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    1. PATIENT 3

      Case#: Patient 3, male, 21 year old, ethnicity unknown

      DiseaseAssertion: Pompe disease

      FamilyInfo: No family history of muscle disease

      CasePresentingHPOs: HP:0003236, HP:0100284

      (Elevated serum creatine kinase, EMG: myotonic discharges

      CaseHPOFreeText: Mild weakness (4/5) of iliopsoas muscles

      Myotonic discharges in the lumbar paraspinal muscles

      Elevated aspartate aminotransferase of 172 I/U ( Normal range 19–55 I/U)

      Elevated alanine aminotransferase of 203 I/U (Normal range 19–72 I/U)

      Serum CK was elevated at 1,373 U/L (normal range 70–185 U/L)

      CaseNotHPOs:

      CaseNotHPOFreeText: Normal alkaline phosphatase and γ-glutamyl transpeptidase levels.

      Liver ultrasound and biopsy at an outside facility were normal

      CasePreviousTesting: GAA level was 1.4 pmol/punch/h (normal range 10–49 pmol/punch/h)

      Variant 1: NM_000152.5(GAA):c.-32-13T>G

      ClinVar: 4027

      CAID: CA116606

      gnomAD: Hughest population MAF= 0.005541 (Ashkenazi Jewish)

      Variant 2: NM_000152.5(GAA):c.877G>A (p.Gly293Arg)

      ClinVar: 4036

      CAID: CA116622

      gnomAD: Highest population MAF= 0.00005704 (Latinos)

      ParentalGenotype:N/A

      PreviouslyPublished:N/A