1,860 Matching Annotations
  1. Last 7 days
    1. PatientID: 1

      KindredID: 1

      Case: 30Y0M, Sex and Ethnicity Unknown

      DiseaseAssertion: VHL

      FamilyInfo: Recorded as a familial tumor; no other family info present

      CasePresentingHPOs: HP:0002666 (Pheochromocytoma)

      CaseHPOFreeText: Bilateral pheochromocytoma reported with an age at diagnosis of 30 years of age.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: RET, SDHB/SDHC/SDHD

      PreviouslyPublished: N/A

      SupplementalData: N/A

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

      CaseProblemVariantFreeText: N/A

      LegacyVariant: N/A

      ClinVarID: 2219 https://www.ncbi.nlm.nih.gov/clinvar/variation/2219/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant; transversion

      CivicName: R167W (c.499C>G)

      MultipleGeneVariants: N/A

    2. PatientID: 6

      KindredID: 2

      Case: 15Y0M, Sex and Ethnicity Unknown

      DiseaseAssertion: VHL

      FamilyInfo: Recorded as a familial tumor; One other family member (Patient ID: 5) was a 29 year old patient with a bilateral pheochromocytoma. "Belonging to the same family", although the connection is unclear.

      CasePresentingHPOs: HP:0002666 (Pheochromocytoma)

      CaseHPOFreeText: Unilateral pheochromocytoma reported with an age at diagnosis of 15 years of age.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: RET, SDHB/SDHC/SDHD

      PreviouslyPublished: N/A

      SupplementalData: N/A

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

      CaseProblemVariantFreeText: N/A

      LegacyVariant: N/A

      ClinVarID: 2219 https://www.ncbi.nlm.nih.gov/clinvar/variation/2219/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant; transversion

      CivicName: R167W (c.499C>G)

      MultipleGeneVariants: N/A

    1. PatientID: V-12

      KindredID: 2

      Case: M, Age Unknown, German

      DiseaseAssertion: VHL (Asymptomatic)

      FamilyInfo: Family 2 is comprised of 131 individuals over six generations including 65 members (50% of those at risk) with VHL type 2A (72% clinically affected, 12% obligate carriers, and 15% positive genetic analysis alone) and nearly equal gender distribution for affected status (54% male). An additional six members (II-3, II-4, II -5, III-1, III-2, and III-3) are suspected to have VHL without confirmation. Of note, the nuclear family (branch IV-13) contains 13 siblings, of whom 12 have been diagnosed with pheo. The presenting tumor types in Family 2 were pheo (70%), HB (17%), and RA (13%). No Family 2 member had RCC as the initial manifestation. Distribution of HB and RA are not described except for patient IV-8.

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

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

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: 7759077

      SupplementalData: N/A

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

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 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. PatientID: 6 (Mother)

      KindredID: 18

      Case: F, 75Y0M, Ethnicity Unknown

      DiseaseAssertion: Assumed VHL

      FamilyInfo: 11 members of this family tested positive for the c.712C>T/c.499C>T germline variant of the VHL gene. 14 members of this family were assumed to carry this variant due to family history/personal medical history. Members of this family range from asymptomatic to multi-organ involvement (pheochromocytoma, pancreatic and renal cysts/tumors and hemangioblastomas). The family was previously reported in PMID 3942913.

      CasePresentingHPOs: HP:0010797; HP:0009711 (Hemangioblastoma, Retinal capillary hemangioma)

      CaseHPOFreeText: This patient presented with CNS hemangioblastoma (54Y) and retinal angioma (28Y).

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

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: 3942913 (some members of this family are previously reported (phenotypes only) but unable to match patients across papers with confidence)

      SupplementalData: Supplementary Table 1.

      Variant: N/A

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: N/A

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: Authors state that the c.712C>T germline familial variant of the VHL gene in this patient is “inferred from the family”. No genetic testing was done on this patient to confirm this. Being that this familial variant is out of bound with respect to the NM_000551.3 reference sequence, it was concluded that this variant is noted in the Latif et al. (1993) reference and was translated to c.499C>T (NM_000551.3).

      MutationType: N/A

      CivicName: N/A

      MultipleGeneVariants: N/A

    2. PatientID: 49 (Cousin)

      KindredID: 18

      Case: F, 62Y0M, Ethnicity Unknown

      DiseaseAssertion: VHL

      FamilyInfo: 11 members of this family tested positive for the c.712C>T/c.499C>T germline variant of the VHL gene. 14 members of this family were assumed to carry this variant due to family history/personal medical history. Members of this family range from asymptomatic to multi-organ involvement (pheochromocytoma, pancreatic and renal cysts/tumors and hemangioblastomas). The family was previously reported in PMID 3942913.

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

      CaseHPOFreeText: This patient presented with retinal angioma (18Y) and pheochromocytoma (20Y). Age of diagnosis of CNS hemangioblastoma and renal cell carcinoma is unknown.

      CaseNotHPOs: HP:0000077; HP:0001732 (Abnormality of the kidney, Abnormality of the pancreas)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: 3942913 (some members of this family are previously reported (phenotypes only) but unable to match patients across papers with confidence)

      SupplementalData: Supplementary Table 1.

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

      LegacyVariant: c.712C>T

      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: A point mutation (c.712C>T) was found. Being that this variant is out of bound with respect to the NM_000551.3 reference sequence, it was concluded that this variant is noted in the Latif et al. (1993) reference and was translated to c.499C>T (NM_000551.3).

      MutationType: missense_variant;transition

      CivicName: R167W (c.499C>T)

      MultipleGeneVariants: N/A

    1. GroupID: 36

      DiseaseAssertion: assumed VHL

      GroupSize: 4

      GroupNumberMales: N/A

      GroupNumberFemales: N/A

      GroupEthnicity: N/A

      GroupAgeRange: N/A

      GroupInfo: 4 of the 573 patients discussed in this paper were found to have the following mutation belonging to 3 families altogether.

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

      GroupHPOFreeText: all 4 patients had retinal angiomas diagnosed at a mean age of 30Y and cerebellar hemangioblastomas diagnosed with a mean age of 25Y, and 2 had RCC diagnosed at a mean age of 29Y

      GroupNotHPOs: HP:0002666 (pheochromocytoma)

      GroupNotHPOFreeText: N/A

      GroupPreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: Supplementary Table S1.

      Variant: p.Y185* (c.555C>G)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 223233 https://www.ncbi.nlm.nih.gov/clinvar/variation/223233/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: stop_gained

      CivicName: Y185* (c.555C>G)

      MultipleGeneVariants: N/A

    1. Of 246 patients affected with von Hippel-Lindau disease, 64 patients (26%) from 38 families had pheochromocytoma, including 33 newly diagnosed during screening studies and 31 treated before screening at NIH. Germline mutations in the VHL gene was determined from peripheral blood. Family 6101 was found with p.Tyr112His mutation in the VHL gene (legacy notation c.547T>C converted to NM_000551.3): one patient was in this family with pheochromocytoma, and retinal angioma. No other family information was provided.

    2. GroupID: 6102

      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: 1/3 members with pheochromocytoma, 3/3 members with CNS hemangioblastoma, 3/3 members with retinal angioma and 2/3 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.G114R (c.340G>C)

      LegacyVariant: c.553G>C

      CaseProblemVariantFreeText: N/A

      ClinVarID: 223193, https://www.ncbi.nlm.nih.gov/clinvar/variation/223193/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: Variant reported as 553, G to C (Gly to Arg), assumed to be reported in legacy nomenclature (AF010238.1) and mapped to c.340G>C, p.Gly114Arg (NM_000551.3).

      MutationType: missense_variant;transversion

      CivicName: G114R (c.340G>C)

      MultipleGeneVariants: N/A

    1. PatientID: V64

      KindredID: V64

      Case: Sex Unknown, Age Unknown, French

      DiseaseAssertion: VHL

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Diagnosed with VHL Type 1.

      CaseNotHPOs: HP:0002666 (Pheochromocytoma)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.E73* (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: missense_variant;transition; stop_gained

      CivicName: E73* (c.217C>T)

      MultipleGeneVariants: N/A

    2. PatientID: V265

      KindredID: V265

      Case: Sex Unknown, Age Unknown, French

      DiseaseAssertion: VHL

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Diagnosed with VHL Type 1.

      CaseNotHPOs: HP:0002666 (Pheochromocytoma)

      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. III 10 26 6 PC (15 years) 1 retinal hb (16 years) T c.1-?_340 + ?del

      PatientID: III

      KindredID: 17

      Case: Sex Unknown, 26Y0M, Danish

      DiseaseAssertion: VHL

      FamilyInfo: 2 other family members were found to have this VHL variant. Patient 17-I was asymptomatic. Patient 17-II presented with CNS hemangioblastoma (8Y).

      CasePresentingHPOs: HP:0009711; HP:0001737 (Retinal capillary hemangioma, Pancreatic cysts)

      CaseHPOFreeText: Diagnosed with VHL at age 10Y. Presented with 6 pancreatic cysts (15Y) and retinal hemangioblastoma (16Y). Age at the end of study: 26Y.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: Exon 1 Deletion (c.1-?_340+?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 1 Deletion

      MultipleGeneVariants: N/A

    2. 7 I 4 40 3 retinal hb (8 + 16 years) M c. 499 C > T (p.Arg167Trp)

      PatientID: I

      KindredID: 7

      Case: Sex Unknown, 40Y0M, Danish

      DiseaseAssertion: VHL

      FamilyInfo: One other family member presented with this variant and was asymptomatic.

      CasePresentingHPOs: HP:0009711 (Retinal capillary hemangioma)

      CaseHPOFreeText: Diagnosed with VHL at age 4Y. presented with 3 retinal hemangioblastomas (8Y, 16Y). Age at the end of study: 40Y.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      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

    1. Genetic Aspects Here, the 3 described cases of ELST were associated with VHL disease. This autosomal-dominant inherited disease is known to be related to a germline mutation in the tumor suppressor gene VHL that has been mapped to chromosome 3p25. The VHL gene encodes a protein (pVHL) that plays an important role in tumor angiogenesis, accounting for the hypervascular pattern of the VHL-related tumors (4). Analysis of our series of cases underlines the interest of a VHL genetic testing, which allows 1) to identify VHL disease in the absence of family history in front of an isolated lesion; 2) in the case of a positive test, to complete imaging and ophthalmologic evaluation and to manage regular and prolonged follow-up to detect early asymptomatic tumors; 3) to propose a familial presymptomatic genetic testing in first relatives and a specific follow-up only for the positive mutation carriers; and 4) conversely, to reassure negative mutation carriers.

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

      GenotypingMethod: N/A

      SamplingMethod: N/A

    1. This 51-year-old male first presented for workup of headaches and a family history of VHL. He was found to have three cerebellar hemangioblastomas (two left-sided cerebellar hemangioblastomas (LHB1, LHB2) and one right-sided cerebellar hemangioblastoma (RHB1), two supratentorial hemangioblastomas (right frontal, suprasellar), and multiple spinal HBs including a large left C7-T1 lesion (C7T1), a T5 (T5), right and left sided T11 lesions (RT11, LT11), L2-3 lesion (L23), and multiple small nerve root lesions of the cauda equine consistent with CNS HBs.The patient underwent urgent resection of the largest cerebellar lesion (LHB1) for obstructive hydrocephalus. Following, an oncologic workup was performed, which revealed bilateral RCC (grade III clear cell) requiring total right and partial left sided nephrectomies, pheochromocytoma requiring adrenalectomy, and a pancreatic neuroendocrine tumor. A clinical diagnosis of VHL was made, and genetic testing confirmed a genetic mutation of p.R167Q consistent with VHL.

      PatientID: None

      KindredID: 1

      Case: M,53Y0M, Ethnicity Unknown

      DiseaseAssertion: VHL

      FamilyInfo: The patient had a family history of VHL.

      CasePresentingHPOs: HP:0006880, HP:0009713, HP:0010797, HP:0000238,HP:0005584, HP:0032241, HP:0030405, HP:0002666 (cerebellar hemangioblastoma, spinal hemangioblastoma, hemangioblastoma, Hydrocephalus, renal cell carcinoma, Cervical neoplasm, pancreatic endocrine tumour, pheochromocytoma)

      CaseHPOFreeText: At age 51, he was found to have three cerebellar hemangioblastomas (two left-sided cerebellar hemangioblastomas (LHB1, LHB2) and one right-sided cerebellar hemangioblastoma (RHB1), two supratentorial hemangioblastomas (right frontal, suprasellar), and multiple spinal HBs including a large left C7-T1 lesion (C7T1), a T5 (T5), right and left sided T11 lesions (RT11, LT11), L2-3 lesion (L23), and multiple small nerve root lesions of the cauda equine consistent with CNS HBs. An oncologic workup revealed bilateral RCC (grade III clear cell), pheochromocytoma requiring adrenalectomy, and a pancreatic neuroendocrine tumor. The patient was subsequently started on Pazopanib. Twelve months following initiation of therapy, the C7T1 HB decreased in size from 14 mm to 12 mm as measured on post-contrast axial T1 MRI. Six months later, C7T1 was further decreased to 9.5 mm, resulting in an approximately 50% decreased volume from initiation of treatment and notably reducing the mass effect on the spinal cord. The L23 lesion also demonstrated reduced size during this time period, from 8 mm to 7.5 mm, while the remaining HBs and retroperitoneal lymph nodes remained stable or increased in size. Following 21 months of TKI therapy, the patient’s systemic disease was stable, and he was placed on a drug holiday. Six months following cessation of Pazopanib, many of the CNS HBs increased slightly, including the C7T1 lesion.

      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. GroupID: 49

      DiseaseAssertion: VHL

      GroupSize: 2

      GroupNumberMales: N/A

      GroupNumberFemales: N/A

      GroupEthnicity: French

      GroupAgeRange: N/A

      GroupInfo: 2 members of this family presented with the c.496G>T germline variant of the VHL gene. Member 2046 had no renal involvement. Member 1258 presented with mild renal disease. 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 (Renal neoplasm)

      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]).

      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 2 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.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

    2. GroupID: 21

      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.340G>C germline variant of the VHL gene. Members 1070 and 744 had unknown renal involvement. Member 742 presented with 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:0005584 (Renal cell carcinoma)

      GroupHPOFreeText: 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, where 2 individuals with this mutation are reported. It is unclear if one or both of these previously reported individuals correspond to members of the current family.

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

      Variant: p.G114R (c.340G>C)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 223193, https://www.ncbi.nlm.nih.gov/clinvar/variation/223193/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: Authors state that this mutation is predicted to disturb the splicing process.

      MutationType: missense_variant;transversion

      CivicName: G114R (c.340G>C)

      MultipleGeneVariants: N/A

    1. PatientID: 217

      KindredID: 81

      Case: F, 33Y0M, Chinese

      DiseaseAssertion: VHL

      FamilyInfo: The proband's brother had the same germline mutation, and presented with a CNS hemangioblastoma at 20, and a pheochromocytoma at 26. The proband's mother had a CNS hemangioblastoma at 35, however no genotyping information is available for her.

      CasePresentingHPOs: HP:0010797; HP:0005584; HP:0001737; HP:0001732 (Hemangioblastoma, Renal cell carcinoma, Pancreatic cysts, Abnormality of the pancreas)

      CaseHPOFreeText: The patient presented with a CNS hemangioblastoma at age 24, renal cell carcinoma at 32, and multiple pancreatic cysts/tumors at 33.

      CaseNotHPOs: HP:0009711; HP:0002666 (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.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

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

      PatientID: 1

      KindredID: A

      Case: F, Age unknown, Turkish

      DiseaseAssertion: VHL

      FamilyInfo: 5 family members are grouped with this deletion (ages 16-37Y; mean 31Y). VHL was clinically diagnosed in, at minimum, the proband. See Fig. 2 for family pedigree. The proband’s last two brothers were not tested for the DNA deletion however it is assumed by the authors due to the segregation observed.

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

      CaseHPOFreeText: N/A

      CaseNotHPOs: HP:0002666 (pheochromocytoma)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: Deletion of exons 1 and 2

      CaseProblemVariantFreeText: N/A

      LegacyVariant: N/A

      ClinVarID:N/A

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: HindIII and revealed an aberrant banding pattern in three affected family members (1, 2, and 9); Southern blot analysis after EcoR1 digestion, with the g7 probe and an internal control probe, demonstrated an extra band above the 20-kb normal fragment

      MutationType: exon_loss_variant

      CivicName: exon 1-2 deletion

      MultipleGeneVariants: N/A

    1. c.319C>G [p.Arg107Gly]

      PatientID: 7

      KindredID: 7

      Case: 55Y0M, Sex unknown, Chinese

      DiseaseAssertion: VHL

      FamilyInfo: Positive -- Their father and brother both had the same germline mutation. Their father was screened after genetic testing and found to have a left RCC with lung metastasis at age 80, and their brother was asymptomatic.

      CasePresentingHPOs: HP:0010797 (hemangioblastoma)

      CaseHPOFreeText: CNS hemangioblastoma first presenting at 55Y

      CaseNotHPOs: HP:0005584; HP:0002666; HP:0009715 (renal cell carcinoma, pheochromocytoma, Papillary cystadenoma of the epididymis)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

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

      CaseProblemVariantFreeText: N/A

      LegacyVariant: 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

    1. V#2exon 3c.485G > Ap.C162YCNS-HB

      PatientID: 2

      KindredID: 2

      Case: Sex Unknown, Age Unknown, Ethnicity Unknown

      DiseaseAssertion: VHL

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0010797 (hemangioblastoma)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: Yes

      Variant: p.C162Y (c.485G>A)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 223225, https://www.ncbi.nlm.nih.gov/clinvar/variation/223225/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant;transition

      CivicName: C162Y (c.485G>A)

      MultipleGeneVariants: N/A

    1. PatientID: None (Proband)

      KindredID: 108

      Case: M, 30Y0M, Spanish

      DiseaseAssertion: VHL

      FamilyInfo: Positive for familial antecedents. Family history of cerebellar hemangioblastoma.

      CohortInfo: Probands belonging to 18 unrelated Spanish VHL families carrying germline VHL deletions.

      CasePresentingHPOs: HP:0009711 (Retinal capillary hemangioma)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: Exon 1-3 Deletion (c.1-?_642+?del)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: N/A

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: Germline IRAK2 (unclear if partial or complete) and ENST197804 gene deletions. Loss of exons 2-3 of HSPC300. Study provides evidence to show that loss of HSPC300 highly correlates with the absence of ccRCC in VHL patients.

      MutationType: exon_loss_variant

      CivicName: Exon 1-3 Deletion

      MultipleGeneVariants: Germline, IRAK2, Deletion MultipleGeneVariants: Germline, ENST197804, Deletion MultipleGeneVariants: Germline, HSPC300, Exon 2-3 Deletion

    2. PatientID: None

      KindredID: 93

      Case: M, 31Y0M, Spanish

      DiseaseAssertion: VHL

      FamilyInfo: Positive for familial antecedents. Family history of renal cysts and clear cell renal cell carcinoma.

      CohortInfo: Probands belonging to 18 unrelated Spanish VHL families carrying germline VHL deletions.

      CasePresentingHPOs: HP:0006880 (Cerebellar hemangioblastoma)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      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: Germline HSPC300 retention. Study provides evidence to show that loss of HSPC300 highly correlates with the absence of ccRCC in VHL patients.

      MutationType: exon_loss_variant

      CivicName: Exon 3 Deletion

      MultipleGeneVariants: N/A

    1. PatientID: 356

      KindredID: 356

      Case: Sex Unknown, 54Y0M, Ethnicity Unknown

      DiseaseAssertion: VHL

      FamilyInfo: Family history is positive but no details provided.

      CasePresentingHPOs: HP:0010797; HP:0001732 (Hemangioblastoma, Abnormality of the pancreas)

      CaseHPOFreeText: CNS hemangioblastoma and pancreatic cyst or tumor.

      CaseNotHPOs: HP:0006770; HP:0002666; HP:0000107; HP:0009711 (Clear cell renal cell carcinoma, 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

    2. PatientID: 173

      KindredID: 173

      Case: Sex Unknown, 49Y0M, Ethnicity Unknown

      DiseaseAssertion: VHL

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0000107; HP:0001732; HP:0006770 (Renal cyst, Abnormality of the pancreas, Clear cell renal cell carcinoma)

      CaseHPOFreeText: Pancreatic cyst or tumor and clear cell renal cell carcinoma and renal cyst.

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

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished:N/A

      SupplementalData: Table S1, S2 and S3

      Variant: Partial Deletion (3kb)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: N/A

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: deletion

      CivicName: Partial deletion of 3kb

      MultipleGeneVariants: N/A

    1. VHL p.Ser139fs

      An international consortium of registered patients with head and neck paragangliomas with VHL or RET gene mutations were analyzed. Eleven of the 12 patients were found to carry germline mutations in theVHL gene. Blood was used for molecular genetic analyses and the NM_000551.2 reference sequence was used. The 26 year old female proband was found to harbour the p.Ser139fs mutation of the VHL gene. She had a family history of VHL and presented with lumbar pain. CT showed a right adrenal pheochromocytoma that was removed. Two years later, she had left nephrectomy for multiple renal cell carcinoma. At age 33, she presented with a lateral cervical mass associated with Horner’s syndrome and pain in the right ear. CT showed a 6cm carotid paraganglioma that was removed and histologically confirmed. At age 42, a cerebellar hemangioblastoma was removed. As the publication only provides the p., the mutation p.Ser139fs was not able to be matched to the exact mutation.

    1. The proband (Patient III‐1) was admitted into our ward in October 2015 with a complaint of an occipital headache for 1 month. He was conscious, and a physical examination did not reveal ataxia. Tests for cranial nerve function, limb sensation and motor function were unremarkable. Contrast‐enhanced brain magnetic resonance imaging (MRI) revealed a solid‐cystic mass in the vermis cerebelli and left cerebellar hemisphere (Figure ​(Figure2a),2a), indicating a radiological diagnosis of CH. Cerebellar tumor resection was performed through a sub‐occipital craniotomy under general anesthesia, and the tumor was completely removed. The tumor, which was 30 mm in diameter, was pink and soft and composed of dilated veins and dense blood capillaries. A postoperative pathological analysis of the tumor indicated a hemangioblastoma. The patient completed outpatient follow‐up in October 2018. The occipital headache had disappeared, brain MRI showed no recurrence, and abdominal computerized tomography (CT) revealed no neoplasms.

      PatientID: III-3

      KindredID: 1

      Case: M, 25Y0M, Ethnicity Unknown

      DiseaseAssertion: VHL

      FamilyInfo: Both of the patient’s uncles (Patient II-1 and II-4) were clinically diagnosed with VHL disease, and carried the mutation NM_000551.3:c.269A>T. Patient II-1 presented with RCCC at age 33 and cerebral hemangioblastoma at age 41. Patient II-4 presented with RCCC at age 53. The patient’s deceased father (Patient II‐3) and deceased aunt (Patient II‐5) were also clinically diagnosed with VHL disease, but the mutation was undetermined before death. His father died of advanced RCCC, and his aunt (Patient II‐5) died of a ruptured CH. The patient’s grandparents (Patient I-1 and I-2) were also deceased from other causes. The patient’s son (Patient IV‐1), wife (Patient III‐2), and mother (Patient II‐2) were healthy and did not carry the mutation. Their annual physical examination did not reveal a hemangioblastoma, kidney mass or abdominal cyst.

      CasePresentingHPOs: HP:0006880 (Cerebellar hemangioblastoma)

      CaseHPOFreeText: The 25Y male patient presented with occipital headache at 21Y. Upon initial examination, the patient was diagnosed with cerebellar hemangioblastoma and the tumour was resected. The patient completed outpatient follow‐up three years later. The occipital headache had disappeared, brain MRI showed no recurrence, and abdominal CT revealed no neoplasms.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

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

      LegacyVariant: N/A

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

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant;transversion

      CivicName: N90I(c.269A>T)

      MultipleGeneVariants: N/A

    1. In our study, group 5 represented the c.262T > C p.Trp88Arg mutation that included 21 patients from 2 families (Figure 4 and Table 3). Variability was observed in the mean age at onset for CHB and RCC, which were 41.1 ± 9.1 (range = 29–62) and 37.4 ± 12.9 (range = 23–65), respectively.

      PatientID: 3

      KindredID: 2 (group ID 5)

      Case: M, 52Y0M, Chinese

      DiseaseAssertion: assumed VHL

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

      FamilyInfo: In family 2, 4 members were described in a 3 generation family. The patient’s father, sister, and niece were also present with the VHL mutation. See Fig 4 for family pedigree; Table 3 for details.

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

      CaseHPOFreeText: CNS hemangioblastoma and pheochromocytoma both presented at age of onset of 50Y

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

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

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 496053 https://www.ncbi.nlm.nih.gov/clinvar/variation/496053/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant;transition

      CivicName: W88R (c.262T>C)

      MultipleGeneVariants: N/A

    2. In our study, group 5 represented the c.262T > C p.Trp88Arg mutation that included 21 patients from 2 families (Figure 4 and Table 3). Variability was observed in the mean age at onset for CHB and RCC, which were 41.1 ± 9.1 (range = 29–62) and 37.4 ± 12.9 (range = 23–65), respectively.

      PatientID: 8

      KindredID: 1 (group ID 5)

      Case: M, 48Y0M, Chinese

      DiseaseAssertion: assumed VHL

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

      FamilyInfo: In family 1, 17 members were described. The first generation describes 5 members with the VHL mutation, each passing on the gene to further generations. Patient 8’s father and sister had this familial mutation. His one son had not been yet tested at the time of the study. See Fig 4 for family pedigree; Table 3 for details.

      CasePresentingHPOs: HP:0010797 (hemangioblastoma)

      CaseHPOFreeText: He had CNS hemangioblastomas at 40Y

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

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

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 496053 https://www.ncbi.nlm.nih.gov/clinvar/variation/496053/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant;transition

      CivicName: W88R (c.262T>C)

      MultipleGeneVariants: N/A

    1. PatientID: None (Daughter)

      KindredID: 1

      Case: F, Age Unknown, Ethnicity Unknown

      DiseaseAssertion: Asymptomatic

      FamilyInfo: Maternal grandmother had cerebral vascular lesions. Mother presented with retinal capillary hemangioma, photophobia, macular thickening, vitreomacular traction, retinal exudate, retinal vascular proliferation, tractional retinal detachment and a 151 nucleotide deletion of the VHL gene.

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: Partial Deletion

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: N/A

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: 151 nucleotide deletion in exon 1.

      MutationType: deletion

      CivicName: NULL (PARTIAL DELETION OF EXON 1)

      MultipleGeneVariants: N/A

    1. PatientID: ccRCC-159

      KindredID: 159

      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 56.

      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. MRI of the brain of the patient's brother (II-3) indicated a nodule in the left cerebellar tonsil with a size of ~9.0×10.5 mm, which indicated the presence of a hemangioblastoma, astrocytoma or ependymoma. However, the diagnosis could not be confirmed. Therefore, patient II-3 was regarded as a carrier of the mutant gene.

      PatientID:II-3

      KindredID: 2

      Case: M, Sex Unknown, Chinese

      DiseaseAssertion:Asymptomatic

      FamilyInfo: The mother of the patient (I-2) was deceased, and the cause was unknown. The mother exhibited a brain tumor and coronary heart disease whilst alive. Multiple nodules were detected in the thyroid gland of the patient's eldest sister (II-1), but were not treated. Another sister (II-2) also had the mutation but was asymptomatic. See Figure 2 for pedigree.

      CasePresentingHPOs: N/A

      CaseHPOFreeText: MRI of the brain of the patient's brother (II-3) indicated a nodule in the left cerebellar tonsil with a size of ~9.0×10.5 mm, which indicated the presence of a hemangioblastoma, astrocytoma or ependymoma. However, the diagnosis could not be confirmed.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      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: 55

      KindredID: 55

      Case: F, 44Y0M, Korean

      DiseaseAssertion: VHL

      FamilyInfo: Family history positive for VHL. No further details provided.

      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. 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; HP:0005584 (Pheochromocytoma, Retinal capillary hemangioma, Renal cell carcinoma)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: 19270817

      SupplementalData: N/A

      Variant: Exon 1-3 Deletion (c.1-?_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 1-3 Deletion

      MultipleGeneVariants: N/A

    2. PatientID: 43

      KindredID: 43

      Case: M, 30Y0M, 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:0002666; HP:0009711 (Pheochromocytoma, Retinal capillary hemangioma)

      CaseHPOFreeText: Multiple or bilateral pheochromocytoma. Other phenotypes presented but not specified (one or more of: pancreatic cyst or tumor, renal or hepatic cyst). Diagnosed with VHL Type 2A. Phenotypes revised from previous reports (see “PreviouslyPublished” section below for PMID).

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

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: 19949673

      SupplementalData: N/A

      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

      VariantEvidence: N/A

      MutationType: missense_variant;transition

      CivicName: R167W (c.499C>T)

      MultipleGeneVariants: N/A

    1. PM 28 31 F ? ? ? - - - - VHL FLD – BRK1, FANCD2

      PatientID: 28

      KindredID: PM

      Case: F, 31Y0M, Indian

      DiseaseAssertion: VHL

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0010797; HP:0001737 (Hemangioblastoma, Pancreatic cysts)

      CaseHPOFreeText: CNS hemangioblastoma and multi-cystic pancreatic lesions.

      CaseNotHPOs: HP:0030393; HP:0009711; HP:0002666; HP:0005584 (Endolymphatic sac tumor, Retinal capillary hemangioma, Pheochromocytoma, Renal cell carcinoma)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: Complete Deletion

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: N/A

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: This variant is noted as a full-length deletion involving genes BRK1 and FANCD2.

      MutationType: deletion

      CivicName: Deletion

      MultipleGeneVariants: N/A

    1. All germline mutations in VHL,

      PatientID: V-PH-05T

      KindredID: 3

      Case: F, 27Y0M, Ethnicity Unknown

      DiseaseAssertion: assumed VHL

      FamilyInfo: No familial cancers/syndromic illnesses

      CasePresentingHPOs: HP:0002666; HP:0009711 (pheochromocytoma, retinal capillary hemangioma)

      CaseHPOFreeText: diagnosed with recurrent phaeochromocytoma at age 12Y, surgery at 27Y. She also had a personal history of angioma of the right eye, laparotomy & numerous thyrocotomies, and a history of hypertension. Presence of elevated catecholamines, but no further details.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: RET, SDHA, SDHB, SDHC, TMEM127

      PreviouslyPublished: 26796762

      SupplementalData: Yes (see table S1 and S10)

      Variant: p.T157I (c.470C>T)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: Stated as ENSP00000256474.2:p.Thr157Ile

      ClinVarID: 223223 https://www.ncbi.nlm.nih.gov/clinvar/variation/223223/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant;transition

      CivicName: T157I (c.470C>T)

      MultipleGeneVariants: Germline, SDHA, c.113A>T (p.Asp38Val)

    1. We identified deletions ranging from 0.5 kb to 250 kb affecting part of or the entire VHL and flanking genes in 54 families.

      GroupID: 49

      DiseaseAssertion: VHL

      GroupSize: N/A GroupNumberMales: N/A GroupNumberFemales: N/A GroupEthnicity: N/A GroupAgeRange: N/A

      GroupInfo: 54 VHL deletion families from the Freiburg registry were selected in order to assist in the correlation of VHL deletions to clinical phenotypes.

      GroupPresentingHPOs: HP:0000107; HP:0010797; HP:0009713; HP:0001737 (Renal cyst, Hemangioblastoma, Spinal hemangioblastoma, Pancreatic cysts)

      GroupHPOFreeText: # of affected individuals: Renal cyst (1), Hemangioblastoma/brain/cerebellum (4), Spinal hemangioblastoma (3), Pancreatic cysts (2)

      GroupNotHPOs: N/A

      GroupNotHPOFreeText: N/A

      GroupPreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: Supplemental Table 2, Table 1, Table 3

      Variant: Exon 1-3 Deletion (c.1-?_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 1-3 Deletion

      MultipleGeneVariants: Germline, FANCD2, partial deletion

      MultipleGeneVariants: Germline, IRAK2, deletion

    1. 221519N—N—NNYYNc.481C>T

      PatientID: 22

      KindredID: 15

      Case: Sex Unknown, 19Y0M, Brazilian (Latino/Admixed American)

      DiseaseAssertion: VHL

      FamilyInfo: none

      CasePresentingHPOs: HP:0010797; HP:0001737 (hemangioblastoma, pancreatic cyst)

      CaseHPOFreeText: N/A

      CaseNotHPOs: HP:0002668, HP:0002666; HP:0009711; HP:0030405; HP:0005584; HP:0000107 (Paraganglioma, pheochromocytoma, retinal capillary hemangioma, pancreatic endocrine tumor, renal cell carcinoma, renal cyst)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

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

      CaseProblemVariantFreeText: N/A

      LegacyVariant: N/A

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

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: stop_gained

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

      MultipleGeneVariants: N/A

    2. 10412Y12Y13NNNNNc.500G>AExon 3p.Arg167GlnMissense

      PatientID: 10

      KindredID: 4

      Case: M, 13Y0M, Ethnicity Unknown

      DiseaseAssertion: VHL

      FamilyInfo: Four other family members were found to have the same mutation (Patients 6,7,8,9).

      CasePresentingHPOs: HP:0002668, HP:0002666, HP:0030405 (Paraganglioma, pheochromocytoma, pancreatic endocrine tumor)

      CaseHPOFreeText: The patient was diagnosed with a pancreatic endocrine tumor at age 13 it was found to be 0.7cm in size. He was diagnosed with pheochromocytoma and paraganglioma at age 12. He was found to have a right side pheochromocytoma measuring 5.5 cm and a left side pheochromocytoma measuring 1.5 cm. He was also found to have a paraganglioma measuring 2.2 cm.

      CaseNotHPOs: HP:0009711, HP:0001737, HP:0000107, HP:0005584, HP:0010797 (retinal capillary hemangioma, pancreatic cysts, renal cyst, renal cell carcinoma, hemangioblastoma)

      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

    1. 3Deletion

      PatientID: unknown (sister)

      KindredID: 13

      Case: F, 30Y0M, Chinese

      DiseaseAssertion: VHL

      FamilyInfo: the patient’s brother was found with hemangioblastomas, RCC, and multiple pancreatic cysts or tumors at 23Y, and retinal angiomas at 24Y. Their mother was found at 43Y with CNS hemangioblastomas, however she died before diagnosis; no DNA sample was available.

      CasePresentingHPOs: HP:0010797; HP:0005584; HP:0001737 (hemangioblastoma; renal cell carcinoma; pancreatic cysts)

      CaseHPOFreeText: patient had hemangioblastomas, RCC, and multiple pancreatic cysts or tumors diagnosed at 30Y

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: exon 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 3 deletion

      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: II-2

      KindredID: 1

      Case: F, 58Y0M, 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. This patient’s 3 siblings had the mutation, 2 of her sons, and 3 grandchildren, and more. See Fig. 1 for detailed family pedigree.

      CasePresentingHPOs: HP: 0006748; HP:0005584; HP:0001737; HP:0030405 (adrenal pheochromocytoma, renal cell carcinoma, pancreatic cysts, pancreatic endocrine tumor)

      CaseHPOFreeText: Right adrenal nonfunctional pheochromocytoma; right renal cell carcinoma; Pancreatic serous cystadenoma (with a 7.3 cm tumor at 55Y), and this patient was reoperated 3 years later due to a pancreatic neuroendocrine tumor.

      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. X214T one case (female)

      PatientID: None

      KindredID: 4

      Case: F, 32Y0M, Ethnicity Unknown

      DiseaseAssertion: Assumed VHL

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0002666; HP:0001737 (Pheochromocytoma, pancreatic cyst)

      CaseHPOFreeText: The patient presented with pheochromocytoma and pancreatic cysts. The age of diagnosis was not specified.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: p.*214Trpt*14(c.642A>G)

      LegacyVariant: N/A

      ClinVarID: 625269, http://www.ncbi.nlm.nih.gov/clinvar/variation/625269

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: stop_loss

      CivicName: *214Trpt*14(c.642A>G)

      MultipleGeneVariants: N/A

    1. Germline DNA was extracted from leukocytes according to standard protocols. Tumor samples were powdered in liquid nitrogen (30–50 mg for DNA extraction and 20–30 mg for RNA extraction). Tumor DNA was extracted using a QIAamp DNA mini kit or an AllPrep kit (Qiagen). RNAs were extracted using an RNeasy mini kit (Qiagen), analyzed by electrophoresis on a Bioanalyser 2100 (Agilent Technologies) and quantified using a NanoDrop ND-1000 spectrophotometer (Labtech). Stringent criteria for RNA quality were applied to rule out degradation, especially a 28S/18S ratio above 1.5. Genetic testing NF1 diagnosis was based on clinical criteria. Mutation analysis for RET, VHL, SDHB, SDHC and SDHD genes was performed by direct sequencing of germline DNA for each patient. When direct sequencing was negative, VHL, SDHB, SDHC and SDHD were also analyzed for the presence of large deletions using the MLPA (SALSA MLPA P016® version C1 for VHL and SALSA MLPA P226® version B1 for SDHx, MRC Holland, The Netherlands) method as described previously (44). Mutation analyses for SDHA and TMEM127 were performed retrospectively by direct sequencing and were limited to patients whose tumor presented a LOH assessed by BAC array CGH at the corresponding locus (5p15 for SDHA and 2q11 for TMEM127) (7,52). As mutations in the SDHAF2 gene were only described in patients with familial head and neck paragangliomas, we did not systematically analyze the SDHAF2 gene in this study. Mutation analysis for SDHAF1, IDH1 and IDH2 genes was performed by direct sequencing in candidate tumor samples.

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

      GenotypingMethod: Direct sequencing, if negative, VHL, SDHB, SDHC and SDHD were also analyzed for the presence of large deletions using the MLPA (SALSA MLPA P016® version C1 for VHL and SALSA MLPA P226® version B1 for SDHx, MRC Holland, The Netherlands).

      SamplingMethod: leukocytes and tissue resection

    1. 6 Deletion Deletion of exon 2 1 0

      GroupID: 6

      DiseaseAssertion: VHL

      Group size: 1

      GroupNumberMales: N/A

      GroupNumberFemales: N/A

      GroupEthnicity: N/A

      GroupAgeRange: N/A

      Group Info: Retrospective analysis of a longitudinal cohort of 21 VHL germline mutation carriers and retinal haemangioblastomas. All patients were categorized in two genotypic categories: missense mutations and truncating mutations. 

      GroupPresentingHPOs: HP:0009711 (retinal capillary hemangioma)

      GroupHPOFreeText: This patient presented with retinal capillary hemangioma.

      GroupNotHPOs: N/A

      GroupNotHPOFreeText: N/A

      GroupPreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: Table S1

      Variant: Exon 2 deletion

      CaseProblemVariantFreeText: N/A

      LegacyVariant: N/A

      ClinVarID: N/A

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: Chr3(GRCh37): g.10184170_10189331del c.341-4028_463+1011del5162

      MutationType: deletion

      CivicName: Exon 2 deletion

      MultipleGeneVariants: N/A

    1. MSon1c.208G > Ap.Glu70Lys–––––––14, 19

      PatientID: Son

      KindredID: 3

      Case: M, Age Unknown, Korean

      DiseaseAssertion: Asymptomatic

      FamilyInfo: Mother presented with the same VHL mutation and bilateral retinal hemangioblastoma at 46Y. Since his aunt also had suffered from RHB, the mutation was considered to be passed down from his maternal grandparents.

      CohortInfo: Thirteen unrelated patients with germline VHL mutations who were diagnosed with VHL disease were evaluated.

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: HP:0002666; HP:0010797; HP:0005584; HP:0001732; HP:0000107; HP:0009711 (Pheochromocytoma, Hemangioblastoma, Renal cell carcinoma, Abnormality of the pancreas, Renal cyst, Retinal capillary hemangioma)

      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

    1. 15PExon 3Missensec.500G>Ap. Arg167GlnPPGL, Metastatic PanNET

      PatientID: 15

      KindredID: 10

      Case: Sex Unknown, Age Unknown, Ethnicity Unknown

      DiseaseAssertion: VHL

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0002668; HP:0030405 (paraganglioma, pancreatic endocrine tumor)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: MEN1/ RET

      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. 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: Immunohistochemistry was performed as previously described on resected tumour using the P-16 polyclonal antibody to TFE (Santa Cruz Biotechnology, Santa Cruz, CA). Fresh tissue was sent to the Emory Cytogenetics Laboratory (Atlanta, GA) for karyotyping. Peripheral blood was sent to the DNA Diagnostic Laboratory of Johns Hopkins School of Medicine (Baltimore, MD), for sequence analysis of the VHL gene.

      SamplingMethod: peripheral blood, tissue resection

    1. c. 470C > T

      PatientID: None

      KindredID: 11

      Case: age, sex, ethnicity unknown

      DiseaseAssertion: Unknown

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Described as a positive control but not stated anything further

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: Likely previously published - not clear where the controls came from/ how they were used.

      SupplementalData: N/A

      Variant: p.T157I (c.470C>T)

      CaseProblemVariantFreeText: N/A

      LegacyVariant: N/A

      ClinVarID: 223223 https://www.ncbi.nlm.nih.gov/clinvar/variation/223223/

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant; transition

      CivicName: T157I (c.470C>T)

      MultipleGeneVariants: N/A

    1. GroupID: 11

      DiseaseAssertion: VHL

      GroupSize: 4

      GroupNumberMales: N/A

      GroupNumberFemales: N/A GroupEthnicity: Japanese GroupAgeRange: N/A

      GroupInfo: The 4 patients are grouped based on both having the same mutation. They are unrelated to one another.

      GroupPresentingHPOs: HP:0010797 (Hemangioblastoma)

      GroupHPOFreeText: 4/4 patients in this group presented with CNS hemangioblastoma.

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

      GroupNotHPOFreeText: N/A

      GroupPreviousTesting: N/A

      PreviouslyPublished: 10761708

      SupplementalData: N/A

      Variant: p.C162Y (c.485G>A)

      LegacyVariant: p.C233Y (c.698G>A)

      CaseProblemVariantFreeText: N/A

      ClinVarID: 43604, https://www.ncbi.nlm.nih.gov/clinvar/variation/43604/

      CAID: N/A

      gnomAD: 0.000003977, https://gnomad.broadinstitute.org/variant/3-10191492-G-T?dataset=gnomad_r2_1

      VariantEvidence: Nucleotide deletion (i.e. 698G>A) coincides with legacy variant nomenclature (i.e. AF010238.1) and was mapped to c.485G>A (NM_000551.3).

      MutationType: missense_variant;transition

      CivicName: C162Y (c.485G>A)

      MultipleGeneVariants: N/A

    2. 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. 697T>C) which coincides with legacy variant nomenclature (AF010238.1) and was mapped to c.484T>C (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 4 had a C162R (c.484T>C) mutation. 2 members were affected: both had RCC, 1 had retinal angioma, and 1 had CNS Hb. We were not able to determine which member had more than one phenotype. Other demographics of the members were not described.

    3. GroupID: 8

      DiseaseAssertion: VHL

      GroupSize: 5

      GroupNumberMales: N/A

      GroupNumberFemales: N/A GroupEthnicity: Japanese GroupAgeRange: N/A

      GroupInfo: The 5 patients are grouped based on both having the same mutation. They are unrelated to one another.

      GroupPresentingHPOs: HP:0005584 (Renal cell carcinoma)

      GroupHPOFreeText: 5/5 patients in this group presented with RCC.

      GroupNotHPOs: HP:0009711; HP:0010797; HP:0002666 (Retinal capillary hemangioma, Hemangioblastoma, Pheochromocytoma)

      GroupNotHPOFreeText: N/A

      GroupPreviousTesting: N/A

      PreviouslyPublished: 10761708

      SupplementalData: N/A

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

      LegacyVariant: p.W159S (c.476G>C)

      CaseProblemVariantFreeText: N/A

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

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: Nucleotide deletion (i.e. 476G>C) coincides with legacy variant nomenclature (i.e. AF010238.1) and was mapped to c.263G>C (NM_000551.3).

      MutationType: missense_variant;transversion

      CivicName: W88S (c.263G>C)

      MultipleGeneVariants: N/A

    1. three familial cases

      PatientID: 7

      KindredID: C

      Case: M, Age Unknown, Japanese

      DiseaseAssertion: Asymptomatic

      FamilyInfo: This mutation was found in a family of 10 individuals; six were found to carry the mutation NM_000551.3:c.464-1G>T the patient carried, and three presented with symptoms. They were identified with hemangioblastomas of the central nervous system and retinal angiomas. The eldest patient also had renal cell carcinoma (patient C-1).

      CasePresentingHPOs: N/A

      CaseHPOFreeText: The paper states this case was not yet symptomatic, suggesting they may be too young to show symptoms yet

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: (c.464-1G>T)

      LegacyVariant: (c.677-1G>T)

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

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: splice_site_variant

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

      MultipleGeneVariants: N/A

    1. a blood DNA analysis was given and identified a well-known pathogenic VHL mutation c.239G>T; p.(Ser80Ile), which is associated with a severe phenotype

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

      GenotypingMethod: Sanger sequencing of the VHL gene.

      SamplingMethod: Blood.

    1. A 39-year-old man with molecularly confirmed VHL disease presented with epistaxis in 2012. Molecular analysis had confirmed a germline VHL mutation in 2004. He had previously undergone excision of cerebellar haemangioblastoma in 2003. He had also undergone bilateral nephron sparing surgery for ccRCC (stage pT1a, Fuhrman grade up to 3) in 2005 and renal radiofrequency ablation in both 2008 and 2012. CT imaging demonstrated an ethmoid mass measuring 35 × 34 × 44 mm. The patient underwent endoscopic transsphenoidal resection of the lesion. Staging investigations were negative for metastatic disease.Two years later, in 2014, the patient developed symptoms of nasal obstruction. Sinonasal tumour recurrence was suspected. Imaging demonstrated limited progression in the nasal cavity. Excision biopsy was performed. Histology appeared consistent with the initial presenting sinonasal tumour. Excision appeared complete, with no evidence of residual tumour. Subsequently, symptoms recurred. Therapeutic excision was performed in 2015 and again in 2016. To date, the patient's VHL disease remains stable with no evidence of new lesions or metastatic disease.The patient remained under the management of specialist multidisciplinary (MDT) team which coordinated regular imaging surveillance and clinical review. The MDT recommended regular magnetic resonance imaging (MRI) surveillance with localised resection as applicable. More extensive surgery or adjuvant therapy was not felt to be indicated.

      PatientID: None

      KindredID: 1

      Case: M, 39Y0M, Ethnicity Unknown

      DiseaseAssertion: VHL

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0006880, HP:0005584; HP:0030072 (Cerebellar hemangioblastoma, clear cell renal cell carcinoma, Paranasal sinus neoplasm)

      CaseHPOFreeText: Previously undergone excision of cerebellar haemangioblastoma in 2003. He had also undergone bilateral nephron sparing surgery for ccRCC (stage pT1a, Fuhrman grade up to 3) in 2005 and renal radiofrequency ablation in both 2008 and 2012. CT imaging demonstrated an ethmoid mass measuring 35 × 34 × 44 mm. The patient underwent endoscopic transsphenoidal resection of the lesion in 2012. Two years later, in 2014, sinonasal tumour recurrence was suspected and imaging demonstrated limited progression in the nasal cavity. Excision biopsy was performed and appeared complete, with no evidence of residual tumour. Subsequently, symptoms recurred. Therapeutic excision was performed in 2015 and again in 2016. To date, the patient's VHL disease remains stable with no evidence of new lesions or metastatic disease.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: Exon 1 Deletion (c.1-?_340+?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 1 Deletion and c.341-50G>A

      MultipleGeneVariants: Somatic, VHL, c.341-50G>A

    1. Sanger sequencing and MLPA for mutation screeningWhole blood is taken from the patient's venous circulation and stored at 4 °C. Subsequently 200 µl of whole blood are used for genomic DNA extraction using the QIAsymphony CDN Kit, QIAsynphony SP (Qiagen, Hilden, Germany), which allows to obtain the eluted DNA ready for use. In short, the extraction procedure is divided into various steps starting with a lysis, where lysate and magnetic particles are transferred in the sample preparation cartridge, subsequently DNA binds to magnetic particles, and then two separation steps follow magnetic interspersed with a wash to arrive at the release of the eluate. The DNA quality and quantity were measured with a Qubit ds assay on Qubit 2.0 Fluorometer (Thermo Fisher Scientific, Monza, Italy). When we searched for germline mutations of the VHL gene, the coding regions and exon-intron boundaries were amplified by PCR: 100 ng of DNA was PCR-amplified using the forward and revers primers located at exon-intron boundaries, performed in standard reaction conditions with an initial denaturation at 95 °C for 5 min followed by 30 cycles each composed of 1 min at 95 °C, 30 s at 58 °C, 30 s at 72 °C, and a final extension of 7 min at 72 °C. Total PCR products were than purified using a PCR purification kit (Qiagen, Milan, Italy). To perform the cycle-sequencing reaction, 5 ng of DNA were then blended with each primer (0.8 µM) in a terminator ready reaction mix containing big dye terminators (Applied Biosystems, Thermo Fisher Scientific) and submitted to 1 minute at 96 °C and 25 cycles at 96 °C for 10 s, 50 °C for 5 s, 60 °C for 4 min. A second purification step was necessary for the big dye removal with DyeEx 2.0 Spin Kit (Qiagen). Five µl of marked and purified DNA were submitted to sequencing analysis with ABI PRISM 310 Genetic Analyser (Applied Biosystems). Subsequently we searched eventual genomic rearrangements using the MLPA test (multiplex ligation-dependent probe amplification/MRC Holland, SALSA Kit P016-C2 VHL version C2) approach. For analysis of MLPA data we used Coffalyser.Net software (MRC, Holland, Netherlands). Analysis of variant by querying different databases i.e. Clinvar-NCBI-NIH and Intervar (Clinical Interpretation of genetic variants by ACMG/AMP 2015 guideline) allowed us to classify the variant [14].

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

      GenotypingMethod: PCR amplification of the coding regions and exon-intron boundaries followed by Sanger sequencing

      SamplingMethod: Whole blood

    1. PatientID: V-17

      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 (Pheochromocytoma, Paraganglioma)

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

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

      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. Molecular analysisGenomic DNA was isolated from peripheral blood samples with ethylenediaminetetraacetic acid tetrasodium salt dihydrate (EDTA) of the patients by using EZ1 DNA Investigator Kit (Qiagen, Hilden, Germany). Primary quality control of the isolated DNA samples was performed using NanoDrop (Thermo Fisher Scientific, Waltham, MA), and samples having A260/280 values between 1.8 and 2.0 were included in the study.QIAseq Targeted DNA Panel (Qiagen, Hilden, Germany) was performed to analyze six genes (KIF1B, RET, SDHB, SDHD, TMEM127, and VHL). Libraries were prepared according to the manufacturer’s instructions. Quality control of the prepared libraries was applied with Qubit dsDNA BR Assay system (Invitrogen, Carlsbad, CA). Fastq files were performed on Illumina NextSeq550 (Illumina Inc., San Diego, CA, ABD). Libraries covering the target genes were prepared according to the QIAseq Targeted DNA Panel protocol (Qiagen, Hilden, Germany). Following the target enrichment process, libraries were sequenced on the Illumina NextSeq550 (Illumina Inc., San Diego, CA, ABD). QCI analysis (Qiagen, Hilden, Germany) was used for Quality control and ordering Variant Call Format file. Variant analysis was performed with Ingenuity software (Qiagen, Hilden, Germany).For verifying the variants and segregation analysis, primers were designed for all needed regions, and Sanger sequencing was performed using an ABI 3130 (Applied Biosystems, USA) capillary electrophoresis system.

      ArticleReferenceSequence: NM_000551.4

      GenotypingMethod: Next-generation sequencing method was explored; Sanger sequencing was used for verifying the variants.

      SamplingMethod: peripheral blood

    1. missense variants

      PatientID: 31

      KindredID: 31

      Case: Sex Unknown, Age Unknown, Ethnicity Unknown

      DiseaseAssertion: VHL

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0010797; HP:0009711; HP:0100634 (hemangioblastoma, retinal capillary hemangioma, neuroendocrine neoplasm)

      CaseHPOFreeText: N/A

      CaseNotHPOs: HP:0006770; HP:0030405; HP:0030421 (clear cell renal cell carcinoma, pancreatic neuroendocrine neoplasm, Epididymal neoplasm)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: 29437867 (Family 1 - see here for more info)

      SupplementalData: Yes; see table S1 for VHL subject genetic and manifestation information.

      Variant: p.S65A (c.193T>G)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: 223160 https://www.ncbi.nlm.nih.gov/clinvar/variation/223160

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: missense_variant; transversion

      CivicName: S65A (c.193T>G)

      MultipleGeneVariants: N/A

    1. PatientID: None

      KindredID: 6

      Case: F, 18Y0M, Ethnicity unknown

      DiseaseAssertion: assumed VHL

      FamilyInfo: Familial/syndromic (FS) association

      CasePresentingHPOs: HP:0002666; HP:0002668; HP:0010797; HP:0030405 (Pheochromocytoma; paraganglioma; hemangioblastoma; pancreatic endocrine tumor)

      CaseHPOFreeText: Benign bilateral pheochromocytoma and sympathetic PGL, CNS hemangioblastoma and PNET at age 18

      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.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. Materials and Methods Sample collection A cohort of 38 PPGL cases was used in this study. Fresh-frozen and/or FFPE tissue samples were collected from the Victorian Cancer Biobank (n = 9, four with matching fresh and FFPE tissue), Royal Brisbane Hospital (n = 3), Royal North Shore Hospital (n = 19), and The Tumor Bank at The Children's Hospital at Westmead (n = 7) (see Supplemental Table 1 for patient details). Nine tumors had previously been analyzed by exome-sequencing in a previous study (19). Samples and clinical data were collected under institutional human research ethics board approval according to the guidelines of the Australian National Health and Medical Research Council. Nucleic acid extraction FFPE Sections (5-μm each) were cut onto glass slides. Regions of surrounding normal tissue or tumor regions containing high levels of stroma or vasculature were marked for exclusion using hematoxylin and eosin staining. Tissue regions of interest were marked and macrodissected from the slide surface using a surgical blade. The tissue fragments were deparaffinized by incubation with 1 mL xylene. Tissue was recovered by high-speed centrifugation and removal of xylene supernatant, residual xylene was eliminated by incubation with 1 mL of absolute ethanol. For gene-expression analysis (Nanostring platform), RNA was extracted from deparaffinized tissue by proteinase K digestion and column chromatography using the RNeasy FFPE extraction kit (QIAGEN) in accordance with the manufacturer's protocol. For genotyping by MPS (MiSeq platform), DNA was extracted from deparaffinized tissue by proteinase K digestion and column chromatography using the DNeasy Blood and Tissue Kit (QIAGEN) in accordance with the manufacturer's protocol. Fresh frozen Between 10 and 30 mg of frozen tissue was placed in QIAzol (QIAGEN) reagent and mechanically disrupted using an Ultra-Turrex (IKA) dispersing instrument. The aqueous phase was separated by addition of chloroform followed by high-speed centrifugation. Total RNA was then purified by column chromatography using the miRNeasy RNA extraction kit (QIAGEN) in accordance with the manufacturer's protocol. Gene selection and pathway analysis A combined set of published microarray data was used to determine six robust disease subtypes as previously described (19). For each of the determined subtypes, all pairs one-vs-one and one-vs-rest differential gene expression analyses were performed using the empirical Bayesian procedure present within the limma package for R (45). The results were filtered for genes with log-fold change greater than 1 and ranked by P-value. For each class, the top 10 genes from each of the five one-vs-one comparisons were combined and then these nonredundant gene sets were intersected with the top 50 genes derived from a one-vs-rest comparison for the respective class. Seven genes were selected from the result of the intersection as representative for each class. In cases where the intersection did not yield at least seven genes, additional genes were selected from the relevant P-value-ranked one-vs-rest comparison. For biologically similar classes (VHL/SDHx and RTK1/3), high-ranking genes (by P-value) were selected from the relevant one-vs-one comparison to provide additional contrast. Nanostring Expression levels using the custom 52-gene panel were determined using the nCounter GX gene expression system (Nanostring Technologies) in accordance with the manufacturer's protocol. Briefly, RNA isolated from fresh-frozen tissue (100 ng) or FFPE tissue (300 ng) was combined with Reporter CodeSet, hybridization buffer, and Capture Probe Set then incubated at 65°C for 12 hours. Post-hybridization processing was performed using the Nanostring nCounter Prep Station and reporter probe counts were assayed on the Nanostring Digital Analyzer.To account for technical and sample variation experimental probes were normalized against positive control and housekeeping gene probes. The geometric mean of the positive control probes for each sample was determined to create a summarized positive control value (SPCV). A sample-scaling factor was determined for each sample by dividing the mean of the SPCVs of all samples by the SPCV for each sample. All experimental and housekeeping probes for each sample were multiplied by the respective sample-scaling factor. Using the positive control scaled data, this process was then repeated using the housekeeping gene controls in place of positive control probes. Support vector machine classifier Using the Affy package for R, expression values for the 46 classifier genes were extracted from the published microarray dataset and standardized to z scores (46). The standardized expression values were combined with the class labels determined through consensus clustering to form the training set for a support-vector machine (SVM). Normalized Nanostring probe counts were standardized to z scores for input as the testing set. Classification was performed using an SVM operated in linear classification mode (C-type) as implemented in the e1071 library for R. Multiclass classification was performed using k(k − 1)/2 (where k is the total number of classes) binary classifiers in a one-against-one approach with the appropriate class found by a voting scheme. Genotyping and targeted sequencing Massively parallel sequencing A custom gene panel (TruSeq Custom Amplicon Assay, Illumina), encompassing nine known PPGL susceptibility genes (MAX [NM_002382], SDHA [NM_004168], SDHB [NM_003000], SDHC [NM_003001], SDHD [NM_003002], SDHAF2 [NM_017841], RET [NM_020975], TMEM127 [NM_017849], and VHL [NM_000551]), was used for genotyping. DNA libraries were prepared (using 250 ng of DNA from each sample) and sequenced on a MiSeq platform (using 2 × 150-bp paired-end reads) according to the manufacturer's instructions (Illumina). FASTQ files (containing reads and their base call quality scores) were generated for each sample; and alignment of reads (banded Smith-Waterman algorithm) and variant calling using GATK (47) was processed by MiSeq Reporter (version 2.0, Illumina). Annotation of functional consequences to variant calls was performed using ANNOVAR (version 2013Jul) (48). Sanger sequencing Sanger sequencing confirmed all variants identified by MPS. In addition, assessment of HRAS exons 2 and 3 was performed in those samples classified as RTK1–3 by Nanostring, using the following primer sequences: exon 2-forward (5′-gtgggtttgcccttcagat-3′), exon 2-reverse (5′-agccctatcctggctgtgt-3′), exon 3-forward (5′-tgagaggtaccagggagagg-3′), exon 3-reverse (5′-acatgcgcagagaggacag-3′). IHC Sections (4-μm each) were cut for each tumor, dewaxed in xylene, and rehydrated through a graded ethanol series. Appropriate control tissues were used to verify the quality of each stain. Staining for chromogranin A was performed using a Roche Ventana Ultra immunostainer (Ventana Medical Systems). Antigen retrieval involved incubation with Ventana Ultra CC1 Conditioning Solution for 32 minutes. Chromogranin A primary antibody (Dako M0869 Clone DAK-A3) was diluted 1:400 with Ventana Antibody Dilution Buffer and incubated at 36°C for 20 minutes. Antibody detection was performed using Ventana OptiView DAB IHC Detection kit and slides were counterstained with hematoxylin. Immunohistochemistry for SDHB was performed using the Leica BondIII autostainer (Leica Biosystem). For SDHB a mouse monoclonal antibody (clone 21A11, ABCAM ab14714) was used at a dilution of 1 in 500. Antibody detection was performed using the biotin-free Bond Polymer Defined Detection System (DS9713 Vision Biosystems), according to the manufacturer's protocol.

      ArticleReferenceSequence: NM_000551.3

      GenotypingMethod: A custom gene panel (TruSeq Custom Amplicon Assay, Illumina), encompassing nine known PPGL susceptibility genes (MAX, SDHA, SDHB, SDHC, SDHD, SDHAF2, RET, TMEM127, and VHL, was used for genotyping. Sanger sequencing confirmed all variants identified by MPS.

      SamplingMethod: Fresh-frozen and/or FFPE tissue samples

    1. A 33-year-old Japanese woman had suffered back pain for seven years. She was referred to our institute because multiple solid tumors in the pancreas had gradually increased in size, which was pointed out at 27 years of age. She had a medical history of treatment for a variety of VHLD-associated tumors, including a pancreatic NET surgically resected at 14 years of age, hemangiomas of the fourth ventricle and cervical spinal cord operated at 19 years of age, and a renal cell carcinoma of the right kidney treated by nephrectomy at 30 years of age.

      PatientID: None

      KindredID: 1

      Case: F, 33Y0M, Japanese

      DiseaseAssertion: VHL

      FamilyInfo: Her father and elder brother were also diagnosed with VHLD, with her father having a medical history of two surgical resections for pancreatic NET and associated metastatic recurrence in the liver.

      CasePresentingHPOs: HP:0030405, HP:0009713, HP:0005584, HP:0010797 (Pancreatic endocrine tumor, Spinal hemangioblastoma, Renal cell carcinoma, hemangioblastoma)

      CaseHPOFreeText: She first developed multiple solid tumors of the pancreas at age 27 and they continued to grow until she was referred to the institute at age 33. She had a pancreatic endocrine tumour at age 14. At age 19, she had hemangiomas of the fourth ventricle and cervical spinal cord and a renal cell carcinoma of the right kidney treated by nephrectomy at 30 years of age.

      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

      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: Immunohistochemical studies revealed that the tumor cells were positive for synaptophysin and chromogranin A.

      MutationType: missense_variant;transition

      CivicName: R167Q (c.500G>A)

      MultipleGeneVariants: N/A

    1. 10PCCF25+VHL60/40Multiple−− VHL 3Germlinec.499C>Tp.Arg167TrpPathogenic

      PatientID: 10

      KindredID: 2

      Case: F, 25Y0M, Ethnicity Unknown

      DiseaseAssertion: VHL

      FamilyInfo: Patient has 2 siblings (patients 11 and 12) with the same mutation and pheochromocytoma.

      CasePresentingHPOs: HP:0002666 (Pheochromocytoma)

      CaseHPOFreeText: Bilateral pheochromocytomas (60mm and 40mm)

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: SDHB (NM_003000.2), SDHC (NM_003001.3), SDHD (NM_003002.2), SDHAF2 (NM_017841.2), RET (exons 10–11 and 13–16, NM_020975.4), TMEM127 (NM_017849.3), MAX (NM_002382.3).

      PreviouslyPublished: N/A

      SupplementalData: Table 2

      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

      VariantEvidence: SNParray analysis of tumour DNA did not show LOH at any locus.

      MutationType: missense_variant;transition

      CivicName: R167W (c.499C>T)

      MultipleGeneVariants: N/A

    1. 16 different families

      PatientID: X-I

      KindredID: 10

      Case: M, 28Y0M, Ethnicity Unknown

      DiseaseAssertion: VHL

      FamilyInfo: No family history reported.

      CasePresentingHPOs: HP:0010797; HP:0006880; HP:0009711; HP:0009713; HP:0001737 (hemangioblastoma, cerebellar hemangioblastoma, retinal capillary hemangioma, spinal hemangioblastoma, pancreatic cyst)

      CaseHPOFreeText: Patient presented with CNS, spinal, retinal and cerebellar hemangioblastoma, as well as a pancreatic cyst at age 28Y0M and was diagnosed with VHL type 2A (see table 2).

      CaseNotHPOs: HP:0000107; HP:0005584; HP:0006748; HP:0002668; HP:0030405 (renal cyst; renal cell carcinoma; adrenal pheochromocytoma; paraganglioma; pancreatic endocrine tumor)

      CaseNotHPOFreeText: Patient negative for renal cyst, renal cell carcinoma, adrenal pheochromocytoma, paraganglioma, and pancreatic endocrine tumor.

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: partial deletion (<1kb)

      LegacyVariant: N/A

      CaseProblemVariantFreeText: N/A

      ClinVarID: N/A

      CAID: N/A

      gnomAD: N/A

      VariantEvidence: N/A

      MutationType: partial_deletion

      CivicName: NULL (partial deletion)

      MultipleGeneVariants: N/A

    1. PatientID: 28

      KindredID: 18

      Case: M, 11Y0M, Indian

      DiseaseAssertion: VHL

      FamilyInfo: Relevant family history but details are not made available.

      CohortInfo: This retrospective study was conducted at Department of Endocrinology of a tertiary care health centre in Western India. Patients presented to our institute between 2008 and 2016 were included in the study. During the study period a total of 33 patients were suspected to have VHL syndrome based on clinical features among whom 31 patients were found to have mutation in VHL gene. All patients are of Asian Indian descent.

      CasePresentingHPOs: HP:0002666; HP:0005584 (Pheochromocytoma, Retinal capillary hemangioma)

      CaseHPOFreeText: Bilateral pheochromocytoma.

      CaseNotHPOs: HP:0009711; HP:0010797; HP:0002668; HP:0030405; HP:0001737 (Renal cell carcinoma, Hemangioblastoma, Paraganglioma, Pancreatic endocrine tumor, Pancreatic cysts)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      PreviouslyPublished: N/A

      SupplementalData: N/A

      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

      VariantEvidence: N/A

      MutationType: missense_variant;transition

      CivicName: R167W (c.499C>T)

      MultipleGeneVariants: N/A

    1. MD-0448

      Case#: MD-0448 proband, female, 18 years old (report), Spain.

      CaseHPOs: HP:0007663, HP:0011003, HP:0000651, HP:0007641 (decreased visual acuity, high myopia, diplopia, dyschromatopsia)

      CaseHPOsFreeText: Onset at 8 years. BCVA, 0.5 on the Snellen-equivalent decimal scale [Snellen equivalent, 20/40]). Rapid deterioration of vision. BCVA progressed to 0.3 (Snellen equivalent, 20/65) at age 9 years and to 0.2 (Snellen equivalent, 20/100) at 12 years but stable since then. Fundus exam showed a tigroid fundus, bull’s eye maculopathy, thin vessels, peripapillary atrophy, and optic pallor. Peripheral retina appeared normal. Photopic responses were undetectable by ERG, and scotopic responses were residual. Visual-evoked potential recorded pathologic responses, including low amplitude and enlarged latency (implicit time).

      CasePreviousTesting: Screened for variants in the ABCA4 gene by ABCA4 genotyping microarray.

      CaseMethod1: WES

      GenotypingMethod: WES found no pathogenic variants in the genes known to be associated with the arCRD phenotype (ABCA4, ADAM9, C8orf37, CERKL, EYS, RPGRIP1, and TULP1), and no other plausible genetic variant.

      Variant: c.651T>G (p.Cys217Trp), homozygous (NM_001017979.3(RAB28):c.574-1238T>G)

      ClinVar: 225879

      gnomAD: The highest population minor allele frequency in gnomAD is 0.00002904 in the Latino/Admixed American population; no homozygotes in any population.

      VariantEvidence: Present only in isoform 2.

      CaseAddInfo: The parents and unaffected sibling are all heterozygous for the variant.

    1. Case#: Iannuzzi_1991_IV-1, M, age unknown, origin unknown

      DiseaseAssertion: VWD type 2A

      FamilyInfo: Affected mother, aunt, grandfather, and many other relatives. LOD score 3.61 reported (12 affected and genotype positive, 4 unaffected genotype positive. 4 affected also have HTT with vWD.

      ParentalGenotype:

      CasePresentingHPOs: As reported elsewhere (Hanna etal1984), the diagnosis of typeII AvWD was based on the following: bleedingtime, FVIII procoagulant activity, vFW:Ag, ristocetincofactoractivity, platelet aggregation studies, and vWF multimer analysis

      CaseHPOFreeText:

      CaseNotHPOs:

      CaseNotHPOFreeText:

      CasePreviousTesting:

      GenotypingMethod: PCR-RFLP of exon 28 of VWF

      Gene: VWF

      Variant:

      HGVS: NM_000552.5(VWF):c.4883T>C (p.Ile1628Thr)

      ClinVarID: 284

      CAID:

      gnomAD: not reported

      MultipleGeneVariants:

    1. Case 13

      Case: Case 13, ages 2-17, Croatian

      DiseaseAssertion: VWF3

      FamilyInfo:

      ParentalGenotypes(s):

      CasePresentingHPOs:

      CaseHPOFreeText:

      CaseNOTHPOs:

      CaseNOTHPOFreeText: bleeding score= 5, VWF:GPIbM (%)= 7.8, VWF:Ag (%)= 9.7, vWF:GPIbM/vWF:Ag ratio= 0.80, FVIII:C (%): 34, VWF: CBA (%)= 7.8

      CasePreviousTesting:

      Gene: VWF

      Variant: c.4975C>T, p.Arg1659Ter

      HGVS: NM_000552.5:c.4975C>T

      ClinVar: 297

      gnomAD: https://gnomad.broadinstitute.org/variant/12-6127609-G-A?dataset=gnomad_r2_1

    1. Case#: Kumar_2016_ , M, 9 months (report)

      DiseaseAssertion: VWD type 2B

      FamilyInfo: no family history, de novo assertion but no testing to prove it.

      ParentalGenotype: not reported

      CasePresentingHPOs:

      CaseHPOFreeText: low von Willebrand factor (vWF) antigen (32%) and ristocetin cofactor activity (<8%). loss of high-molecular-weight multimers, bruising, extensive bleeding

      CaseNotHPOs:

      CaseNotHPOFreeText:

      CasePreviousTesting: not reported

      GenotypingMethod: exon 28 sequencing

      Gene: VWF

      Variant:

      HGVS: NM_000552.5(VWF):c.3940G>C, p.V1314L

      ClinVarID: 302

      CAID:

      gnomAD: not reported

      MultipleGeneVariants:

    1. V‐136

      Case#: Elayaperumal_2018_ , M, 4 y.o. (onset), origin in India

      DiseaseAssertion: VWD type 3

      FamilyInfo: Consanguinity, no family history

      ParentalGenotype: not reported

      CasePresentingHPOs:

      CaseHPOFreeText: bleeding score of 14. VWF:Ag 0.83, FVlll:C of 1.9%.

      CaseNotHPOs:

      CaseNotHPOFreeText:

      CasePreviousTesting: not reported

      GenotypingMethod: CSGE and Sanger sequencing of VWF gene only.

      Gene: VWF

      Variant: homozygous c.757_770del

      HGVS: NM_000552.3:c.757_770del (p.Thr253Cysfs*45)

      ClinVarID: not found

      CAID: CAR unable to parse. Error: unknown

      gnomAD: not found

      MultipleGeneVariants: not reported

    1. 2

      Case#: 2, female, 25yo

      DiseaseAssertion: VWD1

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: HP:0000978, HP:0000421, HP:0000132, HP:0011891, HP:0004846, HP:0012147 (bruising susceptibility, epistaxis, Menorrhagia, Post-partum hemorrhage, Reduced quantity of VWF, Impaired ristocetin cofactor assay activity)

      CaseHPOFreeText: Type A blood, VWF:Ag (0·55–2 iu/ml) pre = 0·48, VWF:RCo (0·55–2 iu/ml) pre = 0·53, FVIII:C (0·55–2 iu/ml) pre = 0·25, FVIII:C/VWF:Ag ratio = 0·52, VWF:FVIII binding (>20%) = N/A, VWF:FVIII binding/VWF:Ag (>0·7) = N/A, multiple surgical interventions with VWF concentrate with adequate haemostasis

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      ProteinExpression: N/A

      CasePreviousTesting: RFLP; confirmatory sequencing

      Gene: VWF

      Variant 1: NM_000552.4(VWF):c.2561G>A (p.Arg854Gln)

      ClinVar: 296; https://www.ncbi.nlm.nih.gov/clinvar/variation/296/

      gnomAD: MAF = 0.005692 (European Non-Finnish); https://gnomad.broadinstitute.org/variant/12-6143978-C-T

      Variant 2: N/A - stated to be a compound heterozygote for a 2N VWD and a presumed null mutation

    1. Supplementary Data, Table 2

      Case: Australian

      DiseaseAssertion: HCM

      CaseHPOFreeText: maximum left ventricular wall thickness of ≥15 mm

      CasePreviousTesting: electrocardiography, echocardiography, Full testing (MYBPC3, MYH7, TNNT2, TNNI3, TPM1, MYL2, MYL3, ACTC1)

      CaseGenotypingMethod: DNA isolated from peripheral blood or buccal swabs, PCR, Sanger sequencing, segregation analysis, haplotype analysis of MYBPC3 and MYH7

      Variant: NM_000257.3(MYH7):c.2087A>G (p.Asn696Ser)

      ClinVar: 181173, https://www.ncbi.nlm.nih.gov/clinvar/variation/181173/

      gnomAD: n/a

    2. Supplementary Data, Table 2

      Case: Australian

      DiseaseAssertion: HCM

      CaseHPOFreeText: maximum left ventricular wall thickness of ≥15 mm

      CasePreviousTesting: electrocardiography, echocardiography, Full testing (MYBPC3, MYH7, TNNT2, TNNI3, TPM1, MYL2, MYL3, ACTC1)

      CaseGenotypingMethod: DNA isolated from peripheral blood or buccal swabs, PCR, Sanger sequencing, segregation analysis, haplotype analysis of MYBPC3 and MYH7

      Variant: NM_000257.3(MYH7):c.1370T>C (p.Ile457Thr)

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

      gnomAD: 0.000003976, https://gnomad.broadinstitute.org/variant/14-23898201-A-G

    1. Supplementary Data: S2 Table

      Case 82: Spanish, 28yo, Female

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      CasePreviousTesting: Full Testing (MYBPC3, TNNT2, TNNI3, MYL2, MYL3, TPM1, ACTC1), additional testing listed in supplementary data table S1

      CaseGenotypingMethod: genomic DNA obtained from blood or saliva, Next-gen sequencing panels of 55 or 78 genes

      Variant: NM_000257.3(MYH7):c.745C>G (p.Arg249Gly)

      ClinVar: 181322, https://www.ncbi.nlm.nih.gov/clinvar/variation/181322/

      gnomAD: n/a

    2. Supplementary Data: S2 Table

      Case 139: Spanish, 44yo, Female

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      CasePreviousTesting: Full Testing (MYBPC3, TNNT2, TNNI3, MYL2, MYL3, TPM1, ACTC1), additional testing listed in supplementary data table S1

      CaseGenotypingMethod: genomic DNA obtained from blood or saliva, Next-gen sequencing panels of 55 or 78 genes

      Variant: NM_000257.3(MYH7):c.2156G>A (p.Arg719Gln)

      ClinVar: 14107, https://www.ncbi.nlm.nih.gov/clinvar/variation/14107/

      gnomAD: n/a

    3. Supplementary Data: S2 Table

      Case 159: Spanish, 65yo, Female

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      CasePreviousTesting: Full Testing (MYBPC3, TNNT2, TNNI3, MYL2, MYL3, TPM1, ACTC1), additional testing listed in supplementary data table S1

      CaseGenotypingMethod: genomic DNA obtained from blood or saliva, Next-gen sequencing panels of 55 or 78 genes

      Variant: NM_000257.3(MYH7):c.2167C>T (p.Arg723Cys)

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

      gnomAD: 0.00001194, https://gnomad.broadinstitute.org/variant/14-23895023-G-A

    4. Supplementary Data: S2 Table

      Case 157: Spanish, 71yo, Female

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      CasePreviousTesting: Full Testing (MYBPC3, TNNT2, TNNI3, MYL2, MYL3, TPM1, ACTC1), additional testing listed in supplementary data table S1

      CaseGenotypingMethod: genomic DNA obtained from blood or saliva, Next-gen sequencing panels of 55 or 78 genes

      Variant: NM_000257.3(MYH7):c.5342G>A (p.Arg1781His)

      ClinVar: 43064, https://www.ncbi.nlm.nih.gov/clinvar/variation/43064/

      gnomAD: 0.00001767, https://gnomad.broadinstitute.org/variant/14-23884421-C-T

    5. Supplementary Data: S2 Table

      Case 5: Spanish, 7yo, Male

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      CasePreviousTesting: Full Testing (MYBPC3, TNNT2, TNNI3, MYL2, MYL3, TPM1, ACTC1), additional testing listed in supplementary data table S1

      CaseGenotypingMethod: genomic DNA obtained from blood or saliva, PCR, Sanger Sequencing

      Variant: NM_000257.3(MYH7):c.2146G>A (p.Gly716Arg)

      ClinVar: 14105, https://www.ncbi.nlm.nih.gov/clinvar/variation/14105/

      gnomAD: n/a

    6. Supplementary Data: S2 Table

      Case 232: Spanish, 32yo, Female

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      CasePreviousTesting: Full Testing (MYBPC3, TNNT2, TNNI3, MYL2, MYL3, TPM1, ACTC1), additional testing listed in supplementary data table S1

      CaseGenotypingMethod: genomic DNA obtained from blood or saliva, Next-gen sequencing panels of 55 or 78 genes

      Variant: NM_000257.3(MYH7):c.2155C>T (p.Arg719Trp)

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

      gnomAD: 0.00003185, https://gnomad.broadinstitute.org/variant/14-23895180-G-A

      MultipleGeneVariants:

      (1) TNNT2 Variant:

      Variant: NM_000364.3(TNNT2):c.878G>A (p.Arg293His) listed in paper as c.857G>A (p.Arg286His)

      ClinVar: 43677, https://www.ncbi.nlm.nih.gov/clinvar/variation/43677/

      gnomAD: 0.00006936, https://gnomad.broadinstitute.org/variant/1-201328348-C-T

      (2) ACTN2 Variant:

      Variant: NM_001103.3(ACTN2):c.1930G>A (p.Ala644Thr)

      ClinVar: 43920, https://www.ncbi.nlm.nih.gov/clinvar/variation/43920/

      gnomAD: 0.0001629, https://gnomad.broadinstitute.org/variant/1-236917337-G-A

    7. Supplementary Data: S2 Table

      Case 6: Spanish, 54yo, Female

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      CasePreviousTesting: Full Testing (MYBPC3, TNNT2, TNNI3, MYL2, MYL3, TPM1, ACTC1), additional testing listed in supplementary data table S1

      CaseGenotypingMethod: genomic DNA obtained from blood or saliva, PCR, Sanger Sequencing

      Variant: NM_000257.3(MYH7):c.2389G>A (p.Ala797Thr)

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

      gnomAD: 0.00002386, https://gnomad.broadinstitute.org/variant/14-23894525-C-T

    1. Table 1 and 4

      Case A37: Female, 40yo

      DiseaseAssertion: DCM

      FamilyInfo: positive family history

      CaseHPOFreeText: interventricular septum thickness = 7.9mm, left ventricular end diastolic diameter = 61.3mm, left ventricular end systolic diameter = 42mm, left ventricular posterior wall thickness = 6.8mm, left atrium = 32.6mm, left ventricular ejection fraction = 48%

      CasePreviousTesting: 12-lead ECG, echocardiography, full testing (MYBPC3, TNNT2, TNNI3, MYL2, MYL3, TPM1, ACTC1), additional testing (LMNA, PRKAG2, SCN5A, MYH6)

      CaseGenotypingMethod: genomic DNA collected from peripheral whole blood samples, PCR, high-throughput sequencing using PGM Sequencing 400 kit, variants verified via Sanger Sequencing

      Variant: NM_000257.3(MYH7):c.77C>T (p.Ala26Val)

      ClinVar: 37375, https://www.ncbi.nlm.nih.gov/clinvar/variation/37375/

      gnomAD: 0.0005233, https://gnomad.broadinstitute.org/variant/14-23902865-G-A

    1. 2.01

      Case 2.01: Family 2, Male, 35yo at follow-up

      DiseaseAssertion: Hypertrophic cardiomyopathy

      CaseHPOFreeText: maximum left ventricular wall thickness ≥ 13 mm, follow-up echo = 9mm, longitudinal stain follow-up = -17.5%

      CaseNotHPOs: HP:0001712, HP:0011675, HP:0002094, HP:0100749 (left ventricular hypertrophy, arrhythmia, dyspnea, chest pain)

      CasePreviousTesting: 2D and M mode echocardiographic measurements, electrocardiography, cardiac MRI, Holter monitoring, measurements of left ventricular wall thickness, cavity dimensions, structural abnormalities, systolic anterior movement of mitral leaflets, outflow gradients, and Doppler inflow parameters.

      CaseGenotypingMethod: method not described

      Variant: NM_000257.3(MYH7):c.1357C>T (p.Arg453Cys)

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

      gnomAD: n/a

    1. HCM456

      Case#: HCM456, male, 28 years, not a smoker

      DiseaseAssertion: HCM

      FamilyInfo: None

      CasePresentingHPOs: 51mm LAD, 15mm LVST, 45mm LVEDD, 69% LVEF, 20mm Maxi LVWT, 90mmHg Maxi LVOTG, 124188740 raw RNA-seq reads, 116826920 HQ reads (94.07%), 96.65% mapping rate, 793088 total variant, 35368 exonic variant

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      CaseGenotypingMethod: RNA-seq, read mapping, variant calling, identify functional variants, differential expression analysis, miRWalk miRNA target prediction, LncRNA annotation, Co-expression network analysis, PPI network analysis, gene over-representation analysis,

      Variant: NM_000257.4(MYH7):c.1207C>T (p.Arg403Trp)

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

      CAID: N/A

      gnomAD: absent

    2. HCM491

      Case#: HCM491, female, 30 years, not a smoker

      DiseaseAssertion: HCM

      FamilyInfo: None

      CasePresentingHPOs: 44mm LAD, 23mm LVST, 32mm LVEDD, 75% LVEF, 28mm Maxi LVWT, 64mmHg Maxi LVOTG, 123213328 raw RNA-seq reads, 115698990 HQ reads (93.90%), 95.97% mapping rate, 756623 total variant, 34040 exonic variant

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      CaseGenotypingMethod: RNA-seq, read mapping, variant calling, identify functional variants, differential expression analysis, miRWalk miRNA target prediction, LncRNA annotation, Co-expression network analysis, PPI network analysis, gene over-representation analysis,

      Variant: NM_000257.4(MYH7):c.1987C>T (p.Arg663Cys)

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

      CAID: N/A

      gnomAD: absent

    3. HCM490

      Case#: HCM490, female, 41 yrs, not a smoker

      DiseaseAssertion: HCM

      FamilyInfo: None

      CasePresentingHPOs: 44mm LAD, 15mm LVST, 39mm LVEDD, 58% LVEF, 21mm Maxi LVWT, 63mmHg Maxi LVOTG, 109178274 raw RNA-seq reads, 102325212 HQ reads (93.72%), 96.79% mapping rate, 728218 total variant, 33873 exonic variant

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      CaseGenotypingMethod: RNA-seq, read mapping, variant calling, identify functional variants, differential expression analysis, miRWalk miRNA target prediction, LncRNA annotation, Co-expression network analysis, PPI network analysis, gene over-representation analysis,

      Variant: NM_000257.4(MYH7):c.4130C>T (p.Thr1377Met)

      ClinVar: 42992 https://www.ncbi.nlm.nih.gov/clinvar/variation/42992/

      CAID: N/A

      gnomAD: 0.000008791 European (non-finnish) https://gnomad.broadinstitute.org/variant/14-23887458-G-A

    4. HCM562

      Case#: HCM562, female, 36 yrs, smoker

      DiseaseAssertion: HCM

      FamilyInfo: None

      CasePresentingHPOs: 36mm LAD, 0mm LVST, 36mm LVEDD, 66% LVEF, 21mm Maxi LVWT, 70mmHg Maxi LVOTG, 119176332 raw RNA-seq reads, 113518840 HQ reads (95.25%), 96.63% mapping rate, 782848 total variant, 34382 exonic variant

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      CaseGenotypingMethod: RNA-seq, read mapping, variant calling, identify functional variants, differential expression analysis, miRWalk miRNA target prediction, LncRNA annotation, Co-expression network analysis, PPI network analysis, gene over-representation analysis,

      Variant: NM_000257.4(MYH7):c.427C>T (p.Arg143Trp)

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

      CAID: N/A

      gnomAD: 0.0001087 East Asian https://gnomad.broadinstitute.org/variant/14-23901923-G-A

    1. CasePT-92: United States

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

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

      NotHPOsFreeText: N/A

      CaseAddInfo:


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


      Variant: NM_000257.3:c.2782G>A (p.Asp928Asn)

      ClinVar: 164313 https://www.ncbi.nlm.nih.gov/clinvar/variation/164313/

      gnomAD: Not in gnomAD

    2. CasePT-57: United States

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

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

      NotHPOsFreeText: N/A

      CaseAddInfo:


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


      Variant: NM_000257.3:c.1231G>A (p.Val411Ile)

      ClinVar: 181339 https://www.ncbi.nlm.nih.gov/clinvar/variation/181339/

      gnomAD: Latino 5.643e-5, Overall 2.121e-5 https://gnomad.broadinstitute.org/variant/14-23898464-C-T

    3. CasePT-31: United States

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

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

      NotHPOsFreeText: N/A

      CaseAddInfo: 1 other patient has the same genotype


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


      Variant: NM_000257.3:c.2761G>A (p.Glu921Lys)

      ClinVar: 181205 https://www.ncbi.nlm.nih.gov/clinvar/variation/181205/

      gnomAD: Not in gnomAD

    1. Supplementary Data Table S3

      Case: 157

      DiseaseEntity: HCM

      HPOsFreeText: left ventricular hypertrophy (LVH) ≥15 mm

      InheritancePattern: n/a

      CasePreviousTesting: MYBPC3, TNNT2, TNNI3, MYL2, MYL3, TPM1, ACTC1 (59 genes total tested)

      CaseGenotypingMethod: NGS of 59 genes (Supplemental Table S1), pathogenic and likely pathogenic variants confirmed via Sanger Sequencing

      Variant1: NM_000257.4(MYH7):c.1816G>A (p.Val606Met)

      ClinVar: 14091 https://www.ncbi.nlm.nih.gov/clinvar/variation/14091/

      gnomAD: 0.00001548, https://gnomad.broadinstitute.org/variant/14-23896866-C-T

      Variant2: NM_000257.4(MYH7):c.3853+7C>T

      ClinVar: 42977 https://www.ncbi.nlm.nih.gov/clinvar/variation/42977/

      gnomAD: 0.003956, https://gnomad.broadinstitute.org/variant/14-23888685-G-A

      MultipleGeneVariants:

      (1) SDHA Variant

      Variant: NM_004168.4(SDHA):c.1886A>T (p.Tyr629Phe)

      ClinVar: 224949 https://www.ncbi.nlm.nih.gov/clinvar/variation/224949/

      gnomAD: 0.5249, https://gnomad.broadinstitute.org/variant/5-254599-A-T

    2. Supplementary Data Table S3

      Case: 296

      DiseaseEntity: HCM

      HPOsFreeText: left ventricular hypertrophy (LVH) ≥15 mm

      InheritancePattern: n/a

      CasePreviousTesting: MYBPC3, TNNT2, TNNI3, MYL2, MYL3, TPM1, ACTC1 (59 genes total tested)

      CaseGenotypingMethod: NGS of 59 genes (Supplemental Table S1), pathogenic and likely pathogenic variants confirmed via Sanger Sequencing

      Variant: NM_000257.4(MYH7):c.2539_2541del (p.Lys847del)

      ClinVar: 42913 https://www.ncbi.nlm.nih.gov/clinvar/variation/42913/

      gnomAD: Not in gnomAD

      MultipleGeneVariants:

      (1) DOLK Variant

      Current transcript of DOLK has a C at location 17 and a Pro rather than an Ala

      Variant: c.17G>C (p.Gly6Ala)

      ClinVar: N/A

      gnomAD: N/A

      (2) MYPN Variant

      Variant: NM_032578.3(MYPN):c.2863C>T (p.Arg955Trp)

      ClinVar: 192126 https://www.ncbi.nlm.nih.gov/clinvar/variation/192126/

      gnomAD: 0.001449, https://gnomad.broadinstitute.org/variant/10-69948821-C-T

      (3) PSEN1 Variant

      Variant: NM_000021.4(PSEN1):c.953A>G (p.Glu318Gly)

      ClinVar: 98094 https://www.ncbi.nlm.nih.gov/clinvar/variation/98094/

      gnomAD: 0.03394, https://gnomad.broadinstitute.org/variant/14-73673178-A-G

    3. Supplementary Data Table S3

      Case: 320

      DiseaseEntity: HCM

      HPOsFreeText: left ventricular hypertrophy (LVH) ≥15 mm

      InheritancePattern: n/a

      CasePreviousTesting: MYBPC3, TNNT2, TNNI3, MYL2, MYL3, TPM1, ACTC1 (59 genes total tested)

      CaseGenotypingMethod: NGS of 59 genes (Supplemental Table S1), pathogenic and likely pathogenic variants confirmed via Sanger Sequencing

      Variant: NM_000257.4(MYH7):c.3158G>A (p.Arg1053Gln)

      ClinVar: 155814 https://www.ncbi.nlm.nih.gov/clinvar/variation/155814/

      gnomAD: 0.0006368, https://gnomad.broadinstitute.org/variant/14-23891476-C-T

      MultipleGeneVariants:

      (1) NEXN Variant

      Variant: NM_144573.3(NEXN):c.995A>C (p.Glu332Ala)

      ClinVar: 47915 https://www.ncbi.nlm.nih.gov/clinvar/variation/47915/

      gnomAD: 0.01350, https://gnomad.broadinstitute.org/variant/1-78395131-A-C

    4. Supplementary Data Table S3

      Case: 49

      DiseaseEntity: HCM

      HPOsFreeText: left ventricular hypertrophy (LVH) ≥15 mm

      InheritancePattern: n/a

      CasePreviousTesting: MYBPC3, TNNT2, TNNI3, MYL2, MYL3, TPM1, ACTC1 (59 genes total tested)

      CaseGenotypingMethod: NGS of 59 genes (Supplemental Table S1), pathogenic and likely pathogenic variants confirmed via Sanger Sequencing

      Variant: NM_000257.3:c.4353+3G>T

      CAID: CA041823, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA041823

      gnomAD: 0.0002122, https://gnomad.broadinstitute.org/variant/14-23886709-C-A

      MultipleGeneVariants:

      (1) DMD Variant

      Variant: NM_004006.2(DMD):c.2391T>G (p.Asn797Lys)

      ClinVar: 94510, https://www.ncbi.nlm.nih.gov/clinvar/variation/94510/

      gnomAD: 0.006548, https://gnomad.broadinstitute.org/variant/X-32509625-A-C

      (2) JUP Variant

      Variant: NM_002230.4(JUP):c.1942G>A (p.Val648Ile)

      ClinVar: 45842, https://www.ncbi.nlm.nih.gov/clinvar/variation/45842/

      gnomAD: 0.007385, https://gnomad.broadinstitute.org/variant/17-39913771-C-T

    5. Supplementary Data Table S3

      Case: 100

      DiseaseEntity: HCM

      HPOsFreeText: left ventricular hypertrophy (LVH) ≥15 mm

      InheritancePattern: n/a

      CasePreviousTesting: MYBPC3, TNNT2, TNNI3, MYL2, MYL3, TPM1, ACTC1 (59 genes total tested)

      CaseGenotypingMethod: NGS of 59 genes (Supplemental Table S1), pathogenic and likely pathogenic variants confirmed via Sanger Sequencing

      Variant: NM_000257.4(MYH7):c.3158G>A (p.Arg1053Gln)

      ClinVar: 155814 https://www.ncbi.nlm.nih.gov/clinvar/variation/155814/

      gnomAD: 0.0006368, https://gnomad.broadinstitute.org/variant/14-23891476-C-T

      MultipleGeneVariants:

      (1) FBN1 Variant

      Variant: NM_000138.4(FBN1):c.3077T>C (p.Phe1026Ser)

      ClinVar: 199948 https://www.ncbi.nlm.nih.gov/clinvar/variation/199948/

      gnomAD: 0.006608, https://gnomad.broadinstitute.org/variant/15-48782053-A-G

    6. Supplementary Data Table S3

      Case: 26

      DiseaseEntity: HCM

      HPOsFreeText: left ventricular hypertrophy (LVH) ≥15 mm

      InheritancePattern: n/a

      CasePreviousTesting: MYBPC3, TNNT2, TNNI3, MYL2, MYL3, TPM1, ACTC1 (59 genes total tested)

      CaseGenotypingMethod: NGS of 59 genes (Supplemental Table S1), pathogenic and likely pathogenic variants confirmed via Sanger Sequencing

      Variant: NM_000257.4(MYH7):c.3158G>A (p.Arg1053Gln)

      ClinVar: 155814, https://www.ncbi.nlm.nih.gov/clinvar/variation/155814/

      gnomAD: 0.00006010, https://gnomad.broadinstitute.org/variant/14-23891476-C-T

      MultipleGeneVariants:

      (1) FBN1 Variant

      Variant: NM_000138.4(FBN1):c.3077T>C (p.Phe1026Ser)

      ClinVar: 199948, https://www.ncbi.nlm.nih.gov/clinvar/variation/199948/

      gnomAD: 0.0006449, https://gnomad.broadinstitute.org/variant/15-48782053-A-G

      (2) SDHA Variant

      Variant: NM_004168.4(SDHA):c.1886A>T (p.Tyr629Phe)

      ClinVar: 224949, https://www.ncbi.nlm.nih.gov/clinvar/variation/224949/

      gnomAD: 0.1547, https://gnomad.broadinstitute.org/variant/5-254599-A-T

    1. DiseaseAssertion: Hypertrophic Cardiomyopathy

      VariantPreviousTesting: ACTC1, ACTN2, CSRP3, LAMP2, MYBPC3, MYH7, NEXN, PLN, TNNC1, TNNI3, TNNT2, TPM1, CAV3, GLA, MYL2, MYL3, MYOZ2, PRKAG2, and TTR were all tested via NGS.

      VariantGenotypingMethod: Next-generation sequencing panels were used to sequence and read the genetic information of the 760 HCM probands for variants within exons and in +/- 10 nucleotides within the flanking introns of the genes provided above. These variants were then interpreted and filtered for pathogenicity.

      VariantAddInfo: Seen in one HCM proband

      Variant: NM_000257.4(MYH7):c.2221G>T (p.Gly741Trp)

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

      gnomAD: Not in gnomAD

    2. DiseaseAssertion: Hypertrophic Cardiomyopathy

      VariantPreviousTesting: ACTC1, ACTN2, CSRP3, LAMP2, MYBPC3, MYH7, NEXN, PLN, TNNC1, TNNI3, TNNT2, TPM1, CAV3, GLA, MYL2, MYL3, MYOZ2, PRKAG2, and TTR were all tested via NGS.

      VariantGenotypingMethod: Next-generation sequencing panels were used to sequence and read the genetic information of the 760 HCM probands for variants within exons and in +/- 10 nucleotides within the flanking introns of the genes provided above. These variants were then interpreted and filtered for pathogenicity.

      VariantAddInfo: Seen in five HCM probands and one PanCM proband

      Variant: NM_000257.4(MYH7):c.1750G>C (p.Gly584Arg)

      ClinVarID: 14090 https://www.ncbi.nlm.nih.gov/clinvar/variation/14090/

      gnomAD: 0.000008790, http://gnomad.broadinstitute.org/variant/14-23896932-C-G

    3. DiseaseAssertion: None

      VariantPreviousTesting: Some combination of ACTC1, ACTN2, CSRP3, LAMP2, MYBPC3, MYH7, NEXN, PLN, TNNC1, TNNI3, TNNT2, TPM1, ABCC9, CTF1, DES, EMD, LDB3, LMNA, MYH6, RBM20, SGCD, TAZ, TCAP, TTN, VCL, CAV3, GLA, MYL2, MYL3, MYOZ2, PRKAG2, TTR, DSC2, DSG2, DSP, JUP, PKP2, RYR2, TMEM43, CASQ2 and RYR2 were tested via NGS.

      VariantGenotypingMethod: Next-generation sequencing panels were used to sequence and read the genetic information of probands for variants within exons and in +/- 10 nucleotides within the flanking introns of the genes provided above. These variants were then interpreted and filtered for pathogenicity.

      Variant: NM_000257.4(MYH7):c.2890G>C (p.Val964Leu)

      ClinVar: 42938 https://www.ncbi.nlm.nih.gov/clinvar/variation/42938/

      gnomAD: 0.0008437, http://gnomad.broadinstitute.org/variant/14-23893148-C-G

    4. DiseaseAssertion: Dilated Cardiomyopathy

      VariantPreviousTesting: ACTC1, ACTN2, CSRP3, LAMP2, MYBPC3, MYH7, NEXN, PLN, TNNC1, TNNI3, TNNT2, TPM1, ABCC9, CTF1, DES, EMD, LDB3, LMNA, MYH6, RBM20, SGCD, TAZ, TCAP, TTN, and VCL were all tested via NGS.

      VariantGenotypingMethod: Next-generation sequencing panels were used to sequence and read the genetic information of the 74 DCM probands for variants within exons and in +/- 10 nucleotides within the flanking introns of the genes provided above. These variants were then interpreted and filtered for pathogenicity.

      VariantAddInfo: Seen in one DCM proband

      Variant: NM_000257.4(MYH7):c.2711G>A (p.Arg904His)

      ClinVarID: 42926 https://www.ncbi.nlm.nih.gov/clinvar/variation/42926/

      gnomAD: Not in gnomAD

    5. DiseaseAssertion: Hypertrophic Cardiomyopathy

      VariantPreviousTesting: ACTC1, ACTN2, CSRP3, LAMP2, MYBPC3, MYH7, NEXN, PLN, TNNC1, TNNI3, TNNT2, TPM1, CAV3, GLA, MYL2, MYL3, MYOZ2, PRKAG2, and TTR were all tested via NGS.

      VariantGenotypingMethod: Next-generation sequencing panels were used to sequence and read the genetic information of the 760 HCM probands for variants within exons and in +/- 10 nucleotides within the flanking introns of the genes provided above. These variants were then interpreted and filtered for pathogenicity.

      VariantAddInfo: Seen in one HCM probands

      Variant: NM_000257.4(MYH7):c.788T>C (p.Ile263Thr)

      ClinVar: 43106 https://www.ncbi.nlm.nih.gov/clinvar/variation/43106/

      gnomAD: 0.000008792, http://gnomad.broadinstitute.org/variant/14-23900635-A-G

    6. DiseaseAssertion: Hypertrophic Cardiomyopathy

      VariantPreviousTesting: ACTC1, ACTN2, CSRP3, LAMP2, MYBPC3, MYH7, NEXN, PLN, TNNC1, TNNI3, TNNT2, TPM1, CAV3, GLA, MYL2, MYL3, MYOZ2, PRKAG2, and TTR were all tested via NGS.

      VariantGenotypingMethod: Next-generation sequencing panels were used to sequence and read the genetic information of the 760 HCM probands for variants within exons and in +/- 10 nucleotides within the flanking introns of the genes provided above. These variants were then interpreted and filtered for pathogenicity.

      VariantAddInfo: Seen in one HCM proband

      Variant: NM_000257.4(MYH7):c.2167C>T (p.Arg723Cys)

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

      gnomAD: 0.00003266, http://gnomad.broadinstitute.org/variant/14-23895023-G-A

    1. an affected Tunisian SCARMD patien

      Case1: Male, Tunisia

      CasePresentingHPOs: N/A

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: Proband is homozygous for this variant, Family is consanguinous, Immunostaining of the patient's muscle showed deficiency of all three sarcoglycan subunits, Variant was found in an affected sibling and in both other families in PMID:1303286

      CasePreviousTesting: N/A

      CaseGenotypingMethod: Rabbit and human y-sarcoglycan were identifed and genomic phages were found to hybridize to the same region implicated in linkage analysis for ARLGMD. RNA from a skeletal muscle biopsy was taken and the PCR products were directly sequenced revealing a homozygous deletion that was confirmed in the DNA via PCR amplification and sequencing.

      PreviouslyPublished: PMID:1303286

      Variant: SGCG, 1-BP DEL, 525T

      ClinVar: 2004 https://www.ncbi.nlm.nih.gov/clinvar/variation/2004/

      Also Reported As

      Variant: NM_000231.2(SGCG):c.525del (p.Phe175fs)

      ClinVar: 189243 https://www.ncbi.nlm.nih.gov/clinvar/variation/189243/

      gnomAD: 0.00009671, https://gnomad.broadinstitute.org/variant/13-23869568-CT-C

    1. KMP 18

      Case KMP 18: Eastern Slovakia, Female, 71yo

      DiseaseAssertion: hypertrophic cardiomyopathy

      FamilyInfo: no family history

      CaseHPOFreeText: left ventricular ejection fraction = 60%, New York Heart Association Classification I-II

      CaseNotHPOFreeText: left ventricular outflow tract obstruction

      CasePreviousTesting: 12-lead ECG, echocardiography, partial testing (MYBPC3, MYH7, NEBL, SCN5A, TNNI3, TNNT2)

      CaseGenotypingMethod: genomic DNA collected from peripheral blood leukocytes, Sanger sequencing

      Variant: NM_000257.3(MYH7):c.2845G>A (p.Glu949Lys)

      ClinVar: 14093, https://www.ncbi.nlm.nih.gov/clinvar/variation/14093/

      gnomAD: n/a

    2. KMP 1

      Case KMP 1: Eastern Slovakia, Female, 39yo

      DiseaseAssertion: hypertrophic cardiomyopathy

      FamilyInfo: no family history

      CaseHPOFreeText: left ventricular ejection fraction = 60%, New York Heart Association Classification I,

      CaseNotHPOFreeText: left ventricular outflow tract obstruction

      CasePreviousTesting: 12-lead ECG, echocardiography, partial testing (MYBPC3, MYH7, NEBL, SCN5A, TNNI3, TNNT2)

      CaseGenotypingMethod: genomic DNA collected from peripheral blood leukocytes, Sanger sequencing

      Variant: NM_000257.3(MYH7):c.2845G>A (p.Glu949Lys)

      ClinVar: 14093, https://www.ncbi.nlm.nih.gov/clinvar/variation/14093/

      gnomAD: n/a

    3. KMP7

      Case KMP 7: Eastern Slovakia, Male, 36yo

      DiseaseAssertion: hypertrophic cardiomyopathy

      FamilyInfo: no family history

      CaseHPOFreeText: left ventricular outflow tract obstruction, left ventricular ejection fraction = 60%

      CasePreviousTesting: 12-lead ECG, echocardiography, partial testing (MYBPC3, MYH7, NEBL, SCN5A, TNNI3, TNNT2)

      CaseGenotypingMethod: genomic DNA collected from peripheral blood leukocytes, Sanger sequencing

      Variant: NM_000257.3(MYH7):c.2845G>A (p.Glu949Lys)

      ClinVar: 14093, https://www.ncbi.nlm.nih.gov/clinvar/variation/14093/

      gnomAD: n/a

    1. Supplementary Data table 1

      Case:

      DiseaseAssertion: hypertrophic cardiomyopathy

      CaseHPOFreeText: maximal wall thickness (MWT) ≥15 mm

      CasePreviousTesting: Full testing (MYBPC3, TNNT2, TNNI3, MYL2, MYL3, TPM1, ACTC1), Additional testing (TNNC1, CSRP3, TCAP, ABCC9, ACTN2, ANKRD1, BAG3, CALR3, CAV3, CRYAB, CTNNA3, DES, DSC2, DSG2, DSP, EMD, FHL1, GLA, JPH2, JUP, LAMA4, LAMP2, LDB3, LMNA, MIB1, MYH6, MYOZ2, MYPN, NEXN, PKP2, PLN, PRDM16, PRKAG2, RBM20, SCN5A, TAZ, TMEM43, TNNC1, TTN, TTR, VCL), electrocardiography

      CaseGenotypingMethod: direct sequencing of all coding intron-exon boundaries of 12 genes (prior to 2012), next-generation sequencing (post 2012)

      Variant: NM_000257.3(MYH7):c.1357C>T (p.Arg453Cys)

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

      gnomAD: n/a

    2. Supplementary Data table 1

      Case:

      DiseaseAssertion: hypertrophic cardiomyopathy

      CaseHPOFreeText: maximal wall thickness (MWT) ≥15 mm

      CasePreviousTesting: Full testing (MYBPC3, TNNT2, TNNI3, MYL2, MYL3, TPM1, ACTC1), Additional testing (TNNC1, CSRP3, TCAP, ABCC9, ACTN2, ANKRD1, BAG3, CALR3, CAV3, CRYAB, CTNNA3, DES, DSC2, DSG2, DSP, EMD, FHL1, GLA, JPH2, JUP, LAMA4, LAMP2, LDB3, LMNA, MIB1, MYH6, MYOZ2, MYPN, NEXN, PKP2, PLN, PRDM16, PRKAG2, RBM20, SCN5A, TAZ, TMEM43, TNNC1, TTN, TTR, VCL), electrocardiography

      CaseGenotypingMethod: direct sequencing of all coding intron-exon boundaries of 12 genes (prior to 2012), next-generation sequencing (post 2012)

      Variant: NM_000257.3(MYH7):c.3169G>A (p.Gly1057Ser)

      ClinVar: 42950, https://www.ncbi.nlm.nih.gov/clinvar/variation/42950/

      gnomAD: 0.000007953, https://gnomad.broadinstitute.org/variant/14-23891465-C-T

    3. Supplementary Data table 1

      Case:

      DiseaseAssertion: hypertrophic cardiomyopathy

      CaseHPOFreeText: maximal wall thickness (MWT) ≥15 mm

      CasePreviousTesting: Full testing (MYBPC3, TNNT2, TNNI3, MYL2, MYL3, TPM1, ACTC1), Additional testing (TNNC1, CSRP3, TCAP, ABCC9, ACTN2, ANKRD1, BAG3, CALR3, CAV3, CRYAB, CTNNA3, DES, DSC2, DSG2, DSP, EMD, FHL1, GLA, JPH2, JUP, LAMA4, LAMP2, LDB3, LMNA, MIB1, MYH6, MYOZ2, MYPN, NEXN, PKP2, PLN, PRDM16, PRKAG2, RBM20, SCN5A, TAZ, TMEM43, TNNC1, TTN, TTR, VCL), electrocardiography

      CaseGenotypingMethod: direct sequencing of all coding intron-exon boundaries of 12 genes (prior to 2012), next-generation sequencing (post 2012)

      Variant: NM_000257.3(MYH7):c.2146G>A (p.Gly716Arg)

      ClinVarID: 14105, https://www.ncbi.nlm.nih.gov/clinvar/variation/14105/

      gnomAD: n/a

    4. Supplementary Data table 1

      Case:

      DiseaseAssertion: hypertrophic cardiomyopathy

      CaseHPOFreeText: maximal wall thickness (MWT) ≥15 mm

      CasePreviousTesting: Full testing (MYBPC3, TNNT2, TNNI3, MYL2, MYL3, TPM1, ACTC1), Additional testing (TNNC1, CSRP3, TCAP, ABCC9, ACTN2, ANKRD1, BAG3, CALR3, CAV3, CRYAB, CTNNA3, DES, DSC2, DSG2, DSP, EMD, FHL1, GLA, JPH2, JUP, LAMA4, LAMP2, LDB3, LMNA, MIB1, MYH6, MYOZ2, MYPN, NEXN, PKP2, PLN, PRDM16, PRKAG2, RBM20, SCN5A, TAZ, TMEM43, TNNC1, TTN, TTR, VCL), electrocardiography

      CaseGenotypingMethod: direct sequencing of all coding intron-exon boundaries of 12 genes (prior to 2012), next-generation sequencing (post 2012)

      Variant: NM_000257.3(MYH7):c.2167C>T (p.Arg723Cys)

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

      gnomAD: 0.00001194, https://gnomad.broadinstitute.org/variant/14-23895023-G-A

    5. Supplementary Data table 1

      Case:

      DiseaseAssertion: hypertrophic cardiomyopathy

      CaseHPOFreeText: maximal wall thickness (MWT) ≥15 mm

      CasePreviousTesting: Full testing (MYBPC3, TNNT2, TNNI3, MYL2, MYL3, TPM1, ACTC1), Additional testing (TNNC1, CSRP3, TCAP, ABCC9, ACTN2, ANKRD1, BAG3, CALR3, CAV3, CRYAB, CTNNA3, DES, DSC2, DSG2, DSP, EMD, FHL1, GLA, JPH2, JUP, LAMA4, LAMP2, LDB3, LMNA, MIB1, MYH6, MYOZ2, MYPN, NEXN, PKP2, PLN, PRDM16, PRKAG2, RBM20, SCN5A, TAZ, TMEM43, TNNC1, TTN, TTR, VCL), electrocardiography

      CaseGenotypingMethod: direct sequencing of all coding intron-exon boundaries of 12 genes (prior to 2012), next-generation sequencing (post 2012)

      Variant: NM_000257.3(MYH7):c.728G>A (p.Arg243His)

      ClinVar: 14126, https://www.ncbi.nlm.nih.gov/clinvar/variation/14126/

      gnomAD: 0.000007953, https://gnomad.broadinstitute.org/variant/14-23900798-C-T

    6. Supplementary Data table 1

      Case:

      DiseaseAssertion: hypertrophic cardiomyopathy

      CaseHPOFreeText: maximal wall thickness (MWT) ≥15 mm

      CasePreviousTesting: Full testing (MYBPC3, TNNT2, TNNI3, MYL2, MYL3, TPM1, ACTC1), Additional testing (TNNC1, CSRP3, TCAP, ABCC9, ACTN2, ANKRD1, BAG3, CALR3, CAV3, CRYAB, CTNNA3, DES, DSC2, DSG2, DSP, EMD, FHL1, GLA, JPH2, JUP, LAMA4, LAMP2, LDB3, LMNA, MIB1, MYH6, MYOZ2, MYPN, NEXN, PKP2, PLN, PRDM16, PRKAG2, RBM20, SCN5A, TAZ, TMEM43, TNNC1, TTN, TTR, VCL), electrocardiography

      CaseGenotypingMethod: direct sequencing of all coding intron-exon boundaries of 12 genes (prior to 2012), next-generation sequencing (post 2012)

      Variant: NM_000257.3(MYH7):c.2221G>C (p.Gly741Arg)

      ClinVar: 14098, https://www.ncbi.nlm.nih.gov/clinvar/variation/14098/

      gnomAD: 0.00003185, https://gnomad.broadinstitute.org/variant/14-23894969-C-T

    7. Supplementary Data table 1

      Case:

      DiseaseAssertion: hypertrophic cardiomyopathy

      CaseHPOFreeText: maximal wall thickness (MWT) ≥15 mm

      CasePreviousTesting: Full testing (MYBPC3, TNNT2, TNNI3, MYL2, MYL3, TPM1, ACTC1), Additional testing (TNNC1, CSRP3, TCAP, ABCC9, ACTN2, ANKRD1, BAG3, CALR3, CAV3, CRYAB, CTNNA3, DES, DSC2, DSG2, DSP, EMD, FHL1, GLA, JPH2, JUP, LAMA4, LAMP2, LDB3, LMNA, MIB1, MYH6, MYOZ2, MYPN, NEXN, PKP2, PLN, PRDM16, PRKAG2, RBM20, SCN5A, TAZ, TMEM43, TNNC1, TTN, TTR, VCL), electrocardiography

      CaseGenotypingMethod: direct sequencing of all coding intron-exon boundaries of 12 genes (prior to 2012), next-generation sequencing (post 2012)

      Variant: NM_000257.3(MYH7):c.2788G>A (p.Glu930Lys)

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

      gnomAD: n/a

    1. HCM125

      CaseHCM125: 39 yrs report, Vietnam, Asian

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: Family history of sudden cardiac death

      CasePresentingHPOs: HP:0002875, HP:0001712, HP:0031295, HP:0011103, HP:0001653, HP:0006698 (Exertional dyspnea, Left ventricular hypertrophy, Left atrial enlargement, Abnormality of the left ventricular outflow tract, Mitral regurgitation, Dilatation of the ventricular cavity)

      HPOsFreeText: Maximal LV thickness 22 mm

      CaseNotHPOs: HP:0005110, HP:0001297, HP:0004756 (Atrial fibrillation, Stroke, Ventricular tachycardia)

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CasePreviousTesting: The gene panel included 10 sarcomeric genes (MYH7, MYBPC3, TNNT2, TNNI3, TPM1, MYL2, MYL3, ACTC1, TNNC1, MYH6), 9 genes encoding Z-disk components and Ca2+ homeostasis factors (LDB3, CSRP3, TCAP, VCL, ACTN2, MYOZ2, NEXN, JPH2, PLN), and 4 genes involved in HCM phenocopies (GLA, LAMP2, PRKAG2, TTR), All probands had left ventricular wall thickness >= 15 mm and no other diseases that can cause secondary hypertrophy

      CaseGenotypingMethod: The coding region, flanking sequences, and untranslated regions of each gene were enriched by LC-PCR, amplified, and sequenced on the Illumina MiSeq or MiniSeq platform. Identified variants were then filtered for pathogenicity and confirmed by Sanger sequencing.

      Variant: NM_000257.4(MYH7):c.2207T>C (p.Ile736Thr)

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

      gnomAD: Not in gnomAD

      Multiple Gene Variants

      (1) MYH6 Variant

      Variant: NM_002471.3(MYH6):c.5410C>A (p.Gln1804Lys)

      ClinVar: 312843 https://www.ncbi.nlm.nih.gov/clinvar/variation/312843/

      gnomAD: 0.002807, http://gnomad.broadinstitute.org/variant/14-23853806-G-T

    2. HCM047

      CaseHCM047: 59 yrs report, Vietnam, Asian

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: Family history of hypertrophic cardiomyopathy, Has a sister with MYBPC3 mutation with asymptomatic HCM (did not mention MYH7 mutation)

      CasePresentingHPOs: HP:0002875, HP:0001712 (Exertional dyspnea, Left ventricular hypertrophy)

      HPOsFreeText: Maximal LV thickness 20 mm

      CaseNotHPOs: HP:0005110, HP:0001297, HP:0004756 (Atrial fibrillation, Stroke, Ventricular tachycardia)

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CasePreviousTesting: The gene panel included 10 sarcomeric genes (MYH7, MYBPC3, TNNT2, TNNI3, TPM1, MYL2, MYL3, ACTC1, TNNC1, MYH6), 9 genes encoding Z-disk components and Ca2+ homeostasis factors (LDB3, CSRP3, TCAP, VCL, ACTN2, MYOZ2, NEXN, JPH2, PLN), and 4 genes involved in HCM phenocopies (GLA, LAMP2, PRKAG2, TTR), All probands had left ventricular wall thickness >= 15 mm and no other diseases that can cause secondary hypertrophy

      CaseGenotypingMethod: The coding region, flanking sequences, and untranslated regions of each gene were enriched by LC-PCR, amplified, and sequenced on the Illumina MiSeq or MiniSeq platform. Identified variants were then filtered for pathogenicity and confirmed by Sanger sequencing.

      Variant: NM_000257.4(MYH7):c.1322C>T (p.Thr441Met)

      ClinVar: 14122 https://www.ncbi.nlm.nih.gov/clinvar/variation/14122/

      gnomAD: 0.002556, http://gnomad.broadinstitute.org/variant/14-23898249-G-A

      Multiple Gene Variants

      (1) MYBPC3 Variant

      Variant: NM_000256.3(MYBPC3):c.2308G>A (p.Asp770Asn)

      ClinVar: 36604 https://www.ncbi.nlm.nih.gov/clinvar/variation/36604/

      gnomAD: 0.00008693, http://gnomad.broadinstitute.org/variant/11-47360071-C-T

    3. HCM033

      CaseHCM033: 30 yrs report, Vietnam, Asian

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: Family history of Sudden Cardiac Death and Hypertrophic Cardiomyopathy, Has a 7 year old son with the same variant but no symptoms

      CasePresentingHPOs: HP:0001712, HP:0100749, HP:0002875, HP:0011103, HP:0031295 (Left ventricular hypertrophy, Chest pain, Exertional dyspnea, Abnormality of the left ventricular outflow tract, Left atrial enlargement)

      HPOsFreeText: Maximal LV thickness 27 mm

      CaseNotHPOs: HP:0005110, HP:0001297, HP:0004756 (Atrial fibrillation, Stroke, Ventricular tachycardia)

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CasePreviousTesting: The gene panel included 10 sarcomeric genes (MYH7, MYBPC3, TNNT2, TNNI3, TPM1, MYL2, MYL3, ACTC1, TNNC1, MYH6), 9 genes encoding Z-disk components and Ca2+ homeostasis factors (LDB3, CSRP3, TCAP, VCL, ACTN2, MYOZ2, NEXN, JPH2, PLN), and 4 genes involved in HCM phenocopies (GLA, LAMP2, PRKAG2, TTR), All probands had left ventricular wall thickness >= 15 mm and no other diseases that can cause secondary hypertrophy

      CaseGenotypingMethod: The coding region, flanking sequences, and untranslated regions of each gene were enriched by LC-PCR, amplified, and sequenced on the Illumina MiSeq or MiniSeq platform. Identified variants were then filtered for pathogenicity and confirmed by Sanger sequencing.

      Variant: NM_000257.4(MYH7):c.1063G>A (p.Ala355Thr)

      ClinVar: 42820 https://www.ncbi.nlm.nih.gov/clinvar/variation/42820/

      gnomAD: Not in gnomAD

    1. WPW385

      Case#: WPW385, 13 yrs

      DiseaseAssertion: LYH, WPW, SVT

      FamilyInfo: inherited

      CasePresentingHPOs: Wolff-Parkinson-White syndrome, Supraventricular tachycardia, Left ventricular hypertrophy (HP:0001716, HP:0004755, HP:0001712)

      CaseHPOFreeText: 0 ARIC, 0 THou, 2.03e-5 gnomAD, 3.3e-5 Exac, 7.7e-5 esp6500, 20.5 CADD_phred, 0 pLI,

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      CaseGenotypingMethod: ECG, exome sequencing, gene analysis, burden analysis,

      Variant: NM_000257.4(MYH7):c.2389G>A (p.Ala797Thr)

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

      CAID: N/A

      gnomAD: 0.0001230 African/African American https://gnomad.broadinstitute.org/variant/14-23894525-C-T

    1. Supplementary Material 4

      Case M-16: Japanese

      DiseaseAssertion: idiopathic cardiomyopathy (HCM and DCM)

      CasePreviousTesting: Clinical evaluation, chest radiography, electrocardiography, echocardiography, cardiac catheterization, full testing (MYBPC3, TNNT2, TNNI3, MYL2, MYL3, TPM1, ACTC1)

      CaseGenotypingMethod: 8 sarcomeric genes amplified from genomic DNA via PCR then screened using bidirectional direct sequencing

      Variant: NM_000257.3(MYH7):c.2156G>A (p.Arg719Gln)

      ClinVar: 14107, https://www.ncbi.nlm.nih.gov/clinvar/variation/14107/

      gnomAD: n/a

    2. Supplementary Material 4

      Case M-29: Japanese

      DiseaseAssertion: idiopathic cardiomyopathy (HCM and DCM)

      CasePreviousTesting: Clinical evaluation, chest radiography, electrocardiography, echocardiography, cardiac catheterization, full testing (MYBPC3, TNNT2, TNNI3, MYL2, MYL3, TPM1, ACTC1)

      CaseGenotypingMethod: 8 sarcomeric genes amplified from genomic DNA via PCR then screened using bidirectional direct sequencing

      Variant: NM_000257.3(MYH7):c.2803G>A (p.Glu935Lys)

      ClinVar: 14106, https://www.ncbi.nlm.nih.gov/clinvar/variation/14106/

      gnomAD: n/a

    3. Supplementary Material 4

      Case M-20: Japanese

      DiseaseAssertion: idiopathic cardiomyopathy (HCM and DCM)

      CasePreviousTesting: Clinical evaluation, chest radiography, electrocardiography, echocardiography, cardiac catheterization, full testing (MYBPC3, TNNT2, TNNI3, MYL2, MYL3, TPM1, ACTC1)

      CaseGenotypingMethod: 8 sarcomeric genes amplified from genomic DNA via PCR then screened using bidirectional direct sequencing

      Variant: NM_000257.3(MYH7):c.2221G>T (p.Gly741Trp)

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

      gnomAD: n/a

    4. Supplementary Material 4

      Case M-19: Japanese

      DiseaseAssertion: idiopathic cardiomyopathy (HCM and DCM)

      CasePreviousTesting: Clinical evaluation, chest radiography, electrocardiography, echocardiography, cardiac catheterization, full testing (MYBPC3, TNNT2, TNNI3, MYL2, MYL3, TPM1, ACTC1)

      CaseGenotypingMethod: 8 sarcomeric genes amplified from genomic DNA via PCR then screened using bidirectional direct sequencing

      Variant: NM_000257.3(MYH7):c.2221G>T (p.Gly741Trp)

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

      gnomAD: n/a

    1. CaseMYH7-35: Australia

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CasePreviousTesting: See Table 1

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

      Variant: NM_000257.3:c.1324C>T (p.Arg442Cys)

      ClinVar: 177897 https://www.ncbi.nlm.nih.gov/clinvar/variation/177897/

      gnomAD: East Asian 5.012e-5, Overall 2.121e-5 https://gnomad.broadinstitute.org/variant/14-23898247-G-A

    2. CaseMYH7-32: Australia

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: 3 other probands share this genotype

      CasePreviousTesting: See Table 1

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

      Variant: NM_000257.3:c.1816G>A (p.Val606Met)

      ClinVar: 14091 https://www.ncbi.nlm.nih.gov/clinvar/variation/14091/

      gnomAD: European (Non-Finnish) 1.548e-5, Overall 7.070e-6 https://gnomad.broadinstitute.org/variant/14-23896866-C-T

    3. CaseMYH7-29: Australia

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CasePreviousTesting: See Table 1

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

      Variant: NM_000257.3:c.2093T>C (p.Val698Ala)

      ClinVar: 42878 https://www.ncbi.nlm.nih.gov/clinvar/variation/42878/

      gnomAD: Not in gnomAD

    4. C

      CaseC: 13 years diagnosis, Australia

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: Three affected relatives (5 possibly affected), Mother died 44 y with heart failure, Brother SCD 16 y

      CasePresentingHPOs: HP:0001639, HP:0005110 (Hypertrophic cardiomyopathy, Atrial fibrillation)

      HPOsFreeText: Maximum left ventricular hypertrophy at 20 mm

      CaseNotHPOs: N/A

      NotHPOsFreeText: Sudden cardiac death event

      CaseAddInfo: Heart transplant was required

      CasePreviousTesting: See Table 1

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

      Variant: NM_000257.3:c.2156G>A (p.Arg719Gln)

      ClinVar: 14107 https://www.ncbi.nlm.nih.gov/clinvar/variation/14107/

      gnomAD: Not in gnomAD

      Multiple Gene Variants:

      MYBPC3 Variant

      Variant: NM_000256.3:c.818G>A (p.Arg273His)

      ClinVar: 161312 https://www.ncbi.nlm.nih.gov/clinvar/variation/161312/

      gnomAD: Latino 2.275e-4, Overall 9.182e-5 https://gnomad.broadinstitute.org/variant/11-47369411-C-T

    5. CaseMYH7-41: Australia

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CasePreviousTesting: See Table 1

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

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

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

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

    6. CaseMYH7-17: Australia

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CasePreviousTesting: See Table 1

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

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

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

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

    7. CaseMYH7-7: Australia

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CasePreviousTesting: See Table 1

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

      Variant: NM_000257.3:c.4124A>G (p.Tyr1375Cys)

      ClinVar: 164293 https://www.ncbi.nlm.nih.gov/clinvar/variation/164293/

      gnomAD: Not in gnomAD

    8. CaseMYH7-14: Australia

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CasePreviousTesting: See Table 1

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

      Variant: NM_000257.3:c.2770G>A (p.Glu924Lys)

      ClinVar: 14092 https://www.ncbi.nlm.nih.gov/clinvar/variation/14092/

      gnomAD: Not in gnomAD

    9. CaseMYH7-38: Australia

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CasePreviousTesting: See Table 1

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

      Variant: NM_000257.3:c.1051A>G (p.Lys351Glu)

      ClinVar: 181335 https://www.ncbi.nlm.nih.gov/clinvar/variation/181335/

      gnomAD: Not in gnomAD

    1. CaseMYH7-17: N/A

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: 3 other probands share this genotype

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

      Variant: NM_000257.3:c.1750G>C (p.Gly584Arg)

      ClinVar: 14090 https://www.ncbi.nlm.nih.gov/clinvar/variation/14090/

      gnomAD: European (Non-Finnish) 8.790e-6, Overall 3.976e-6 https://gnomad.broadinstitute.org/variant/14-23896932-C-G

    2. CaseMYH7-14: N/A

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

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

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

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

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

    3. CaseMYH7-3: N/A

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: 3 other probands share this genotype

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

      Variant: NM_000257.3:c.2717A>G (p.Asp906Gly)

      ClinVar: 14125 https://www.ncbi.nlm.nih.gov/clinvar/variation/14125/

      gnomAD: European (Non-Finnish) 8.792e-6, Overall 3.977e-6 https://gnomad.broadinstitute.org/variant/14-23893321-T-C

    4. CaseMYH7-23: N/A

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

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

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

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

      gnomAD: Not in gnomAD

    1. Supplementary Data: Online Table 1a

      Case:

      CasePresentingHPOs: HP:0001631, HP:0001629 (atrial septal defect, ventricular septal defect)

      CaseHPOFreeText: Trisomy 21

      CasePreviousTesting: Full sarcomere testing (MYBPC3, TNNT2, TNNI3, MYL2, MYL3, TPM1, ACTC1), Additional testing (ABCC9, ACTN2, ANKRD1, BAG3, CALR3, CRYAB, CSRP3, DES, DMD, DSC2, DSG2, DSP, EMD, GLA, JPH2, JUP, LAMA4, LAMP2, LMNA, MYH6, MYPN, MYOZ1, MYOZ2, PKP2, PLN, PRKAG2, RBM20, RYR2, SCN5A, SGCD, TAZ, TCAP, TMEM43, TNNC1, TTN, VCL and LDB3)

      CaseGenotypingMethod: DNA isolated from peripheral blood, targeted enrichment, next-gen sequencing with panel of 46 genes

      Variant: NM_000257.3(MYH7):c.976G>C (p.Ala326Pro)

      ClinVar: 43117, https://www.ncbi.nlm.nih.gov/clinvar/variation/43117/

      gnomAD: 0.00008846, https://gnomad.broadinstitute.org/variant/14-23899792-C-G

    2. Supplementary Data: Online Table 3

      Case:

      CasePreviousTesting: Full sarcomere testing (MYBPC3, TNNT2, TNNI3, MYL2, MYL3, TPM1, ACTC1), Additional testing (ABCC9, ACTN2, ANKRD1, BAG3, CALR3, CRYAB, CSRP3, DES, DMD, DSC2, DSG2, DSP, EMD, GLA, JPH2, JUP, LAMA4, LAMP2, LMNA, MYH6, MYPN, MYOZ1, MYOZ2, PKP2, PLN, PRKAG2, RBM20, RYR2, SCN5A, SGCD, TAZ, TCAP, TMEM43, TNNC1, TTN, VCL and LDB3)

      CaseGenotypingMethod: DNA isolated from peripheral blood, targeted enrichment, next-gen sequencing with panel of 46 genes

      Variant: NM_000257.3(MYH7):c.2945T>C (p.Met982Thr)

      ClinVar: 42941, https://www.ncbi.nlm.nih.gov/clinvar/variation/42941/

      gnomAD: 0.0008484, https://gnomad.broadinstitute.org/variant/14-23892910-A-G

    3. Supplementary Data: Online Table 3

      Case:

      CasePreviousTesting: Full sarcomere testing (MYBPC3, TNNT2, TNNI3, MYL2, MYL3, TPM1, ACTC1), Additional testing (ABCC9, ACTN2, ANKRD1, BAG3, CALR3, CRYAB, CSRP3, DES, DMD, DSC2, DSG2, DSP, EMD, GLA, JPH2, JUP, LAMA4, LAMP2, LMNA, MYH6, MYPN, MYOZ1, MYOZ2, PKP2, PLN, PRKAG2, RBM20, RYR2, SCN5A, SGCD, TAZ, TCAP, TMEM43, TNNC1, TTN, VCL and LDB3)

      CaseGenotypingMethod: DNA isolated from peripheral blood, targeted enrichment, next-gen sequencing with panel of 46 genes

      Variant: NM_000257.3(MYH7):c.4377G>T (p.Lys1459Asn)

      ClinVar: 43012, https://www.ncbi.nlm.nih.gov/clinvar/variation/43012/

      gnomAD: 0.0002937, https://gnomad.broadinstitute.org/variant/14-23886504-C-A

    4. Supplementary Data: Online Table 2a

      Case:

      CasePreviousTesting: Full sarcomere testing (MYBPC3, TNNT2, TNNI3, MYL2, MYL3, TPM1, ACTC1), Additional testing (ABCC9, ACTN2, ANKRD1, BAG3, CALR3, CRYAB, CSRP3, DES, DMD, DSC2, DSG2, DSP, EMD, GLA, JPH2, JUP, LAMA4, LAMP2, LMNA, MYH6, MYPN, MYOZ1, MYOZ2, PKP2, PLN, PRKAG2, RBM20, RYR2, SCN5A, SGCD, TAZ, TCAP, TMEM43, TNNC1, TTN, VCL and LDB3)

      CaseGenotypingMethod: DNA isolated from peripheral blood, targeted enrichment, next-gen sequencing with panel of 46 genes

      Variant: NM_000257.3(MYH7):c.689T>C (p.Phe230Ser)

      ClinVar: 236543, https://www.ncbi.nlm.nih.gov/clinvar/variation/263543/

      gnomAD: n/a

    1. DCM-19

      CaseDCM-19: Male, 5 year diagnosis, Caucasian, Germany

      CasePresentingHPOs: HP:0001644, HP:0001635 (Dilated cardiomyopathy, Heart failure)

      HPOsFreeText: LVEDD at 74 mm, LV-Ejection Fraction at 20%, Cardiac Index at 2.38

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: Proband treated with VAD and ICD, Sporadic family history of cardiac disease, Proband also has a variant in NEXN, Patient is heterozygous for MYH7 variant


      CaseGenotypingMethod: Using a Cardiomyopathy gene panel of 46 genes, the proband's DNA was screened for variants. Afterwards, the variants were classified based on pathogenicity and modeled using predictive software.


      Variant: NM_000257.3:c.1106G>A (p.Arg369Gln)

      ClinVar: 42822 https://www.ncbi.nlm.nih.gov/clinvar/variation/42822/

      gnomAD: Not in gnomAD


      Multiple Gene Variants

      NEXN Variant

      Variant: NM_144573.3:c.1955A>G (p.Tyr652Cys)

      ClinVar: 326 https://www.ncbi.nlm.nih.gov/clinvar/variation/326/

      gnomAD: European (Non-Finnish) 1.407e-4, Overall 7.859e-5 https://gnomad.broadinstitute.org/variant/1-78408441-A-G

    1. Jun-49

      Case#: male, 19 yrs

      DiseaseAssertion:

      FamilyInfo: No apparent history or HCM or SCD

      CasePresentingHPOs:

      CaseHPOFreeText:

      CaseNotHPOs:

      CaseNotHPOFreeText:

      CasePreviousTesting: testing on rest of genes

      CaseGenotypingMethod: MYH7 specific

      Variant: NM_000257.4(MYH7):c.2803G>A (p.Glu935Lys)

      ClinVar: 14106 https://www.ncbi.nlm.nih.gov/clinvar/variation/14106/

      CAID: N/A

      gnomAD: absent

    1. CaseST4-89: Sweden

      DiseaseAssertion: Idiopathic Dilated Cardiomyopathy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001644 (Dilated cardiomyopathy)

      HPOsFreeText: N/A

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

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

      CaseAddInfo: N/A

      CasePreviousTesting: See Supplemental Table 1

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

      Variant: NM_000257.3:c.3286G>T (p.Asp1096Tyr)

      ClinVar: 42953 https://www.ncbi.nlm.nih.gov/clinvar/variation/42953/

      gnomAD: European (Non-Finnish) 3.097e-4, Overall 1.414e-4 https://gnomad.broadinstitute.org/variant/14-23890217-C-A

    1. Clinical case.

      Case: Male, 4yo

      CasePresentingHPOs: HP:0001324, HP:0001270, HP:0006830, HP:0003458, HP:0000467, HP:0003547, HP:0002650 (muscle weakness, delayed motor development, congenital hypotonia, Myopathic electromyogram, neck muscle weakness, shoulder girdle muscle weakness, scoliosis)

      HPOsFreeText: sporadic congenital muscle weakness, decreased cardiac pump function, perinatal encephalopathy, rolled over at 7mo, left ventricular dilation, normal total creatine phosphokinase, unspecified muscle atrophy shown in histological exam, signs of dropped head syndrome, gluteal and quadricep muscle weakness, axial weakness distribution. At 4yo: weight = 14kg, height = 104cm, ejection fraction = 56%, able to walk if head is supported, preserved emotional and intellectual development

      CaseNotHPOs: HP:0002098, HP:0002015, HP:0001635 (breathing difficulties, dysphagia, heart failure)

      DiseaseEntity: DCM

      InheritancePattern: not specified

      FamilyInformation: family not consanguineous, no history of progressive muscular disorders or cardiomyopathy, pedigree in Fig. 1

      CasePreviousTesting: WES

      CaseGenotypingMethod: genomic DNA extracted from white blood cells of proband and parents, WES, confirmed findings in proband, parents and siblings via PCR-based bidirectional Sanger sequencing, abnormal MYH7 transcript confirmed in vivo by RT-PCR, paternity and maternity confirmed by multiplex STR typing of 15 loci

      Variant: NM_000257.3:c.5655+5G>C, confirmed de novo by parental testing

      No ClinVar or CAID

    1. Case390: Male, Birth onset, Japan, Asian

      DiseaseAssertion: Left ventricular noncompaction

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

      HPOsFreeText: Left Ventricular Ejection Fraction at 43.5%, LVDD-Z score at 3.3833

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

      NotHPOsFreeText: Congenital heart disease with significant hemodynamic changes

      CaseAddInfo: No family history


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

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


      Variant: NM_000257.3:c.5740G>A (p.Glu1914Lys)

      ClinVar: 43088 https://www.ncbi.nlm.nih.gov/clinvar/variation/43088/

      gnomAD: Not in gnomAD

    1. 3

      Case3: Male, 37 years report, Netherlands

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

      HPOsFreeText: Positive EPS inducibility

      CaseNotHPOs: HP:0001639, HP:0001635, HP:0001711 (Hypertrophic cardiomyopathy, Congestive heart failure, Abnormality of the left ventricle)

      NotHPOsFreeText: ECG Depolarization abnormality, Cardiac transplant

      CaseAddInfo:


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

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


      Variant: NM_000257.3:c.5536C>T (p.Arg1846Cys)

      ClinVar: 161321 https://www.ncbi.nlm.nih.gov/clinvar/variation/161321/

      gnomAD: East Asian 5.441e-5, Overall 1.208e-5 https://gnomad.broadinstitute.org/variant/14-23884227-G-A

    1. II-1

      CaseBII-1: Female, 64 years diagnosis, Italy, Caucasian

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: See Figure 1

      CasePresentingHPOs: HP:0005110, HP:0001639, HP:0004756, HP:0001712, HP:0005135, HP:0002094, HP:0001962, HP:0006682, HP:0001279, HP:0000821 (Atrial fibrillation, Hypertrophic cardiomyopathy, Ventricular tachycardia, Left ventricular hypertrophy, Abnormal T-wave, Dyspnea, Palpitations, Premature ventricular contractions, Syncope, Hypothyroidism)

      HPOsFreeText: Widespread septal and apical late gadolinium enhancement, Max Left ventricular wall thickness of 20 mm, Left atrium diameter of 54 mm, Left ventricular ejection fraction of 56%, Apical aneurism, Latent tuberculosis

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CasePreviousTesting: The ACM proband from Family B was genotyped for PKP2, DSP, DSC2, DSG2, JUP and CTNNA3; the HCM patient from Family B was genotyped for MYBPC3, MYH7, TNNI3 and TNNT2.

      CaseGenotypingMethod: All patients in Family B were directly sequenced according to the found variants in CTNNA3 and MYH7. These variants were filtered for pathogenicity and prevalence and classified accordingly.

      Variant: NM_000257.3:c.2631G>T (p.Met877Ile)

      ClinVar: 417718 https://www.ncbi.nlm.nih.gov/clinvar/variation/417718/

      gnomAD: Not in gnomAD

    2. II-7

      CaseBII-7: Male, 50 years diagnosis, Italy, Caucasian

      DiseaseAssertion: Borderline Arrhythmogenic Cardiomyopathy

      FamilyInfo: See Figure 1

      CasePresentingHPOs: HP:0005133, HP:0006683 (Right ventricular dilatation, Abnormal ventricular filling)

      HPOsFreeText: LVWT of 12 mm with an abnormal filling pattern, Mild right ventricular dilatation of 30  mm, Left atrium diameter at 45 mm, 62% ejection fraction

      CaseNotHPOs: HP:0003115 (Abnormal ECG)

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CasePreviousTesting: The ACM proband from Family B was genotyped for PKP2, DSP, DSC2, DSG2, JUP and CTNNA3; the HCM patient from Family B was genotyped for MYBPC3, MYH7, TNNI3 and TNNT2.

      CaseGenotypingMethod: All patients in Family B were directly sequenced according to the found variants in CTNNA3 and MYH7. These variants were filtered for pathogenicity and prevalence and classified accordingly.

      Variant: NM_000257.3:c.2631G>T (p.Met877Ile)

      ClinVar: 417718 https://www.ncbi.nlm.nih.gov/clinvar/variation/417718/

      gnomAD: Not in gnomAD

      Multiple Gene Variants

      CTNNA3 Variant:

      Variant: NM_013266.3:c.2296_2298delTTG (p.Leu766del)

      ClinVar: 100657 https://www.ncbi.nlm.nih.gov/clinvar/variation/100657/

      gnomAD: Not in gnomAD

    1. Table 5

      Case EO21: Italian

      DiseaseAssertion: HCM (early-onset)

      FamilyInfo: positive family history

      CasePreviousTesting: echocardiography, Full testing (MYBPC3, MYH7, TNNT2, TNNI3, TPM1, MYL2, MYL3, ACTC1), additional testing: (GLA, LAMP2, PRKAG2, TNNC1, MYH6, CSPR3, PLN, TCAP, CAV3), electrocardiography

      CaseGenotypingMethod: Genomic DNA extracted from periphera whole blood, emulsion PCR, 17 HCM genes sequenced using Personal Genome Machine (PGM) IonTorrent sequencer, variants confirmed via Sanger sequencing

      Variant: NM_000257.3(MYH7):c.2539_2541delAAG (p.Lys847del)

      ClinVar: 42913, https://www.ncbi.nlm.nih.gov/clinvar/variation/42913/

      gnomAD: n/a

    2. Table 5

      Case EO2: Italian

      DiseaseAssertion: HCM (early-onset)

      FamilyInfo: positive family history

      CasePreviousTesting: echocardiography, Full testing (MYBPC3, MYH7, TNNT2, TNNI3, TPM1, MYL2, MYL3, ACTC1), additional testing: (GLA, LAMP2, PRKAG2, TNNC1, MYH6, CSPR3, PLN, TCAP, CAV3), electrocardiography

      CaseGenotypingMethod: Genomic DNA extracted from periphera whole blood, emulsion PCR, 17 HCM genes sequenced using Personal Genome Machine (PGM) IonTorrent sequencer, variants confirmed via Sanger sequencing

      Variant: NM_000257.3(MYH7):c.2156G>A (p.Arg719Gln)

      ClinVar: 14107, https://www.ncbi.nlm.nih.gov/clinvar/variation/14107/

      gnomAD: n/a

    1. CaseMYH7-10: Japan, Asian

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

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo:


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


      Variant: NM_000257.3:c.746G>A (p.Arg249Gln)

      ClinVar: 14088 https://www.ncbi.nlm.nih.gov/clinvar/variation/14088/

      gnomAD: Not in gnomAD

    2. CaseMYH7-2: Japan, Asian

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

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo:


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


      Variant: NM_000257.3:c.2546T>C (p.Met849Thr)

      ClinVar: 42914 https://www.ncbi.nlm.nih.gov/clinvar/variation/42914/

      gnomAD: Not in gnomAD

    1. 6

      Case6: Female, 28 years diagnosis, China, Asian

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      CasePresentingHPOs: HP:0001639, HP:0001667, HP:0006682 (Hypertrophic cardiomyopathy, Right ventricular hypertrophy, Premature ventricular contractions)

      HPOsFreeText: 1 SCD risk factor, NYHA class is I, Right ventricular wall thickness 15 mm

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

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A


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


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

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

      gnomAD: Not in gnomAD


      MultipleGeneVariants:

      MYBPC3 Variant:

      Unknown Variant

      Variant: MYBPC3-E334K

      ClinVar: N/A

      gnomAD: N/A

    1. Case13: Male, 57 years diagnosis, China, Asian

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: N/A

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

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      CasePreviousTesting: Probands were only genotyped for MYH7 and MYBPC3 in that order, stopping once a positive finding was detected.

      CaseGenotypingMethod: Genomic DNA was extracted from peripheral blood. Each gene's coding exons and flanking introns were subject to PCR amplification and sequencing. From there, any variants found were filtered for pathogenicity and low frequencies.

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

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

      gnomAD: Not in gnomAD

    1. proband

      Case#: II:1, 36 yrs, male

      DiseaseAssertion: HCM

      FamilyInfo: Yes, mother (62 yr) also has HCM

      CasePresentingHPOs: Syncope, mitral regurgiation (HP:0001279, HP:0001653)

      CaseHPOFreeText: left ventricular wall thickness 19.2m, small width of flow beam 2.5mm

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: left ventricle diameter, no abnormalities in motion of left ventricular wall (16 points), no echo or blood flow, normal morphology

      CasePreviousTesting: N/A

      CaseGenotypingMethod: cdfi, ultrasound, whole-exome sequencing, pedigree analyses, in silico anaylsis,

      Variant: NM_000257.4(MYH7):c.2207T>C (p.Ile736Thr)

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

      CAID: N/A

      gnomAD: absent

    1. CaseCM1414: Male, 12 years diagnosis, Japan, Asian

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: N/A

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

      NotHPOsFreeText: Neuromuscular disease, Malformation syndromes

      CaseAddInfo: No family history of cardiomyopathy or sudden death, Proband found in Supplementary Table 2


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

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


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

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

      gnomAD: Not in gnomAD

    1. CaseMYH7-1:

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText:

      CaseNotHPOs:

      NotHPOsFreeText:

      CaseAddInfo:


      CasePreviousTesting: All sarcomeric genes were tested in each proband. The probands were tested upon diagnosis, so no record of the method used is provided.

      CaseGenotypingMethod: Each variant was classified for pathogenicity and rarity.


      Variant: NM_000257.3:c.1013T>A (p.Val338Glu)

      ClinVar: 492983 https://www.ncbi.nlm.nih.gov/clinvar/variation/492983/

      gnomAD: Not in gnomAD

    1. One patient, a 78-year-old man with a MYH7 mutation (c.5186_5188del) and normal cardiac assessment, had four family members (two sons, one daughter, and one nephew) who were diagnosed with the same MYH7 mutation and had ICDs implanted (two sons after cardiac arrest and the two remaining patients for primary prevention). Unfortunately, we have no available cardiac data for these patients.

      Case: Male, 78yo

      FamilyInfo: 2 sons, 1 daughter, and 1 nephew also diagnosed with same MYH7 variant and had ICDs implanted

      CasePresentingHPOs: HP:0001324, HP:0003388 (muscle weakness, fatigability)

      HPOsFreeText: congenital myopathy, normal cardiac assessment

      CasePreviousTesting: ACTA1, BIN1, DNM2, MYH7, MTM1, NEB, RYR1, SCN4A, SEPN1, TPM2, TPM3

      CaseGenotypingMethod: PCR amplification of exons of genes investigated and Sanger sequencing or NGS

      Variant: NM_000257.4(MYH7):c.5177_5179AGA[3] (p.Lys1729del)

      ClinVar: 42096, https://www.ncbi.nlm.nih.gov/clinvar/variation/42096/

      gnomAD: absent

    1. PD04

      Patient4: Female, southern China

      CasePresentingHPOs:

      HPOsFreeText: IOPD

      CaseNotHPOs:

      NotHPOsFreeText:

      CaseAddInfo:

      CasePMIDs:

      CasePreviousTesting: same as group

      CaseGenotypingMethod: same as group

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

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

      gnomAD: 0.0001721, http://exac.broadinstitute.org/variant/17-78086721-C-A

      Variant2: NM_000152.4(GAA):c.2185delC (p.Leu729Trpfs) **this is not the same protein transcript listed in paper (p.Thr729fsX8) but I could not find this in clinvar or allele registry)

      ClinVar: 370552, https://www.ncbi.nlm.nih.gov/clinvar/variation/370552/https://www.ncbi.nlm.nih.gov/clinvar/variation/370552/

      gnomAD: n/a

    2. PD07

      Patient7: Female, Southern China

      CasePresentingHPOs:

      HPOsFreeText: IOPD

      CaseNotHPOs:

      NotHPOsFreeText:

      CaseAddInfo:

      CasePMIDs:

      CasePreviousTesting: same as group

      CaseGenotypingMethod: same as group

      Variant1: NM_000152.4(GAA):c.1432G>A (p.Gly478Arg)

      ClinVar: 551295, https://www.ncbi.nlm.nih.gov/clinvar/variation/551295/

      gnomAD: 8.525e-06, http://exac.broadinstitute.org/variant/17-78083849-G-A

      Variant2: NM_000152.4(GAA):c.1802C>T (p.Ser601Leu)

      ClinVar: 194154, https://www.ncbi.nlm.nih.gov/clinvar/variation/194154/

      gnomAD: n/a

    3. In the present study, we describe the clinical course and provide a molecular analysis of another 25 mainland Chinese patients with IOPD, and we identified c.2662G > T (p.Glu888X) as the most common mutation in northern Chinese patients.

      GroupPresentingHPOs: HP:0001324, HP:0001270, HP:0002205, HP:0002098, HP:0001635, HP:0001640, HP:0011968

      HPOsFreeText: IOPD, reduced GAA activity, paucity of movements

      GroupNotHPOs:

      NumberMales: 14

      NumberFemales: 11

      CountryOrigin: mainland China; 12 patients from southern China, 13 from northern China

      Ethnicity: Chinese

      Race: Chinese

      AgeRange: median age at symptom onset = 3.4mo, median age at diagnosis = 4.9mo

      TotalNumber: 25

      FamilyInfo: Parents of those individuals with mutations were sequenced

      NoFamily: n/a

      GroupAddInfo: all patients diagnosed with IOPD between 2013 and 2016 at Shanghai Children's Medical Center. Of the 24 untreated patients, non survived beyond 1.5yrs, only surviving (Patient 25) was 7mo at last follow-up.

      GroupPreviousTesting: IOPD diagnosed via reduced GAA enzyme activity in leukocytes or DBS (PMID: 16702880)

      GroupGenotypingMethod: DNA isolated from blood samples, coding exons (2-20) and intron/exon boundaries of GAA gene amplified via PCR (primers: PMID: 10338092), resulting DNA was sequenced with ABI3730XL sequencer then was analyzed with Mutation Survey or DNA Variant Analysis software, novel mutations were screened in 60 normal individuals (120 alleles) via direct sequencing and no novel variants were found among these suggesting those found in study patients are uncommon polymorphisms.

      fragments containing a mutation in the patients were amplified and sequenced for the corresponding parents

      Phylogenetic conservation of missense mutations analyzed with ClustalX program, and pathogenicity of novel variants predicited with MutationTaster, sorting intolerant from tolerant (SIFT), and PolyPhen-2

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

      this was identified (by present study) as the most common variant in northern Chinese patients, heterozygous for 5 patients, homozygous for one patient

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

      gnomAD: 1.65e-05, http://exac.broadinstitute.org/variant/17-78092467-G-T

    1. Detailed characteristics of these patients

      Patient4: male, 18yo, juvenile onset

      CasePresentingHPOs:

      HPOsFreeText: LOPD, BMI = 19.7 / 20.7 / 22.2, WGMS = 0 / 0 / 0

      CaseNotHPOs: HP:0002355

      NotHPOsFreeText: did not require respiratory support

      CaseAddInfo: homozygous

      CasePMIDs:

      CasePreviousTesting: same as group

      CaseGenotypingMethod: same as group

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

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

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

    1. Case10: Male, 80 years report

      HPOsFreeText: 7 years of ERT completed, 6 Minute Walking Test at 220 meters, Forced Vital Capacity at 44%

      GenotypingMethod: GAA Gene Sequencing


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

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

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


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

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

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


      CaseAddInfo: Late Onset Pompe Disease

    2. Case29: Female, 50 years report

      HPOsFreeText: ERT not started, 6 Minute Walking Test at 354 meters, Forced Vital Capacity at 116%

      GenotypingMethod: GAA Gene Sequencing


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

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

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


      Variant2: NM_000152.4:c.2481+102_2646+31del (p.Gly828_Asn882del) (exon 18 del)

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

      gnomAD: Not in gnomAD


      CaseAddInfo: Late Onset Pompe Disease

    3. Case37: Female, 62 years report

      HPOsFreeText: ERT not started, 6 Minute Walking Test at 475 meters, Forced Vital Capacity at 94%

      GenotypingMethod: GAA Gene Sequencing


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

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

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


      Variant2: NM_000152.4:c.2481+102_2646+31del (p.Gly828_Asn882del) (exon 18 del)

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

      gnomAD: Not in gnomAD


      CaseAddInfo: Late Onset Pompe Disease

    1. Alglucosidase alfa enzyme replacement therapy as a therapeutic approach for a patient presenting with a PRKAG2 mutation

      PMID: 27692944

      Gene: GAA

      Disease: Glycogen Storage Disease II

      MonDO: 0009290

      InheritancePattern: autosomal recessive

      NoEvidence: Case report of individual incorrectly diagnosed with Pompe carrying the NM_000152.4(GAA):c.-32-13T>G variant, he was eventually diagnosed correctly with PRKAG2 syndrome via a pathogenic variant.

    1. CaseOPOPD-75: Female, Taiwan, Birth diagnosis

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

      GenotypingMethod: GAA Gene Sequencing and PCR Amplification


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

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

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


      Variant2: NM_000152.4:c.2815_2816delGT (p.Val939Leufs)

      ClinVar: 371481 https://www.ncbi.nlm.nih.gov/clinvar/variation/371481/

      gnomAD: East Asian 1.631e-4, Overall 1.194e-5 http://gnomad.broadinstitute.org/variant/17-78093082-CTG-C


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

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

      HPOsFreeText: GAA (MS/MS) enzyme activity at 0.46 umol/hr/L, Serum CK at 86 U/L

      GenotypingMethod: GAA Gene Sequencing and PCR Amplification


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

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

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


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

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

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


      Variant3: NM_000152.4:c.1935C>A (p.Asp645Glu)

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

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


      Variant4: NM_000152.4:c.1726G>A (p.Gly576Ser)

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

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


      CaseAddInfo: Late Onset Pompe Disease, Nomenclature indicates Variants 1 and 2 and Variants 3 and 4 are in cis

    3. CasePDC-9: Female, Taiwan, Birth diagnosis

      HPOsFreeText: 4MU enzyme activity at 0.98, MS/MS ennzyme activity at 0.83

      GenotypingMethod: GAA Gene Sequencing and PCR Amplification


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

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

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


      Variant2: NM_000152.4:c.2815_2816delGT (p.Val939Leufs)

      ClinVar: 371481 https://www.ncbi.nlm.nih.gov/clinvar/variation/371481/

      gnomAD:East Asian 1.631e-4, Overall 1.194e-5 http://gnomad.broadinstitute.org/variant/17-78093082-CTG-C


      CaseAddInfo: Patient is either a carrier or has a pseudodeficency allele

    4. CaseOPTPD-6: Female, Taiwan, Birth diagnosis

      HPOsFreeText: GAA (MS/MS) enzyme activity at 0.50 umol/hr/L

      GenotypingMethod: GAA Gene Sequencing and PCR Amplification


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

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

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


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

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

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


      CaseAddInfo: One Pompe Mutation allele and Two Pseudodeficency Mutation alleles, Nomenclature indicates patient is homozygous for Variant 1 and Variant 2 is in cis with one copy, 70 other patients have the same genotype

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

      Case22

      HPOsFreeText: See Group Phenotypes


      CasePreviousTesting: Sanger sequencing

      CaseMethod1: Sanger sequencing and PCR Amplification

      CaseMethod2: Whole Exome Sequencing (WES)

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


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

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

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


      Variant2: NM_000152.4:c.1710C>G (p.Asn570Lys)

      ClinVar: 555153 https://www.ncbi.nlm.nih.gov/clinvar/variation/555153/

      gnomAD: African 1.149e-4, Overall 3.187e-5 http://gnomad.broadinstitute.org/variant/17-78085855-C-G


      CaseAddInfo: Infantile Onset Pompe Disease

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

      Case36

      HPOsFreeText: See Group Phenotypes


      CasePreviousTesting: Sanger sequencing

      CaseMethod1: Sanger sequencing and PCR Amplification

      CaseMethod2: Whole Exome Sequencing (WES)

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


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

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

      gnomAD: Not in gnomAD


      Variant2: NM_000152.4:c.437delT (p.Met146Argfs*7)

      ClinVar: 554096 https://www.ncbi.nlm.nih.gov/clinvar/variation/554096/

      gnomAD: Not in gnomAD


      CaseAddInfo: Infantile Onset Pompe Disease

    3. c.525delT(p.Glu176Argfs*45)

      Case51

      HPOsFreeText: See Group Phenotypes


      CasePreviousTesting: Sanger sequencing

      CaseMethod1: Sanger sequencing and PCR Amplification

      CaseMethod2: Whole Exome Sequencing (WES)

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


      Variant1: NM_000152.4:c.525delT (p.Glu176Argfs*45)

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

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


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

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

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


      CaseAddInfo: Infantile Onset Pompe Disease

    1. recently Van Capele et al. evidenced that a second mutation (defined as severe, less severe or potentially less severe) did not seem to have an effect on the age of onset of the disease [22]. A homozygous status for this mutation has been shown to have a low frequency (maybe explained by a reduced or incomplete penetrance); however, patients homozygous for this mutation do not seem to differ, in their clinical phenotype variation, from heterozygotes [19].

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

    1. 11

      Case11: Female, 48 years onset, 54 years diagnosis, Italy

      HPOsFreeText: See Group Phenotypes, ERT started at 54, GAA Activity at ~8.5 pmol/min/mg before ERT and ~9 after

      GroupGenotypingMethod: PCR Amplification and GAA Gene Sequencing


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

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

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


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

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

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


      CaseAddInfo: Late Onset Pompe Disease

    2. 10

      Case10: Male, 50 years onset, 52 years diagnosis, Italy

      HPOsFreeText: See Group Phenotypes, ERT started at 53, GAA Activity at ~13 pmol/min/mg before ERT and ~15 after

      GroupGenotypingMethod: PCR Amplification and GAA Gene Sequencing


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

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

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


      Variant2: NM_000152.4:c.784G>A (p.Glu262Lys)

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

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


      CaseAddInfo: Late Onset Pompe Disease

    1. Supplement Table 1)

      Patient4: 3yo

      CasePresentingHPOs: HP:0001638

      HPOsFreeText: rhGAA dosage = 20 QW, independent walker

      CaseNotHPOs:

      NotHPOsFreeText:

      CaseAddInfo: homozygous variant, 6days old at ERT start

      CasePMIDs:

      CasePreviousTesting: same as group

      CaseGenotypingMethod: same as group

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

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

      gnomAD: 0.0001721, http://exac.broadinstitute.org/variant/17-78086721-C-A

    2. Supplement Table 1)

      Patient9: 2yo

      CasePresentingHPOs: HP:0001638

      HPOsFreeText: rhGAA dosage = 40 EOW, independent walker

      CaseNotHPOs:

      NotHPOsFreeText:

      CaseAddInfo: 14days old at ERT start

      CasePMIDs:

      CasePreviousTesting: same as group

      CaseGenotypingMethod: same as group

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

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

      gnomAD: 0.0001721, http://exac.broadinstitute.org/variant/17-78086721-C-A

      Variant2: NM_000152.4(GAA):c.2815_2816delGT (p.Val939Leufs)

      ClinVar: 371481, https://www.ncbi.nlm.nih.gov/clinvar/variation/371481/

      gnomAD: 1.653e-05, http://exac.broadinstitute.org/variant/17-78093082-CTG-C

    1. LOPD-3

      CaseLOPD-3: 2 weeks diagnosis

      HPOsFreeText: GAA activity 2.7 (nmol · h−1 · mg−1), Mean percentage of normal 3.7%

      GenotypingMethod: Newborn Screening Panels


      Variant: NM_000152.4:c.2647-7G>A

      ClinVar: 551106 https://www.ncbi.nlm.nih.gov/clinvar/variation/551106/

      gnomAD: South Asian 3.266e-5, Overall 1.780e-5 http://gnomad.broadinstitute.org/variant/17-78092445-G-A


      CaseAddInfo: Late Onset Pompe Disease, Patient is homozygous for the above variant

    2. LOPD-7

      CaseLOPD-7: 24 years diagnosis

      CasePresentingHPOs: HP:0003236, HP:0012378, HP:0002910 (Increased serum CK, Fatigue, Elevated transaminases)

      HPOsFreeText: GAA activity 4.0 (nmol · h−1 · mg−1), Mean percentage of normal 5.6%

      GenotypingMethod: Newborn Screening Panels


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

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

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


      Variant2: NM_000152.4:c.2481+102_2646+31del (p.Gly828_Asn882del) (exon 18 del)

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

      gnomAD: Not in gnomAD


      CaseAddInfo: Late Onset Pompe Disease

    1. Patient 1 was a 22-year old Caucasian female

      Patient1: female, 22 yo, Caucasian

      CasePresentingHPOs: HP:0003710, HP:0003326, HP:0040081, HP:0045040, HP:0002910

      HPOsFreeText: CK = 571 U/l, LDH = 301 U/l, ASAT = 85 U/l, ALAT = 84 U/l, GAA activity = 0.31nmol/spot x21hrs, small droplet lipid deposits in the muscle fibres of vastus lateralis

      CaseNotHPOs: HP:0003457, HP:0009051, HP:0001639, HP:0002111, HP:0002093

      NotHPOsFreeText: MRI of thigh muscles showed no abnormalities, no changes in the PAS positive inclusions

      CaseAddInfo: 14yo at symptom onset, no family history of neuromuscular disease

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

      CaseGenotypingMethod: Sanger Sequencing

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

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

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

    1. 3

      Case3: Female, Swedish, 64 years report, 48 years onset

      CasePresentingHPOs: HP:0008956 (Thigh muscle atrophy)

      HPOsFreeText: 6-min walk test achieved 369 m, MRC score is 4/5 (thigh/calf), Forced vital capacity sitting/supine is 2.8/2.7 (L), On the medications Zopiklon and Ketoprofen

      NotHPOsFreetext: Not on ERT

      GroupGenotypingMethod: Mutation Analysis on the GAA Gene


      Variant1: NM_000152.4:c.2560C>T (p.Arg854Ter)

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

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


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

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

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


      CaseAddInfo: Late Onset Pompe Disease

    1. To validate the U7 snRNA vector, a control experiment was performed on primary fibroblasts derived from a patient with adult Pompe disease (patient 1), who carried the IVS1 variant on one allele and the c.525delT on the second allele.

      Patient1: control experiment performed on patient's primary fibroblasts to validate U7 snRNA vector, screen showed multiple U7 snRNA-based AONs that modulate inclusion of exon 2 in GAA mRNA

      CasePresentingHPOs:

      HPOsFreeText: LOPD

      CaseNotHPOs:

      NotHPOsFreeText:

      CaseAddInfo:

      CasePMIDs:

      CasePreviousTesting: n/a

      CaseGenotypingMethod: n/a

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

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

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

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

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

      gnomAD: 7.041e-05, http://exac.broadinstitute.org/variant/17-78078909-CT-C

    1. 20 mg/kg (N = 16)

      Case15HPOsFreeText: 20 mg/kg GAA treatment, GAA activity at 8.3 pmol/spot/hr, GAA activity at 35% lower limit of normal

      CaseAddInfo: Late Onset Pompe Disease


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


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

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

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


      Variant2: NM_000152.4:c.2482_2646del165 (p.Gly828_Asn882del) (Exon 18 del)

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

      gnomAD: Not in gnomAD


      CaseAddInfo:

    1. 10

      Patient10: 50yo

      CasePresentingHPOs: HP:0003325, HP:0004944, HP:0020038

      HPOsFreeText: GAA = 3.6%, BMI = 22.4, MCA M1 4mm aneurysm, normal CT

      CaseNotHPOs:

      NotHPOsFreeText: No cardiovascular risk factor

      CaseAddInfo: 13yr disease duration, variants in cis

      CasePMIDs:

      CasePreviousTesting: same as group

      CaseGenotypingMethod: same as group

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

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

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

      Variant2: NM_000152.4(GAA):c.1551+1G>C

      ClinVar: 554983, https://www.ncbi.nlm.nih.gov/clinvar/variation/554983/

      gnomAD: n/a

    1. P7a

      Patient7: Male, 59yo

      CasePresentingHPOs: HP:0000822, HP:0000819, HP:0003077, HP:0001513

      HPOsFreeText: LOPD

      CaseNotHPOs:

      NotHPOsFreeText:

      CaseAddInfo: 5yr follow-up MRI, 14yr disease duration, ERT lasted for 135mo

      CasePMIDs: PMID: 25614309

      CasePreviousTesting: same as group

      CaseGenotypingMethod: same as group

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

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

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

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

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

      gnomAD: n/a