not available

      PatientID: None

      KindredID: 4

      Case: M, 34Y0M, Ethnicity Unknown

      DiseaseAssertion: VHL

      FamilyInfo: None.

      CasePresentingHPOs: HP:0010797, HP:0005584 (hemangioblastoma, renal cell carcinoma)

      CaseHPOFreeText: The patient had three tumours, one hemangioblastoma of the central nervous system and two renal cell carcinomas.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: Previously published in 24301059.

      SupplementalData: N/A

      Variant: p.Q164* (c.490C>T)

      LegacyVariant: N/A

      ClinVarID: 223228 https://www.ncbi.nlm.nih.gov/clinvar/variation/223228/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: The patient had a mosaic mutation with a mutated allele frequency of 3.3%. Copy number events of the mutated and wild type allele are available in table S4 of the supplemental.

      MutationType: stop_gained

      CivicName: Q164* (c.490C>T)

      MultipleGeneVariants: N/A

    1. Table 1

      PatientID: N/A

      KindredID: 20

      Case: Sex Unknown, Age Unknown, Ethnicity Unknown

      DiseaseAssertion: VHL

      FamilyInfo: Family history not mentioned. Patient’s variant reported as germline.

      CasePresentingHPOs: HP:0010797; HP:0005584 (Hemangioblastoma, Renal cell carcinoma)

      CaseHPOFreeText: Patient had VHL disease type 1; CNS-HB and RCC (see table 1).

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: 2624160

      SupplementalData:  N/A

      Variant: p.F76del (c.227_229del)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: N/A

      CAID: CA357012, https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvsOrDescriptor=NM_000551.3%3Ac.227_229delTCT

      gnomAD: N/A

      VariantEvidence: Variant reported as c.226_228del and was mapped to c.227_229del.

      MutationType: inframe_deletion

      CivicName: F76del (c.227_229del)

      MultipleGeneVariants: N/A

    2. 5 patients with VHL disease (Figs. 1 and 2, and Table 1)

      PatientID: 4

      KindredID: 3

      Case: M, 45Y0M, Arab

      DiseaseAssertion: VHL

      FamilyInfo: No family history of VHL disease was described for this patient. Immediate family members were recommended to genetically test for the relevant variant or monitor for VHL-related symptoms.

      CasePresentingHPOs: HP:0006880; HP:0009713; HP:0000107; HP:0001737; HP:0000787 (cerebellar hemangioblastoma; spinal hemangioblastoma; renal cyst; pancreatic cysts; nephrolithiasis)

      CaseHPOFreeText: At 40Y, Patient 4 was diagnosed with spinal and cerebellar hemangioblastomas, as well as multiple renal and pancreatic cysts. He was diagnosed with VHL disease type 1. At 43Y, renal cysts and stones were discovered. A year later, more spinal hemangioblastomas and renal stones were found. A year later, cerebellar lesions, as well as renal and pancreatic cysts were reported (see table 1).

      CaseNotHPOs: HP:0002088; HP:0001392; HP:0005264; HP:0001743 (abnormal lung morphology; abnormality of the liver; abnormality of the gallbladder; abnormality of the spleen)

      CaseNotHPOFreeText: No lesions were observed in the lungs, liver, gallbladder, and spleen.

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData:  N/A

      Variant: p.N90del (c.268_270del)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: N/A

      CAID: CA645524783, https://reg.genome.network/redmine/projects/registry/genboree_registry/by_caid?caid=CA645524783

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: inframe_deletion

      CivicName: N90del (c.268_270del)

      MultipleGeneVariants: N/A

    1. GroupID: 3315

      DiseaseAssertion: assumed VHL

      GroupSize: 4

      GroupNumberMales: N/A

      GroupNumberFemales: N/A

      GroupEthnicity: N/A

      GroupAgeRange: N/A

      GroupInfo: Familial VHL stated; 4 family members recorded with this mutation.

      GroupPresentingHPOs: HP:0010797; HP:0009711; HP:0005584 (hemangioblastoma, retinal capillary hemangioma, renal cell carcinoma)

      GroupHPOFreeText: 1/4 members had a retinal angioma (hemangioma), 2 had CNS hemangioblastoma, and 2 had RCC

      GroupNotHPOs: HP:0002666 (pheochromocytoma)

      GroupNotHPOFreeText: N/A

      GroupPreviousTesting: N/A

      PreviouslyPublished: Possibly previously published in PMID 9829911

      SupplementalData: N/A

      Variant: p.S111N (c.332G>A)

      CaseProblemVariantFreeText: N/A

      LegacyVariant: p.S182N (c.545G>A)

      ClinVarID: 223186 https://www.ncbi.nlm.nih.gov/clinvar/variation/223186/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant; transition

      CivicName: S111N (c.332G>A)

      MultipleGeneVariants: N/A

    1. Metastatic phaeochromocytoma in a 23-year-old woman with an unclassified variant in the von Hippel Lindau disease gene: how can the pathogenicity of this variant be determined? Nicholas Russell, Corresponding Author Nicholas Russell Department of Endocrinology, Austin Health, Heidelberg, VIC, AustraliaCorrespondence: Nicholas Russell, nicholas.russell@austin.org.auSearch for more papers by this authorMartin Delatycki, Martin Delatycki Department of Medicine Austin Health, University of Melbourne, Heidelberg, VIC, Australia Clinical Genetics Service, Austin Health, Heidelberg, VIC, AustraliaSearch for more papers by this authorMathis Grossmann, Mathis Grossmann Department of Endocrinology, Austin Health, Heidelberg, VIC, Australia Department of Medicine Austin Health, University of Melbourne, Heidelberg, VIC, Australia Clinical Genetics Service, Austin Health, Heidelberg, VIC, AustraliaSearch for more papers by this author

      PMID: 25557216

      Gene: VHL

      StandardizedReferenceSequence: NM_000551.3

    1. 21 missense mutations

      PatientID: 13

      KindredID: 354

      Case: Sex unknown, Age unknown, French

      DiseaseAssertion: VHL

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0002666; HP:0030405 (pheochromocytoma, pancreatic endocrine tumour)

      CaseHPOFreeText: N/A

      CaseNotHPOs: HP:0005584 (renal cell carcinoma)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.R167Q (c.500G>A)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVar: 2216 https://www.ncbi.nlm.nih.gov/clinvar/variation/2216/

      CAID: N/A

      gnomAD: 0.000003977 https://gnomad.broadinstitute.org/variant/3-10191507-G-A

      VariantEvidence:N/A

      MutationType: missense_variant;transition

      CivicName: R167Q (c.500 G >A)

      MultipleGeneVariants: N/A

    2. 2 small deletions leading to a frameshift

      Among patients prospectively followed by the members of the French VHL Study Group, 35 consecutive patients with well-documented endocrine pancreatic tumour (20 women and 15 men; median age,37 [21Y-57] years) were included. The data from 7 patients with EPT have been partially reported previously in Hammel et al., 1995;2000. All 35 patients had VHL germline mutations and were assessed for the presence of pheochromocytoma and renal carcinoma in addition to pancreatic tumours. The presence of other phenotypes was not described. Patient no. 20 from family 900 had a frameshift mutation in the VHL gene (c.284delC) and presented with pancreatic endocrine tumour. The patients' phenotypes are highly specific to VHL disease (PP4) and frameshift mutation supports PM4.

    1. third family with a VHL type 1 disease carried a c.475T>C/p.Trp88Arg exchange

      PatientID: CV1

      KindredID: C

      Case: M, 15Y0M, Serbian

      DiseaseAssertion: Asymptomatic

      FamilyInfo: Families were selected based on their clinical data and family history. Patient and his brother (CV2) are both currently asymptomatic, but possess the same variant as their father (CIV2), who was diagnosed with retinal hemangioblastoma at 12Y0M. Then, multiple pancreatic and kidney cysts were detected at 29Y0M and left kidney cancer was found at age 35Y0M. Patient’s grandfather, great grandfather and great uncle (CIII1; CII1, CII2) had retinal capillary hemangioma, CNS hemangioblastoma and renal cell carcinoma. Out of the three of them, only the great grandfather had genetic testing performed and was found to have the same mutation as the patient. See pedigree in figure 1.

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.W88R (c.262T>A)

      LegacyVariant: p.W88R (c.475T>A)

      CaseProblemVariantFreeText: N/A

      ClinVarID: 456577, https://www.ncbi.nlm.nih.gov/clinvar/variation/456577/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense variant; transversion

      CivicName: W88R (c.262T>A)

      MultipleGeneVariants: N/A

    1. 171Yes101015b––Partial deletion–Rearrangement–

      GroupID: None

      KindredID: 17

      DiseaseAssertion: VHL

      GroupSize: 10

      GroupNumberMales: N/A

      GroupNumberFemales: N/A

      GroupEthnicity: American Admixed /Latino

      GroupAgeRange: N/A

      GroupInfo: 10 members of a South American family expressed this c.183C>G mutation.

      GroupPresentingHPOs: HP:0010797, HP:0009711, HP:0005584 (hemangioblastoma, retinal capillary hemangioma, renal cell carcinoma)

      GroupHPOFreeText: All 10 family members had a central nervous system hemangioblastoma. One also had a retinal angioma. Five had renal carcinoma. One patient per family with renal tumour <3 cm under follow up detected by imaging.

      GroupNotHPOs: HP:0002894, HP:0002666 (neoplasm of the pancreas, pheochromocytoma )

      GroupNotHPOFreeText: N/A

      GroupPreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: P61= (183C>G)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 135951 https://www.ncbi.nlm.nih.gov/clinvar/variation/135951/

      CAID: N/A

      gnomAD: 0.0009632 https://gnomad.broadinstitute.org/variant/3-10183714-C-G

      VariantEvidence: N/A

      MutationType: synonymous_variant

      CivicName: P61=(c.183C>G)

      MultipleGeneVariants: Germline, VHL, Partial Deletion

    1. In four families, partial deletions of one or more exons were detected by Southern blot analysis

      GroupID/ KindredID: Family D

      DiseaseAssertion: VHL (clinically diagnosed in, at minimum, the proband)

      GroupSize: 2

      GroupNumberMales: N/A

      GroupNumberFemales: N/A

      GroupEthnicity: Belgian

      GroupAgeRange: 46-? (mean 46Y)

      GroupInfo: 2 family members are grouped with this deletion

      GroupPresentingHPOs: HP:0010797; HP:0009711; HP:0001737 (hemangioblastoma, retinal capillary hemangioma, pancreatic cysts)

      GroupHPOFreeText: both (2) patients were found with hemangioblastoma, 1 with retinal capillary hemangioma, and 1 with pancreatic cysts. Unclear specific patient-phenotype grouping

      GroupNotHPOs: HP:0005584; HP:0002666 (renal cell carcinoma, pheochromocytoma)

      GroupNotHPOFreeText: No patients were found to have pheochromocytoma or RCC

      GroupPreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: Deletion of exon 1

      CaseProblemVariantFreeText: N/A

      LegacyVariant: N/A

      ClinVarID: N/A

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: Southern blot analysis with EcoRI and hybridization with the g7 probe generated an aberrant restriction fragment (Fig. 3). This aberrant restriction fragment was recognized by probes representing exons 2 and 3. However, hybridization with the exon 1 probe resulted in a normal banding pattern, indicating a deletion encompassing exon 1.

      MutationType: exon_loss_variant

      CivicName: exon 1 deletion

      MultipleGeneVariants: N/A

    1. PatientID: 37

      KindredID: F01

      Case: F, Age Unknown, Unknown Ethnicity

      DiseaseAssertion: Asymptomatic

      FamilyInfo: A total of 12 members of this family (F01) had a complete deletion of the VHL gene. Five of these patients (16, 18, 21, 33, 43) presented with clinical features of VHL. This family was previously published except for patients 43 and 48 which were newly diagnosed with VHL disease in the current study.

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: 17537157

      SupplementalData: Figure 2.

      Variant: Complete Deletion

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: N/A

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: Deletion of ~250.9kb resulted in deletion of the VHL gene.

      MutationType: deletion

      CivicName: Deletion

      MultipleGeneVariants: N/A

    1. PatientID: 7

      KindredID: 7

      Case: F, 40Y0M, Ethnicity Unknown

      DiseaseAssertion: Cerebellar Hemangioblastoma

      FamilyInfo: N/A

      CohortInfo: The cohort included a series of 20 capillary haemangioblastomas of the central nervous system for mutations of the VHL gene.

      CasePresentingHPOs: HP:0006880 (cerebellar hemangioblastoma)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.P25L (c.74C>T)

      LegacyVariant: p.P25L (c.287C>T)

      CaseProblemVariantFreeText: N/A

      ClinVarID: 93330 https://www.ncbi.nlm.nih.gov/clinvar/variation/93330/

      CAID: N/A

      gnomAD: 0.002988 https://gnomad.broadinstitute.org/variant/3-10183605-C-T

      VariantEvidence: Refer to Table 1 for abnormal SSCP or heteroduplex patterns.

      MutationType: missense_variant;transition

      CivicName:P25L(c.74C>T)

      MultipleGeneVariants: N/A

    1. ProbandMalec.293A>G; p.Try98Cys

      PatientID: 5

      KindredID: 5

      Case: M, 10Y0M, Chinese

      DiseaseAssertion: VHL

      FamilyInfo: (See figure 3E for pedigree). The proband (Patient 5's) mother had left adrenal pheochromocytomas, and his grandmother had bilateral adrenal pheochromocytomas.

      CasePresentingHPOs: HP:0006748 (adrenal pheochromocytoma)

      CaseHPOFreeText: Proband presented with bilateral adrenal pheochromocytoma

      CaseNotHPOs:None

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.Y98C (c.293A>G)

      LegacyVariant: N/A

      CaseProblemVariant Free Text: N/A

      ClinVar: 223176, https://www.ncbi.nlm.nih.gov/clinvar/variation/223176/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_transition

      CivicName: Y98C (c.293A>G)

      MultipleGeneVariants: N/A

    1. No abstract available

      PatientID: IV-3

      KindredID: 1

      Case: M, 77Y0M, Ethnicity Unknown

      DiseaseAssertion: VHL

      FamilyInfo: The patient’s mother and two brothers had died with cerebellar hemangioblastoma, although genetic testing was not performed. One of the patient’s four children, a 46Y male, also presented with a small renal tumour, renal cysts, and pancreatic cysts; he was found to carry the same mutation the patient carried. One of the patient’s grandsons, a 10Y male, was also found to carry the same mutation as the patient but was asymptomatic. Genealogical inquiry also revealed that the patient was distantly related to a known VHL family; one member, a 47Y male, was previously operated on for CNS hemangioblastoma, RCC and symptomatic pheochromocytoma and was found to carry the same mutation as the proband. Another female member had previously presented with retinal hemangioblastoma before becoming deceased at 37Y. The paper also asserted that the patient’s grandmother and two distant relatives carried the mutation, although genotyping was not performed and phenotypic information was not provided.

      CasePresentingHPOs: HP:0006880; HP:0001737; HP:0006770; HP:0006748; HP:0000479 (Cerebellar hemangioblastoma, pancreatic serous cystadenoma, clear cell renal cell carcinoma, adrenal pheochromocytoma, retinal lesions)

      CaseHPOFreeText: The patient was originally diagnosed with metastatic bilateral clear cell renal cell carcinoma at 68Y and underwent chemotherapy for three months. The metastases were later reinterpreted to be a cystic hemangioblastoma and a benign serous cystadenoma. The patient was also found to have a non-secreting adrenal pheochromocytoma at 73Y and a clear cell renal cell carcinoma metastasis in the thyroid at 74Y. The patient had also previously presented with retinal lesions, although detailed records were unavailable.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.R82P(c.245G>C)

      LegacyVariant: N/A

      ClinVarID: 193118, http://www.ncbi.nlm.nih.gov/clinvar/variation/193118

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant;transversion

      CivicName: R82P(c.245G>C)

      MultipleGeneVariants: N/A

    1. 12 patients with supratentorial hemangioblastoma were studied at Le Kremlin-Bicêtre University. Other phenotypes included: 6 patients with pancreatic cysts, 1 patient with an endocrine pancreatic tumor, 5 patients with renal cell carcinoma, 3 patients with phaeochromocytoma, and 6 patients with retina hemangioblastomas, although specific phenotypes for each patient was not described. Blood samples were isolated from patients and the coding sequence and flanking intronic sequences were directly sequenced. Quantitative Southern blotting and multiplex ligation-dependent probe amplification studies were performed to detect large genomic rearrangements. Two patients were found with the germline p.Arg161Gln mutation. Patient 9 (female diagnosed with hemangioblastoma at 23Y) and patient 10 (female diagnosed with hemangioblastoma at 14Y and then at 16Y) are related.

    1. Arg167Trp

      GroupID: 9

      DiseaseAssertion: Neuroendocrine neoplasm (pheochromocytoma or paraganglioma)

      GroupSize: 3

      GroupNumberMales: N/A

      GroupNumberFemales: N/A

      GroupEthnicity: Ethnicity unknown

      GroupAgeRange: N/A

      GroupInfo: This mutation (p.R167W (c.499C>T)) was found in 3 patients, 2 with a family history and/or a syndromic presentation, and 1 patient with an apparently sporadic presentation.

      GroupPresentingHPOs: HP:0100634 (Neuroendocrine neoplasm)

      GroupHPOFreeText: Patients with a pheochromocytoma or a functional paraganglioma were recruited from several different French clinical centers participating in several clinical research networks (Cortico et Medullosurrènale: les Tumeurs Endocrines, Paragan-Glioma Network, Groupe des Tumeurs Endocrines)

      GroupNotHPOs: N/A

      GroupNotHPOFreeText: N/A

      GroupPreviousTesting: RET, NF1, SDHB/SDHC/SDHD

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.R167W (c.499C>T)

      CaseProblemVariantFreeText: N/A

      LegacyVariant: N/A

      ClinVarID: 2218 https://www.ncbi.nlm.nih.gov/clinvar/variation/2218/

      CAID: N/A

      gnomAD: 0.000007954 https://gnomad.broadinstitute.org/variant/3-10191506-C-T

      VariantEvidence: N/A

      MutationType: missense_variant; transition

      CivicName: R167W (c.499C>T)

      MultipleGeneVariants: N/A

    1. PatientID: None

      KindredID: 10

      Case: F, 9Y0M, Ethnicity unknown

      DiseaseAssertion: pheochromocytoma

      FamilyInfo: Familial/syndromic (FS) association

      CasePresentingHPOs: HP:0002666 (Pheochromocytoma)

      CaseHPOFreeText: Benign bilateral metachronous pheochromocytoma at age 6Y0M

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: SDHB,SDHC, SDHD, and exons 10, 11, 13, 14, 15 and 16 of RET proto-oncogene

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.R161Q (c.482G>A)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 182983 https://www.ncbi.nlm.nih.gov/clinvar/variation/182983/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant;transition

      CivicName: R161Q (c.482G>A)

      MultipleGeneVariants: N/A

    1. Germline genotype analysisGenomic DNA was extracted from peripheral blood using the QIAamp DNA Blood Mini Kit (QIAGEN, Germany). Three coding exons and their flanking intronic regions were amplified by polymerase chain reaction (PCR) using primers as described previously [12]. Direct sequencing was used to detect missense and splicing mutations. Large exon deletions were detected using a multiplex ligation-dependent probe amplification kit (MLPA, P016-C2, MRC-Holland, Amsterdam) and confirmed by real-time quantitative PCR using the primers described by Ebenazer et al. [13]. All patients were divided into the following five groups: missense group, partial deletion group, large deletion group, frameshift group and splicing site mutation group.

      ArticleReferenceSequence: Not specified – Assumption: variants assumed to have been documented by the author under reference sequence NM_000551.3

      GenotypingMethod: Three coding exons and flanking introns of VHL were amplified by PCR, followed by direct sequencing to detect missense and splice mutations. MLPA was used to detect large exon deleteions.

      SamplingMethod: peripheral blood

    1. The genetic testing revealed the presence of NF1 germline mutation (c.3516_3517delTC, p.D1172DfsX21). However, while the genetic analysis of the RET proto-oncogene did not reveal any mutation, the screening of the VHL gene revealed the presence of a so far undescribed missense variant (c.788 C>G, p.Pro192Arg). Both variants were present in the mother and absent in the healthy son.

      PatientID: 1 (case)

      KindredID: 1

      Case: F, 70Y0M, Ethnicity Unknown

      DiseaseAssertion: NF1

      FamilyInfo: Her son bearing the clinical characteristics of NF 1 died at the age of 17Y from an undefined malignancy. The patient has another son, 40 years old, who is clinically well.

      CasePresentingHPOs: HP:0002666; HP:0000843; HP:0002865 (pheochromocytoma; hyperparathyroidism; medullary thyroid cancer)

      CaseHPOFreeText: diagnosed with an isolated pheochromocytoma of the right adrenal gland underwent adrenalectomy) at 20Y. Further diagnosed with hyperparathyroidism and medullary thyroid cancer, having the full spectrum of the clinical picture of the MEN2A syndrome. Patient was diagnosed with NF1 at 20Y with multiple café–au-lait spots on her back and lower limbs were identified. She also had multiple dermal neurofibromas on the abdomen and lower limbs. Her medical history included diabetes mellitus type II, as well as hypertension.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: MRI of the brain was performed at 20Y, which did not reveal any brain neurofibromas.

      CasePreviousTesting: NF1, RET

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.P192R (c.575C>G)

      LegacyVariant: p.P192R (c.788C>G)

      CaseProblemVariantFreeText: N/A

      ClinVarID: 825946 https://www.ncbi.nlm.nih.gov/clinvar/variation/825946/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: According to in silico analysis and clinical history of the patient, VHL was more likely a rare polymorphic variant of the population of patient’s origin, rather than a disease causing mutation.

      MutationType: missense_variant;transversion

      CivicName: P192R (c.575C>G)

      MultipleGeneVariants: Germline, NF1, c.3516_3517delTC, p.D1172Dfs*21

    1. The concurrence of different types of brain tumors is extremely rare. We present a 29-yearold women with brainstem hemangioblastoma, posterior fossa meningiomas and a pituitary spaceoccupying lesion causing hyperprolactinemia.Despite multiple primary intracranial tumors,through systemic work-up, no other manifestation related to von Hippel-Lindau(VHL) disease was found. Complete resection of the brainstem hemangioblastoma and posterior fossa meningiomas was achieved in one single operation via a sub-occipital posterior combined with retrosigmoid approach. The patient was discharged without obvious postoperative complications

      PatientID: 1

      KindredID: 1

      Case: F, 29Y0M, Ethnicity Unknown

      DiseaseAssertion: assumed VHL

      FamilyInfo: Negative family history, suggesting a de novo mutation.

      CasePresentingHPOs: HP:0010797; HP:0002858; HP:0012503; HP:0000141 (hemangioblastoma; meningioma; pituitary lesion; amenorrhea)

      CaseHPOFreeText: 1-year history of amenorrhea, she was found to have a brainstem hemangioblastoma, posterior fossa meningiomas and a pituitary spaceoccupying lesion causing hyperprolactinemia. Complete resection of the brainstem hemangioblastoma and posterior fossa meningiomas was achieved in one single operation via a sub-occipital posterior combined with retrosigmoid approach. The patient was later discharged without obvious postoperative complications.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: Partial deletion of Exon 1

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: N/A

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: deletion

      CivicName: N/A

      MultipleGeneVariants: N/A

    1. HGB-65 B Germline 3 3 c.517 G > T E173X This study NA NA  

      PatientID: HGB-65

      KindredID: 8

      Case: Sex Unknown, 31Y0M, Italian

      DiseaseAssertion: VHL

      FamilyInfo: None.

      CohortInfo: The patient cohort consisted of 57 patients (26 male and 31 female) from Southern Italy, most of whom (55 of 57) presented with solitary HGB of the CNS: 6 were syndromic and 51 were apparently sporadic.

      CasePresentingHPOs: HP:0006880, HP:0009713 (cerebellar hemangioblastoma, spinal hemangioblastoma)

      CaseHPOFreeText: The patient had a multiple cerebellar hemangioblastomas at age 26. The cerebellar hemangioblastomas reoccured at age 29. The patient had a spinal hemangioblastoma at age 30.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.E173* (c.517G>T)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 825515 https://www.ncbi.nlm.nih.gov/clinvar/variation/825515/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: stop_gained

      CivicName: E173* (c.517G>T)

      MultipleGeneVariants: N/A

    1. P7PCC VHL c.292T>C

      PatientID: P7

      KindredID: 4

      Case: Sex Unknown, Age Unknown, Ethnicity Unknown

      DiseaseAssertion: pheochromocytoma

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0002666 (pheochromocytoma)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.Y98H (c.292T>C)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVar: 2223 https://www.ncbi.nlm.nih.gov/clinvar/variation/2223/

      CAID: N/A

      gnomAD: 0.00001343 https://gnomad.broadinstitute.org/variant/3-10183823-T-C

      VariantEvidence: N/A

      MutationType: missense_variant;transition

      CivicName: Y98H (c.292T>C)

      MultipleGeneVariants: N/A

    1. oth brothers with renal cell carcinoma with VHL gene mutation

      PatientID: None (Brother 1)

      KindredID: 1

      Case: M, 79Y0M, Ethnicity Unknown

      DiseaseAssertion: VHL

      FamilyInfo: FamilyInfo: One brother (proband, 75Y) presented with Hemangioblastoma, Hypertension, Cataract, Visual loss, Amblyopia, Diabetes mellitus, Adenocarcinoma of the colon, Clear cell renal cell carcinoma, Retinitis, Anal canal adenocarcinoma, Spinal hemangioblastoma, Gastrointestinal carcinoma, Cerebellar hemangioblastoma and the same VHL mutation as this patient. Mother with a brain tumor of unconfirmed pathology, and another brother (70Y) with renal cell carcinoma with the VHL gene mutation. Nephew (44Y) has VHL mutation but is asymptomatic. Niece (40Y) had a brain hemorrhage, other niece had hematologic malignancy, son has pancreatic cancer; genetic information is unclear or not provided for either.

      CasePresentingHPOs: HP:0005584 (Renal cell carcinoma)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: Figure 1

      Variant: p.E70K (c.208G>A)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 43598, https://www.ncbi.nlm.nih.gov/clinvar/variation/43598/

      CAID: N/A

      gnomAD: 0.000004365, https://gnomad.broadinstitute.org/variant/3-10183739-G-A

      VariantEvidence: N/A

      MutationType: missense_variant;transition

      CivicName: E70K (c.208G>A)

      MultipleGeneVariants: N/A

    1. PatientID: 19

      KindredID: 19

      Case: F, 72Y0M, Ethnicity Unknown

      DiseaseAssertion: Adrenal pheochromocytoma

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0006748 (Adrenal pheochromocytoma)

      CaseHPOFreeText: Unilateral benign adrenal pheochromocytoma that was operated on at age 58.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.I147T (c.440T>C)

      LegacyVariant: I147T (c.653T>C)

      CaseProblemVariantFreeText: N/A

      ClinVarID: 411964, https://www.ncbi.nlm.nih.gov/clinvar/variation/411964/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: Variant reported as I147T (c.653T>C), legacy nomenclature (AF010238.1), and was mapped to p.Ile147Thr (c.440T>C) in accordance with reference sequence NM_000551.3.

      MutationType: missense_variant;transition

      CivicName: I147T (c.440T>C)

      MultipleGeneVariants: N/A

    1. We evaluated the utility of a previously described real-time quantitative PCR (RQ-PCR) using SYBR Green for detection of larger deletions in the VHL gene

      ArticleReferenceSequence: Not specified – Assumption: variants assumed to have been documented by the author under reference sequence NM_000551.3

      GenotypingMethod: realtime quantitative PCR (RQ-PCR) was used to detect large deletions in the VHL gene. RQ-PCR assay was done using SYBR green master mix for detecting large deletions in the VHL gene.

      SamplingMethod: peripheral venous blood

    1. 4/m

      Case#: 4, Male, Han Chinese

      DiseaseAssertion: Hurler Syndrome

      FamilyInfo: Not Provided

      CasePresentingHPOs: HP:0001249, HP:0007957, HP:0001433 (Mental Retardation (severe), Corneal Clouding, Hepatosplenomegaly)

      CaseHPOFreeText: Skeletal Deformities

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: 0 Leukocyte IDUA activity (nmol/h/mg protein) (isolated leukocytes in the latter)

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      GenotypingMethod: Using the artificial substrate 4-methyl-umbelliferyl α-L-iduronide (Sigma)

      Variant1: c.792+1G>T

      Variant1ClinVarID: N/A

      Variant1CAID: CA355962278

      Variant2: c.792+1G>T

      Variant2ClinVarID: N/A

      Variant2CAID: CA355962278

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. Case#: Patient 4, 11 years old, Iranian

      DiseaseAssertion: MPS1-H (Severe)

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: IDUA activity not detected

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.1029C>A (p.Y343X)

      Variant1ClinVarID: 222997

      Variant1CAID: CA356984

      Variant2: c.1029C>A (p.Y343X)

      Variant2ClinVarID: 222997

      Variant2CAID: CA356984

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. P13

      Case#: P13, Female, 2.7 years (diagnosed), 5.1 (report), 18 kg (weight), 96 cm (height), Algerian

      DiseaseAssertion: Hurler Syndrome

      FamilyInfo: Parents are not consanguineous

      CasePresentingHPOs: HP:0001249, HP:0001999, HP:0000943, HP:0001387, HP:0002240, HP:0001387, HP:0007957, HP:0000238 (Mental Retardation, Facial Dysmorphic Features, Multiple Dysostosis, Joint Stiffness, Hepatomegaly, Hernia(Ombelical), Corneal Opacity, Hydrocephalus)

      CaseHPOFreeText: Chronic Rhinorrhea

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: Cardiac Manifestations

      CaseEnzymeAssay: IDUA Enzyme activity 2 (% to the reference range mean)

      CaseUrineGAGs: GAG quantitation 19.6 (fold change to the reference range mean according to age)

      CaseERT: N/A

      CaseBMT: N/A

      GenotypingMethod: Direct DNA Fragments Sequencing

      Variant1: c.501C>G (p.Tyr167*)

      Variant1ClinVarID: 92644

      Variant1CAID: CA220511

      Variant2: c.501C>G (p.Tyr167*)

      Variant2ClinVarID: 92644

      Variant2CAID: CA220511

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. 17

      Case#: Patient 17 (see Table 2), 40 weeks (Gestational age)

      DiseaseAssertion: MPS1-H

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.1205G>A (p.W402X)

      Variant1ClinVarID: 11908

      Variant1CAID: CA220498

      Variant2: c.1205G>A (p.W402X)

      Variant2ClinVarID: 11908

      Variant2CAID: CA220498

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    2. 2

      Case#: Patient 2 (see Table 2), 38 weeks, 1 day (Gestational age)

      DiseaseAssertion: MPS1-H

      FamilyInfo: N/A

      CasePresentingHPOs: Inguinal hernia (HP:0000023)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: Upper respiratory tract involvement

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.1205G>A (p.W402X)

      Variant1ClinVarID: 11908

      Variant1CAID: CA220498

      Variant2: c.208C>T (p.Q70X)

      Variant2ClinVarID: 11909

      Variant2CAID: CA204563

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    3. 7

      Case#: Patient 7 (see Table 2), 33 weeks, 1 day (Gestational age)

      DiseaseAssertion: MPS1-H

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: 0.44 nmol x mg-1 × hr-1

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.208C>T (p.Q70X)

      Variant1ClinVarID: 11909

      Variant1CAID: CA204563

      Variant2: c.653T>C (p.L218P)

      Variant2ClinVarID: 222995

      Variant2CAID: CA356986

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. 1

      Case#: Subject 1, female, in her 30s (age at enrollment), died during extension study from pneumonia and respiratory failure sixty-five days after her first dose in the extension study.

      DiseaseAssertion: MPS1-HS

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0002093, HP:0002540, HP:0002090, HP:0002176 (Chronic respiratory insufficiency, inability to walk, pneumonia, spinal cord compression)

      CaseHPOFreeText: Hemidiaphragmatic paralysis, improved strength and range of motion

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: Yes - Enzyme replacement therapy with laronidase

      CaseBMT: N/A

      Variant1: N/A

      Variant1ClinVarID: N/A

      Variant1CAID: N/A

      Variant2: N/A

      Variant2ClinVarID: N/A

      Variant2CAID: N/A

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. the patient (II‐2)

      Case#: II-2, Female, 2 years (onset), Chinese

      DiseaseAssertion: MPS 1

      FamilyInfo: I-1 and I-2 are the parents, II-4 is a full sibling of II-2 and a full child of I-1 and I-2. II-4 also carries the disease. (pedigree is figure # 1).

      CasePresentingHPOs: HP:0001367, HP:0000622, HP:0007663, HP:0001718, HP:0001643, HP:0001698, HP:0000238, (Abnormal joints, Blurred vision, Decreased vision, Mitral stenosis (severe), Patent ductus arteriosus (tubular), Pericardial effusion (moderate), Hydrocephalus)

      CaseHPOFreeText: Abnormal mitral valve development, Anterior mitral valve prolapses and insufficiency (moderate), Pulmonary hypertension (moderate), Bilateral temporal arachnoid cyst, Congenital spinal stenosis, Congenital glaucoma, Corneal gray degeneration, Corneal staphyloma

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      GenotypingMethod: Sanger Sequencing

      Variant1: c.1037T>G

      Variant1ClinVarID: 11927

      Variant1CAID: CA256128

      Variant2: c.18115dupT

      Variant2ClinVarID: 1454082

      Variant2CAID: CA2573137507

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished: N/A

    1. D4

      Case#: Patient D4, Druze religious group, located in lower Galilee.

      DiseaseAssertion: N/A

      FamilyInfo: May have relation with Patient D5 due to being located in the same village. Parents were found to be heterozygous for the mutation.

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.1096A>C (p.T366P)

      Variant1ClinVarID: 11916

      Variant1CAID: CA:256117

      Variant2: N/A

      Variant2ClinVarID: N/A

      Variant2CAID: N/A

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. 19/F

      Case#: 19, Female, infancy (onset), 3 years (diagnosed), 17 years (report)

      DiseaseAssertion: Hurler Syndrome

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0004322, HP:0001387, HP:0002240, HP:0001744, HP:0001537, HP:0001007, HP:0000158, HP:0000280, HP:0000943, HP:0007957 (Short Stature, Joint Stiffness, Hepatomegaly (severe), Splenomegaly(severe), Umbilical Hernia, Hirsutism, Large Tongue, Coarse Facial Features, Dysostosis Multiplex, Corneal Clouding)

      CaseHPOFreeText: (Mental Development (delayed), Systolic murmur 3/6/combined defect of mitral valve)

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      GenotypingMethod: Not Provided

      Variant1: p.H539T (fsX21)

      Variant1ClinVarID: N/A

      Variant1CAID: N/A

      Variant2: c.1650+5G>A (splicing error)

      Variant2ClinVarID: 92634

      Variant2CAID: CA220504

      AdditionalVariants: p.A8, p.A20, p.Q33H

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    2. 18/M

      Case#: 18, Male, 15 years (onset), 15 years (diagnosed), 15 years (report)

      DiseaseAssertion: Scheie Syndrome

      FamilyInfo: Patients 17 and 18 are siblings

      CasePresentingHPOs: HP:0004322, HP:0001387, HP:0002240, HP:0001744, HP:0001537, HP:0000280, HP:0000943 (Short Stature, Joint Stiffness, Hepatomegaly (moderate), Splenomegaly(mild), Umbilical Hernia, Coarse Facial Features (mild), Dysostosis Multiplex)

      CaseHPOFreeText: (Mental Development (developmental quotient 93 at 15y, Verbal IQ 77; CIQ 79), Umbilical/Carpal Tunnel Syndrome)

      CaseNotHPOs: HP:0000256 (Macrocephaly)

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      GenotypingMethod: Not Provided

      Variant1: p.Q380R

      Variant1ClinVarID: 550799

      Variant1CAID: CA2802202

      Variant2: p.Q380R

      Variant2ClinVarID: 550799

      Variant2CAID: CA2802202

      AdditionalVariants: p.A8/A8, p.A20/A20

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    3. 7/F

      Case#: 7, Female, 8 months (onset), 10 months (diagnosed), 5 years (report)

      DiseaseAssertion: Hurler Syndrome

      FamilyInfo: Not Provided

      CasePresentingHPOs: HP:0000256, HP:0001387, HP:0002240, HP:0001537, HP:0000486, HP:0002857, HP:0012185, HP:0000280, HP:0000943, HP:0007957 (Macrocephaly (at 8m), Joint Stiffness (at 8m), Hepatomegaly (Severe before HSCT, mild after HSCT), Umbilical Hernia, Strabismus, genua valga, carpal tunnel syndrome, Coarse Facial Features (very mild), Dysostosis Multiplex, Corneal Clouding)

      CaseHPOFreeText: Mental Development (developmental quotient 110 at 1y, Developmental quotient 115 at 5y), Normal psychomotor development, Hearing problems,

      CaseNotHPOs: HP:0004322, HP:0001744 (Short Stature, Splenomegaly)

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: normal IDUA activity in leucocytes (4 years after HSCT)

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: Hematopoietic Stem Cell Transplantation at 1y

      GenotypingMethod: Not Provided

      Variant1: p.W402X

      Variant1ClinVarID: 11908

      Variant1CAID: CA220498

      Variant2: c.1650 + 5G > A

      Variant2ClinVarID: 92634

      Variant2CAID: CA220504

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    4. 8/M

      Case#: 8, Male, 2, 5 years (onset), 3,5 months (diagnosed), 16 years (report)

      DiseaseAssertion: Hurler-Scheie Syndrome

      FamilyInfo: Not Provided

      CasePresentingHPOs: HP:0000256, HP:0001387, HP:0002240, HP:0001744, HP:0001537, HP:001285, HP:0000280, HP:0000943, HP:0007957 (Macrocephaly, Joint Stiffness, Hepatomegaly (mild before HSCT), Splenomegaly (mild before HSCT), Umbilical Hernia, Carpal tunnel syndrome, Coarse Facial Features, Dysostosis Multiplex, Corneal Clouding)

      CaseHPOFreeText: Mental Development (Borderline developmental quotient at 3y, IQ 117 at 12y)

      CaseNotHPOs: HP:0004322, HP:0002240, HP:0001744 (Short Stature, Hepatomegaly (after HSCT), Splenomegaly (after HSCT))

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: normal IDUA activity at 16 years

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: Hematopoietic Stem Cell Transplantation at 5y

      GenotypingMethod: Not Provided

      Variant1: p.W402X

      Variant1ClinVarID: 11908

      Variant1CAID: CA220498

      Variant2: p.E640fs

      Variant2ClinVarID: 558359

      Variant2CAID: CA355966048

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. Hurler disease

      Case#: Patient 55, 6 months old (age at report), female, Indian

      DiseaseAssertion: MPS1-H

      FamilyInfo: N/A

      CasePresentingHPOs: Coarse facial features, hepatosplenomegaly, dysostosis multiplex (HP:0000280, HP:0001433, HP:0000943)

      CaseHPOFreeText: Cardiac disease

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: 2.7% (Range of residual enzyme activity: 0.0%-4.8%)

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.589G>A (p.Gly197Ser)

      Variant1ClinVarID: 1526094

      Variant1CAID: CA355961839

      Variant2: c.1091C>T (p.Thr364Met)

      Variant2ClinVarID: 11925

      Variant2CAID: CA256126

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    2. Hurler disease

      Case#: Patient 16, 2 years old (age at report), male, Indian

      DiseaseAssertion: MPS1-H

      FamilyInfo: N/A

      CasePresentingHPOs: Coarse facial features, hepatosplenomegaly, joint contractures, corneal clouding, recurrent infections, dysostosis multiplex, intellectual disability, hernia (HP:0000280, HP:0001433, HP:0002828, HP:0007957, HP:0002719, HP:0000943, HP:0001249, HP:0100790)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: 3.3% (Range of residual enzyme activity: 0.0%-4.8%)

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.568_581del (p.Asn190Hisfs*204)

      Variant1ClinVarID: 3639714

      Variant1CAID: CA2801994

      Variant2: c.568_581del (p.Asn190Hisfs*204)

      Variant2ClinVarID: 3639714

      Variant2CAID: CA2801994

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    3. Hurler disease

      Case#: Patient 5, 2 years old (age at report), male, Indian

      DiseaseAssertion: MPS1-H

      FamilyInfo: N/A

      CasePresentingHPOs: Coarse facial features, hepatosplenomegaly, corneal clouding, recurrent infections, dysostosis multiplex (HP:0000280, HP:0001433, HP:0007957, HP:0002719, HP:0000943)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: 2.2% (Range of residual enzyme activity: 0.0%-4.8%)

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.343G>T (p.Asp115Tyr)

      Variant1ClinVarID: N/A

      Variant1CAID: CA355961128

      Variant2: c.343G>T (p.Asp115Tyr)

      Variant2ClinVarID: N/A

      Variant2CAID: CA355961128

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. siblings

      Case#: Case 2, proband was an 2-year-old female of Mexican origin. She was born at full term via cesarian section at 7 lbs and 6 oz.

      DiseaseAssertion: MPS1-H

      FamilyInfo: Proband came from a consanguineous union (uncle-niece). Case 1 is the proband's brother.

      CasePresentingHPOs: Recurrent otitis media (HP:0000403)

      CaseHPOFreeText: She also had more than 10 ear infections, and was diagnosed with bilateral moderate to severe hearing loss. She was mildly delayed, mainly in language.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: Her physical growth was not impaired.

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: Given the conclusion to discontinue enzyme replacement therapy in her brother, the decision was made, again with the participation of the patient's mother, not to initiate ERT unless she developed somatic symptoms that could be alleviated with treatment.

      CaseBMT: N/A

      Variant1: c.923T>C (p.L308P)

      Variant1ClinVarID: 502243

      Variant1CAID: CA2802119

      Variant2: c.923T>C (p.L308P)

      Variant2ClinVarID: 502243

      Variant2CAID: CA2802119

      AdditionalVariants: Shee also had a homozygous variant (c.268G>A) in the SGSH gene, and additionally diagnosed with Sanfilippo syndrome type A.

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    2. siblings

      Case#: Case 1, proband was an 8-year-old male of Mexican origin. He was born at 32 weeks gestational age; 3 lbs and 12 oz. He was diagnosed at 1.5 years old.

      DiseaseAssertion: MPS1-H

      FamilyInfo: Proband came from a consanguineous union (uncle-niece). Case 2 is the proband's sister.

      CasePresentingHPOs: Developmental delay, coarse facial features, gastroesophageal reflux, hiatal hernia, umbilical hernia, recurrent otitis media, hepatomegaly, dysostosis multiplex, joint stiffness (HP:0001263, HP:0000280, HP:0002020, HP:0002036, HP:0001537, HP:0000403, HP:0002240, HP:0000943, HP:0001387)

      CaseHPOFreeText: He had bilateral moderate to severe hearing loss. He had a normal ophthalmologic examination at 3 years of age, and at age 8 has not developed corneal clouding. He had contractures at the knees as well.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: Enzyme analysis on fibroblasts showed 10% residual alpha-l-iduronidase activity and no detectable activity for heparan N-sulfatase.

      CaseUrineGAGs: Urinary quantitation of glycosaminoglycans showed 127 mg/g creatinine of uronic acid by the orcinol reaction (nl. 10.7 ± 8.0) and 449 mg/g creatinine by the carbazole reaction (nl. 16.9 ± 9.9), giving a carbazole to orcinol ratio of almost 3, which is indicative of excess heparan sulfate as compared with dermatan sulfate. The electrophoresis which revealed a strong band of heparan sulfate and slightly less chondroitin sulfate was confirmatory of this conclusion. N-sulfated hexosamine was 126 mg/g creatinine (nl. 15.8 ± 12).

      CaseERT: He was started on enzyme replacement therapy (ERT) for iduronidase deficiency at age 3 years. However, his severe hyperactivity often precluded therapy as he could not sit still during the infusions, and the intravenous access catheter infiltrated on numerous occasions. Given his mild somatic symptoms, the concurrent diagnosis of Sanfilippo syndrome, a lethal condition, as well as the difficulty his family had with his complex medical care, the decision was made with the family's participation and accord to discontinue ERT and to treat only those problems that would improve his quality of life. He was on ERT for a total of 3 years.

      CaseBMT: He was evaluated for a bone marrow transplant but was determined to be ineligible due to his low developmental quotient.

      Variant1: c.923T>C (p.L308P)

      Variant1ClinVarID: 502243

      Variant1CAID: CA2802119

      Variant2: c.923T>C (p.L308P)

      Variant2ClinVarID: 502243

      Variant2CAID: CA2802119

      AdditionalVariants: He also had a homozygous variant (c.268G>A) in the SGSH gene, and additionally diagnosed with Sanfilippo syndrome type A.

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. 50/M

      Case#: Patient 50, male, Han origin, 5 years 6 months old (age at diagnosis)

      DiseaseAssertion: MPS1-H/S

      FamilyInfo: N/A

      CasePresentingHPOs: Macrocephaly, Joint stiffness, Hepatosplenomegaly, Hernia, Airway obstruction (HP:0000256, HP:0001387, HP:0001433, HP:0100790, HP:0006536)

      CaseHPOFreeText: N/A

      CaseNotHPOs: Global Developmental Delay, Mongolian macula (HP:0001263, HP:0011369)

      CaseNotHPOFreeText: Cardiac disease

      CaseEnzymeAssay: IDUA activity 0.8 nmol/h/mg protein. The normal range in Chinese controls was found to be 27.2–52 nmol/h/mg protein.

      CaseUrineGAGs: Diagnosis was confirmed biochemically by the demonstration of an increased excretion of urinary dermatan sulfate and heparan sulfate.

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.1898C>T (p.S633L)

      Variant1ClinVarID: 556406

      Variant1CAID: CA355966010

      Variant2: N/A

      Variant2ClinVarID: N/A

      Variant2CAID: N/A

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    2. 55/F

      Case#: Patient 55, female, Han origin, 2 years 3 months old (age at diagnosis)

      DiseaseAssertion: MPS1-H/S

      FamilyInfo: N/A

      CasePresentingHPOs: Global Developmental Delay, Macrocephaly, Joint stiffness, Hepatosplenomegaly (HP:0001263, HP:0000256, HP:0001387, HP:0001433)

      CaseHPOFreeText: Cardiac disease

      CaseNotHPOs: Mongolian macula, Hernia, Airway obstruction (HP:0011369, HP:0100790, HP:0006536)

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: IDUA activity 1.0 nmol/h/mg protein. The normal range in Chinese controls was found to be 27.2–52 nmol/h/mg protein.

      CaseUrineGAGs: Diagnosis was confirmed biochemically by the demonstration of an increased excretion of urinary dermatan sulfate and heparan sulfate.

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.236C>T (p.A79V)

      Variant1ClinVarID: 1458769

      Variant1CAID: CA356987

      Variant2: c.503G>T (p.G168V)

      Variant2ClinVarID: 4069658

      Variant2CAID: CA355961655

      AdditionalVariants: N/A

      ParentalGenotype: The transmission of sequence variations found in each patient was inferred by sequencing the corresponding exons of the patient's parents - confirmed in trans by parental testing.

      PreviouslyPublished N/A

    3. 42/M

      Case#: Patient 42, male, Han origin, 2 years old (age at diagnosis)

      DiseaseAssertion: MPS1-H

      FamilyInfo: N/A

      CasePresentingHPOs: Global Developmental Delay, Macrocephaly, Joint stiffness, Mongolian macula, Hepatosplenomegaly, Hernia (HP:0001263, HP:0000256, HP:0001387, HP:0011369, HP:0001433, HP:0100790)

      CaseHPOFreeText: Cardiac disease

      CaseNotHPOs: Airway obstruction (HP:0006536)

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: IDUA activity 1.0 nmol/h/mg protein. The normal range in Chinese controls was found to be 27.2–52 nmol/h/mg protein.

      CaseUrineGAGs: Diagnosis was confirmed biochemically by the demonstration of an increased excretion of urinary dermatan sulfate and heparan sulfate.

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.1402+1G>T

      Variant1ClinVarID: 1323099

      Variant1CAID: CA355964387

      Variant2: c.1402+1G>T

      Variant2ClinVarID: 1323099

      Variant2CAID: CA355964387

      AdditionalVariants: N/A

      ParentalGenotype: The transmission of sequence variations found in each patient was inferred by sequencing the corresponding exons of the patient's parents - confirmed by parental testing.

      PreviouslyPublished N/A

    4. 22/M

      Case#: Patient 22, male, Han origin, 1 year 8 months old (age at diagnosis)

      DiseaseAssertion: MPS1-H

      FamilyInfo: N/A

      CasePresentingHPOs: Global Developmental Delay, Macrocephaly, Joint stiffness, Mongolian macula, Hepatosplenomegaly, Hernia, Airway obstruction (HP:0001263, HP:0000256, HP:0001387, HP:0011369, HP:0001433, HP:0100790, HP:0006536)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: Cardiac disease

      CaseEnzymeAssay: IDUA activity 1.8 nmol/h/mg protein. The normal range in Chinese controls was found to be 27.2–52 nmol/h/mg protein.

      CaseUrineGAGs: Diagnosis was confirmed biochemically by the demonstration of an increased excretion of urinary dermatan sulfate and heparan sulfate.

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.236C>T (p.A79V)

      Variant1ClinVarID: 1458769

      Variant1CAID: CA356987

      Variant2: c.236C>T (p.A79V)

      Variant2ClinVarID: 1458769

      Variant2CAID: CA356987

      AdditionalVariants: N/A

      ParentalGenotype: The transmission of sequence variations found in each patient was inferred by sequencing the corresponding exons of the patient's parents - confirmed by parental testing.

      PreviouslyPublished N/A

    1. P1

      Case#: P1, male, 1.1 years (age at HCT - hematopoietic cell transplantation), 2 iPS colonies per 100,000 cells (KC)

      DiseaseAssertion: MPS1-H

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: Yes - Donor cells were received from KC, keratinocytes. Study was conducted 0.2 years after HCT.

      Variant1: c.501C>G (p.Y167X)

      Variant1ClinVarID: 92644

      Variant1CAID: CA220511

      Variant2: c.1205G>A (p.W402X)

      Variant2ClinVarID: 11908

      Variant2CAID: CA220498

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. c.536C > A

      Case#: No additional case information provided

      DiseaseAssertion: MPSI-H/S

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: 0.07 umol/g hr, reference range 10–50 umol/g hr.

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.536C>A (p.T179K)

      Variant1ClinVarID: 2734636

      Variant1CAID: CA355961717

      Variant2: c.536C>A (p.T179K)

      Variant2ClinVarID: 2734636

      Variant2CAID: CA355961717

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. Abnormal

      Case#: No additional case information provided

      DiseaseAssertion: Not specified

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: Abnormal

      CaseUrineGAGs: Normal

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.1054T>C (p.F352L)

      Variant1ClinVarID: 2432790

      Variant1CAID: CA2802178

      Variant2: c.1112T>A (p.V371D)

      Variant2ClinVarID: 1470032

      Variant2CAID: CA355963356

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    2. Abnormal

      Case#: No additional case information provided

      DiseaseAssertion: MPSI-H

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: Abnormal

      CaseUrineGAGs: Abnormal

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.250G>A (p.G84S)

      Variant1ClinVarID: 726495

      Variant1CAID: CA2801152

      Variant2: c.250G>A (p.G84S)

      Variant2ClinVarID: 726495

      Variant2CAID: CA2801152

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    3. Abnormal

      Case#: No additional case information provided

      DiseaseAssertion: MPSI-H/S

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: Abnormal

      CaseUrineGAGs: Normal

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.1205G>A (p.W402X)

      Variant1ClinVarID: 11909

      Variant1CAID: CA220498

      Variant2: c.1577T>C (p.L526P)

      Variant2ClinVarID: 567566

      Variant2CAID: CA2802300

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. older sibling

      Case#: OS of sibship 2, male, 1.3 years old (age at diagnosis), 3.3 years old (age at ERT enrollment), 11.7 years (duration of ERT)

      DiseaseAssertion: MPS1-HS

      FamilyInfo: Affected female YS (YS of sibship 2)

      CasePresentingHPOs: HP:0007957, HP:0000943, HP:0002828, HP:0002650 (Corneal opacity, dysostosis, joint contractures, scoliosis)

      CaseHPOFreeText: Cardiac disease, mild organomegaly, learning difficulties, progression of musculoskeletal symptoms,

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: Yes - Motor development remained normal while learning difficulties present at onset of ERT persisted. After 5 years of ERT, showed significant scoliosis and other spinal deformities

      CaseBMT: N/A

      Variant1: c.1598C>G (p.P533R)

      Variant1ClinVarID: 11910

      Variant1CAID: CA256112

      Variant2: c.1598C>G (p.P533R)

      Variant2ClinVarID: 11910

      Variant2CAID: CA256112

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    2. older sibling

      Case#: OS of sibship 8, male, 6.8 years old (age at diagnosis), 7 years old (age at ERT enrollment), 6.0 years (duration of ERT)

      DiseaseAssertion: MPS1-HS

      FamilyInfo: Affected YS (YS of sibship 8)

      CasePresentingHPOs: HP:0007957, HP:0000943, HP:0002828 (Corneal opacity, dysostosis, joint contracture)

      CaseHPOFreeText: Cardiac disease

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: Yes - Had progression of cardiac symptoms at T2 and dysostosis multiplex stabilized. Had behavioral issues and required an aide for 1-on-1 schooling.

      CaseBMT: N/A

      Variant1: N/A

      Variant1ClinVarID: N/A

      Variant1CAID: N/A

      Variant2: N/A

      Variant2ClinVarID: N/A

      Variant2CAID: N/A

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. 8

      Case#: Patient 8 (see Table 2), male, 22.3 years old (age at report), 12.5 years (duration of treatment), 8 surgeries

      DiseaseAssertion: MPS1-HS

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: HP:0000238, HP:0002176, HP:0002360 (Hydrocephalus, spinal cord compression, sleep abnormality)

      CaseNotHPOFreeText: Shunt placement, psychiatric problems

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: Yes

      CaseBMT: N/A

      Variant1: c.793G>C (p.G265R)

      Variant1ClinVarID: 638074

      Variant1CAID: CA2802098

      Variant2: c.979G>C (p.A327P)

      Variant2ClinVarID: 167190

      Variant2CAID: CA234128

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    2. 2

      Case#: Patient 2 (see Table 2), male, 18.3 years old (age at report), 9.1 years (duration of treatment), 7 surgeries

      DiseaseAssertion: MPS1-HS

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0000238, HP:0002176, HP:0002360 (Hydrocephalus, spinal cord compression, sleep abnormality)

      CaseHPOFreeText: Shunt placement, psychiatric problems

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: Yes

      CaseBMT: N/A

      Variant1: c.712T>A (p.L238Q) CDNA and protein change do not match. Known variant p.L238Q has a CDNA change of c.713T>A.

      Variant1ClinVarID: 265418

      Variant1CAID: CA2802065

      Variant2: c.1205G>A (p.W402X)

      Variant2ClinVarID: 11908

      Variant2CAID: CA220498

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    3. 4

      Case#: Patient 4 (see Table 2), female, 19.8 years old (age at report), 9.7 years (duration of treatment), 8 surgeries

      DiseaseAssertion: MPS1-HS

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0000238, HP:0002360 (Hydrocephalus, sleep abnormality)

      CaseHPOFreeText: Shunt placement, psychiatric problems

      CaseNotHPOs: HP:0002176 (Spinal cord compression)

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: Yes

      CaseBMT: N/A

      Variant1: c.712T>A (p.L238Q) CDNA and protein change do not match. Known variant p.L238Q has a CDNA change of c.713T>A.

      Variant1ClinVarID: 265418

      Variant1CAID: CA2802065

      Variant2: c.1205G>A (p.W402X)

      Variant2ClinVarID: 11908

      Variant2CAID: CA220498

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. Patient 5

      Case#: Patient 5, Male, 1 year 4 months (diagnosed), 4 years (report), Djerba Island (Tunisian origin)

      DiseaseAssertion: N/A

      FamilyInfo: Parents are consanguineous between 3rd cousins

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: Leukocyte IDUA activity 0.2% (% normal) ; determined in sonicated leukocyte pellets using the artificial substrate 4-methylumbellifery IDUA

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      GenotypingMethod: Sequencing exons and intro-exon junctions; Phenol/chloroform procedure

      Variant1: p.P533R

      Variant1ClinVarID: 11910

      Variant1CAID: CA256112

      Variant2: p.P533R

      Variant2ClinVarID: 11910

      Variant2CAID: CA256112

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. Patient F

      Case#: Patient F, female, 25 years old (age at report), 61 kg of weight (50th percentile), height of 154 cm (10th percentile). She is now working as an office secretary and also practices aerobic activity three times a week. She drives a car autonomously with her driving license which is renewed every 2 years. Her quality of life was measured with EQ-5D-Y and resulted good (100/100). Overall cognitive abilities are in the lower average expected for age (IQ:80), with difficulties in executive functioning, working memory, and arithmetic reasoning.

      DiseaseAssertion: attenuated form of MPS-1

      FamilyInfo: Affected younger sibling (Patient M), born to non-consanguineous Italian parents.

      CasePresentingHPOs: Moderate facial coarseness, moderately severe dysostosis multiplex, scoliosis, hyperlordosis, genua valga, corneal clouding, hyperopia, astigmatism, otitis media (completely corrected by eyeglasses), hearing impairment, mild obstructive sleep apnea (since 16 years old), mild thickened skin (HP:0000280, HP:0000943, HP:0002650, HP:0003307, HP:0002857, HP:0007957, HP:0000540, HP:0000483, HP:0000388, HP:0000365, HP:0010535, HP:0001072)

      CaseHPOFreeText: Liver and spleen volumes were normalized within the first year of ERT and remained within normal limits at clinical examination, claw feet, stiffness of the tibio-tarsal joint, ROM of hip and knees were within the normal ranges, improved stiffness of the trunk, movements of shoulders, elbows and wrists were within the normal range, limited flexion of fingers due to mild rigidity, normal cerebral MRI, a mild–moderate tricuspid insufficiency with pulmonary artery pressure (PAP) within the upper normal range (25 mmHG) was reported (at 16 years old), cardiac involvement.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: Total urinary GAG excretion was slightly above the upper limit of the normal range (47 μg/mg creatinine with normal values < 26) with the qualitative assay showing a band of DS.

      CaseERT: Yes - Began ERT and 5 years old. Laronidase infusions were started delivering weekly (at the dose of 0.5 mg/kg) using implanted venous access devices. Laronidase infusion generally lasted approximately 4 h, without the need for any premedication.

      CaseBMT: N/A

      Variant1: c.1205G>A (p.W402X)

      Variant1ClinVarID: 11908

      Variant1CAID: CA220498

      Variant2: c.1603C>T (p.L535F)

      Variant2ClinVarID: 638076

      Variant2CAID: CA355865038

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished Yes (PMID: 20026495) and (PMID:26965916)

    2. Patient M

      Case#: Patient M, male, 19 years of age (age at report), 71 kg of weight (50th percentile), height of 171 cm (25th percentile). He attended the last year of high school Institute of Art and practices aerobic activity three times a week. He is intellectually normal (IQ: 108) with a good quality of life (100/100 assessed by EQ-5D-Y).

      DiseaseAssertion: attenuated form of MPS 1

      FamilyInfo: Affected older sibling (Patient F), born to non-consanguineous Italian parents.

      CasePresentingHPOs: Mild facial coarseness, temporomandibular joint dislocation, hypoplasia of the odontoid process, severe worsening of corneal clouding (noted at 12 months), mild hyperopia (noted at 7 years), astigmatism (noted at 7 years but completely corrected by eyeglasses), minimal multiplex dysostosis, mild joint stiffness, kyphosis, initial signs of carpal tunnel syndrome (HP:0000280, HP:6000814, HP:0003311, HP:0007957, HP:0000540, HP:0000483, HP:0000943, HP:0001387, HP:0002808, HP:0012185)

      CaseHPOFreeText: Mild shoulder stiffness was present with limited forward elevation up to 120° and in abduction up to 100°, mild scoliosis with Cobb angle of 17°, triangular shape of cervical and thoracic vertebres (C4, C5, C6, D6, and D7), several dorsal herniated discs, normal brain MRI, mild heart involvement, stabilization of the cardiac valvulopathy, normal hearing.

      CaseNotHPOs: Hepatosplenomegaly (HP:0001433)

      CaseNotHPOFreeText: Respiratory or sleep disturbances, no recurrent infections.

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: Total urinary glycosaminoglycans (GAG) determination on samples collected just before infusion remained within normal ranges (20,8 μg/mg creatinine with normal values < 42) but at the qualitative assay was present a band of DS.

      CaseERT: Yes - Began ERT at 5 months old (pre symptomatically). Laronidase infusions were started delivering weekly (at the dose of 0.5 mg/kg) using implanted venous access devices. Laronidase infusion generally lasted approximately 4 h, without the need for any premedication.

      CaseBMT: N/A

      Variant1: c.1205G>A (p.W402X)

      Variant1ClinVarID: 11908

      Variant1CAID: CA220498

      Variant2: c.1603C>T (p.L535F)

      Variant2ClinVarID: 638076

      Variant2CAID: CA355865038

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished Yes (PMID: 20026495) and (PMID:26965916)

    1. Case#: Patient 9, 4 years old, Iranian

      DiseaseAssertion: MPS1-S (Attenuated)

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: 0.19 µmol/g.h (Normal ranges: 10-50 µmol/g.h)

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.903C>G (p.D301E)

      Variant1ClinVarID: 1458511

      Variant1CAID: CA355962528

      Variant2: c.903C>G (p.D301E)

      Variant2ClinVarID: 1458511

      Variant2CAID: CA355962528

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. 50.198 (3.0)9.2DS 4.6heterozygous pathogenic: c.1029C>G; p.Y343*Normal examinationHS 6.1heterozygous PD: c.235G>A; p.A79TCarrierheterozygous PD: c.296C>T; p.T99I

      Case#:Patient Sample unique ID 5, Infant screened positive at birth (specimens with activity ≤15% of the DMA for enzyme activity and a CLIR screening algorithm result of indeterminate or MPS I)

      DiseaseAssertion:Carrier

      FamilyInfo:None

      CasePresentingHPOs:None

      CaseHPOFreeText:None

      CaseNotHPOs:None

      CaseNotHPOFreeText: Normal examination at follow up after screening positive at birth (specimens with activity ≤15% of the DMA for enzyme activity and a CLIR screening algorithm result of indeterminate or MPS I)

      CaseEnzymeAssay: IDUA activity 0.198 (9.2) umol/L/h (%DMA) during new born screening through dried blood spot (plasma) and 9.2 pmol/punch/h Confirmatory IDUA enzyme measured at follow-up appointment

      CaseUrineGAGs: DS 4.6 g/mol creatinine and HS 6.1 g/mol creatinine (Normal)

      CaseERT:No

      CaseBMT:No

      Variant1:heterozygous pathogenic: c.1029C>G; p.Y343* (Normal examination)

      Variant1ClinVarID: 560781

      Variant1CAID: CA352049896

      Variant2: heterozygous PD: c.235G>A; p.A79T (Carrier)

      Variant2ClinVarID:41682

      Variant2CAID:CA000358

      AdditionalVariants:heterozygous PD: c.296C>T; p.T99I (ClinVarID:53610, CAID:CA326991)

      ParentalGenotype:N/A

      PreviouslyPublished:N/A

    1. MPS IH patients

      Case#: Patient 2

      DiseaseAssertion: MPS1-H

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.208C>T (p.Q70X)

      Variant1ClinVarID: 11909

      Variant1CAID: CA204563

      Variant2: c.398_403del (p.Met133_Gly134del)

      Variant2ClinVarID: 863830

      Variant2CAID: CA2801912

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. Case#: Patient 5, male, 7.5 months (age at HSCT), 5.3 months (age at ERT).

      DiseaseAssertion: MPS1-H

      FamilyInfo: N/A

      CasePresentingHPOs: Pneumonia (HP:0002090)

      CaseHPOFreeText: Adenovirus, gastrointestinal and skin (GVHD)

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: 0.2 (at diagnosis), 38.3 (after HSCT) Units not provided.

      CaseUrineGAGs: N/A

      CaseERT: Yes - 87 days duration

      CaseBMT: Yes - MUD (matched unrelated donor) with stem cells sourcing from the CB (cord blood)

      Variant1: c.208C>T (p.Q70X)

      Variant1ClinVarID: 11909

      Variant1CAID: CA204563

      Variant2: c.1205G>A (p.W402X)

      Variant2ClinVarID: 11908

      Variant2CAID: CA220498

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. 2

      Case#: Patient 2: Enrolled in study at 9.9 years, female, onset at 0.3 years, diagnosed at 5.2 years, ERT started 7.9 years DiseaseAssertion:MPS1 H FamilyInfo:No consanguinity, Sister similarly affected CasePresentingHPOs:Corneal opacity (HP:0007957), Joint stiffness (HP:0001387), Macrocephaly (HP:0000256), CaseHPOFreeText: CaseNotHPOs: Hepatosplenomegaly (HP:0001433) CaseNotHPOFreeText: CaseEnzymeAssay: CaseUrineGAGs: 0.36(min)-4.55(max) mg GAG/mmol creatinine while on ERT CaseERT: Laronidase dose-optimization trial : standard regimen – 0.58 mg/kg/week; biweekly regimen – 1.2 mg/kg every two weeks CaseBMT:Nil Variant1:P533R Variant1ClinVarID:11910 Variant1CAID:CA256112 Variant2:P533R Variant2ClinVarID:11910 Variant2CAID:CA256112 AdditionalVariants:Nil ParentalGenotype:NA PreviouslyPublishedNA

    1. Case#: Variant not associated with a proband. Variant listed in supplementary materials in Supplementary Table 4

      DiseaseAssertion: Mucopolysaccharidosis type I, MPS I

      FamilyInfo: N/A

      CasePresentingHPOs:

      CaseHPOFreeText:

      CaseNotHPOs:

      CaseNotHPOFreeText:

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: L218P

      Variant1ClinVarID: 222995

      Variant1CAID:CA356986

      Variant2: N/A

      Variant2ClinVarID: N/A

      Variant2CAID: N/A

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished: N/A

    1. 19

      Case#: Patient 19, born in 2004 (paper published in 2017), 11 months (age at first treatment)

      DiseaseAssertion: MPSI-H

      FamilyInfo: N/A

      CasePresentingHPOs: Corneal clouding (HP:0007957)

      CaseHPOFreeText: N/A

      CaseNotHPOs: Retinopathy, cataract (HP:0000488, HP:0000518)

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: 66 ng/mol (56 weight matched enzyme reference assay)

      CaseUrineGAGs: 0.55 DS/CS

      CaseERT: Yes

      CaseBMT: Yes, Cord

      Variant1: c.1205G>A (p.W402X)

      Variant1ClinVarID: 11908

      Variant1CAID: CA220498

      Variant2: c.1205G>A (p.W402X)

      Variant2ClinVarID: 11908

      Variant2CAID: CA220498

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    2. 1

      Case#: Patient 1, born in 2007 (paper published in 2017), 9 months (age at first treatment)

      DiseaseAssertion: MPSI-H

      FamilyInfo: N/A

      CasePresentingHPOs: Corneal clouding (HP:0007957)

      CaseHPOFreeText: N/A

      CaseNotHPOs: Retinopathy, cataract (HP:0000488, HP:0000518)

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: 44.29 ng/mol (33.09 weight matched enzyme reference assay)

      CaseUrineGAGs: 0.4 DS/CS

      CaseERT: Yes

      CaseBMT: Yes, cord

      Variant1: c.208C>T (p.Q70X)

      Variant1ClinVarID: 11909

      Variant1CAID: CA204563

      Variant2: c.979G>C (p.A327P)

      Variant2ClinVarID: 167190

      Variant2CAID: CA234128

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. R628X

      Case#: Family 4, Middle East

      DiseaseAssertion: MPS1-H

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: The paper states that "Hurler form is characterized by skeletal abnormalities, hepatosplenomegaly and severe mental retardation" but is not specific to this patient.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: The α-L-iduronidase enzyme activities in leucocytes from all patients in the study was measured using the artificial substrate 4-methylumbelliferyl α-L iduronide (Sigma). Values ranged from 0 to 2.47 nmol/h/mg protein (reference range: 28–92 nmol/h/mg protein) and did not correlate to the clinical phenotype.

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.1882C>T (p.R628X)

      Variant1ClinVarID: 550421

      Variant1CAID: CA2802462

      Variant2: c.1882C>T (p.R628X)

      Variant2ClinVarID: 550421

      Variant2CAID: CA2802462

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    2. G208V

      Case#: Family 1, Middle East

      DiseaseAssertion: MPS1-H

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: The paper states that "Hurler form is characterized by skeletal abnormalities, hepatosplenomegaly and severe mental retardation" but is not specific to this patient.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: The α-L-iduronidase enzyme activities in leucocytes from all patients in the study was measured using the artificial substrate 4-methylumbelliferyl α-L iduronide (Sigma). Values ranged from 0 to 2.47 nmol/h/mg protein (reference range: 28–92 nmol/h/mg protein) and did not correlate to the clinical phenotype.

      α-L-iduronidase activity in COS-7 cells transiently transfected with wild-type or mutagenised cDNAs. α-L-iduronidase activity: 4.5 nmol/h/mg cell protein; values are the means of two experiments.

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.623G>T (p.G208V)

      Variant1ClinVarID: 3591555

      Variant1CAID: CA355961949

      Variant2: c.623G>T (p.G208V)

      Variant2ClinVarID: 3591555

      Variant2CAID: CA355961949

      AdditionalVariants: N/A

      ParentalGenotype: Parental testing conducted, each parent was shown to carry one of the sequence changes found in their affected child.

      PreviouslyPublished N/A

    1. Case#: Pt 1, age is 20 months (proband can be found in Table 1)

      DiseaseAssertion: Hurler syndrome, mucopolysaccharidosis type IH, MPS IH, MPS type I

      FamilyInfo: No family information provided

      CasePresentingHPOs:

      CaseHPOFreeText:

      CaseNotHPOs:

      CaseNotHPOFreeText:

      CaseEnzymeAssay: In methods it is stated that an IDUA activity assay was conducted on cartilaginous pellets generated from patient-derived bone marrow stromal cells at 5 weeks. However, results of the IDUA activity assays are not stated.

      CaseUrineGAGs: "Significantly higher levels of GAGs in MPS IH compared with HD pellets at.1 week of chondrogenic differentiation, thus indicating that GAG accumulation in MPS IH can be seen during cell condensation and early differentiation stages." Total GAG content for each sample in ug GAG/ug DNA shown in Figure 4 graphs.

      CaseERT: Don't know

      CaseBMT: Don't know

      Variant1: p.Q70X

      Variant1ClinVarID:

      Variant1CAID: PA3044620172

      Variant2: p.P496R

      Variant2ClinVarID: 496861

      Variant2CAID: CA2802275

      AdditionalVariants: No additional variants mentioned

      ParentalGenotype: No parental information provided

      PreviouslyPublished: No mention of previously being published

    1. Patient of family F

      Case#: Family F proband, male, 1 year old (age of onset), Tunisia.

      DiseaseAssertion: MPS1-H

      FamilyInfo: Seven unaffected brothers with MPS1 (See results), parents were 2nd degree relatives (See Table 1)

      CasePresentingHPOs: HP:0001433, HP:0001744, HP:0001999, (Hepatosplenomegaly, splenomegaly, abnormal facial shape)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: IDUA activity (0.1 nmol/h/mg) (usual values: 1-5).

      CaseUrineGAGs: glycosaminoglycans (102 mg/g of creatinine) (usual values: 9-46), abnormal electrophoresis profile with dermatan sulfate and heparan sulfate

      CaseERT: N/A

      CaseBMT: Yes

      Variant1: c.1598C>G (p.P533R)

      Variant1ClinVarID: 11910

      Variant1CAID: CA256112

      Variant2: c.1598C>G (p.P533R)

      Variant2ClinVarID: 11910

      Variant2CAID: CA256112

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. 6

      Case#: 6, Male, 0.9 years (diagnosed), 13.0 years (report), 15 kg (weight), 102 cm (height), Iranian

      DiseaseAssertion: Hurler Syndrome

      FamilyInfo: Parents are consanguineous

      CasePresentingHPOs: HP:0001249, HP:0001999, HP:0000943, HP:0001387, HP:0100790, HP:0000365, HP:0000238 (Mental Retardation, Facial Dysmorphic Features, Multiple Dysostosis, Joint Stiffness, Hernia, Deafness, Hydrocephalus)

      CaseHPOFreeText: HM/HSM, Chronic Rhinorrhea

      CaseNotHPOs: HP:0007957 (Corneal Capacity)

      CaseNotHPOFreeText: Cardiac Manifestations

      CaseEnzymeAssay: IDUA activity 1.3 (μmol/spot.20h)

      CaseUrineGAGs: Quantitative urinary GAG 11.54 (mg/gCr)

      CaseERT: N/A

      CaseBMT: N/A

      GenotypingMethod: Sanger Sequencing

      Variant1: p.D301E

      Variant2: N/A

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished: N/A

  2. watermark.silverchair.com watermark.silverchair.com
    1. Case#: No additional case information provided.

      DiseaseAssertion: MPS1-H

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.653T>C (p.L218P)

      Variant1ClinVarID: 222995

      Variant1CAID: CA356986

      Variant2: c.653T>C (p.L218P)

      Variant2ClinVarID: 222995

      Variant2CAID: CA356986

      AdditionalVariants: In the paper an additional variant is listed on the same allele as "G387 + 6c->t". It seems that the current nomenclature for this variant is "c.299+6C>T". This variant is classified as benign by the LD VCEP.

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. c.1081G>A

      Case#: Functional assay variant with a clinical significance of clinically benign.

      DiseaseAssertion: MPS-I

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.1081G>A (p.A361T)

      Variant1ClinVarID: 92624

      Variant1CAID: CA145865

      Variant2: N/A

      Variant2ClinVarID: N/A

      Variant2CAID: N/A

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. Pt3

      Case#: Pt3, Male, 38 months (diagnosis), 4 months (onset)

      DiseaseAssertion: Hurler Syndrome

      FamilyInfo: N/A Pedigree (Figure 4Pt3)

      CasePresentingHPOs: HP:0000280, HP:0007957, HP:0001387, HP:0001654, HP:0100814, (Coarse face, Cornea clouding, Joint stiffness, Valvular heart disease, Dermal melanocytosis)

      CaseHPOFreeText: Spinal Deformation, Inguinal or Umbilical hernia

      CaseNotHPOs: HP:0001433 (Hepatosplenomegaly)

      CaseNotHPOFreeText: Long bone deformation

      CaseEnzymeAssay: α-L-iduronidase 0.13 (dried blood spots, normal >1.32 µM/h)

      CaseUrineGAGs: Urine heparan sulfate 8.18 (mg/mmol creatinine) {<0.76}

      CaseERT: N/A

      CaseBMT: N/A

      GenotypingMethod: Not Provided.

      Variant1: c.1190-10C>A

      Variant1ClinVarID: 950888

      Variant1CAID: CA1139658405

      Variant2: c.1046A>G

      Variant2ClinVarID: 950889

      Variant2CAID: CA2802173

      AdditionalVariants: N/A

      ParentalGenotype: Both parents are homozygous for not having the c.1190-10C>A and c.1046A>G variants (figure 4 Pt3)

      PreviouslyPublished: N/A

    1. A second patient

      Case#: Second patient

      DiseaseAssertion: MPS-I

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.299+6C>T

      Variant1ClinVarID: 92640

      Variant1CAID: CA145880

      Variant2: c.653T>C (p.L218P)

      Variant2ClinVarID: 222995

      Variant2CAID: CA356986

      AdditionalVariants: c.1205G>A (p.W402X), ClinVarID: 11908, CAID:CA220498

      ParentalGenotype: Parental studies demonstrated that the c.299+6C>T and p.L218P changes are in cis.

      PreviouslyPublished N/A

    1. splicing mutations

      Case#: Patient 81, Turkey

      DiseaseAssertion: MPS1-H/S

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.494-1G>A

      Variant1ClinVarID: 557942

      Variant1CAID: CA355961634

      Variant2: c.494-1G>A

      Variant2ClinVarID: 557942

      Variant2CAID: CA355961634

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A