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    1. PATIENT 2

      Case#: Patient 2, Male, 71 year old, ethnicity unknown

      DiseaseAssertion: Pompe disease

      diagnosed at age 52 with SMA type III following an EMG reporting neurogenic changes and a muscle biopsy from a hamstring muscle that demonstrated denervation atrophy

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0003701, HP:0003445

      (Proximal muscle weakness, EMG:neuropathic changes

      CaseHPOFreeText: Normal strength in the upper extremities with moderate weakness of hip flexion at 3/5, hip abduction 3–4/5, hip adduction 3–4/5, and hamstrings 4/5.

      EMG showed myotonic discharges in the anterior tibialis, medial gastrocnemius, iliopsoas, tensor fasciae latae, and biceps brachii muscles.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      Staining for PAS and acid phosphatase was normal.

      Serum CK was 208 U/L (normal range 70–185)

      CasePreviousTesting: GAA activity was 1.3pmol/punch/h (normal 10–49 pmol/punch/h) and he was found to have 2 heterozygous mutations

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

      ClinVar: 4027

      CAID: CA116606

      gnomAD: Highest population MAF= 0.005541 (Ashkenazi Jewish)

      Variant 2: NM_000152.5(GAA):c.1841C>A (p.Thr614Lys)

      ClinVar: 167113

      CAID: CA234050

      gnomAD: Highest population MAF= 0.00004784 (European nin-Finnish)

      ParentalGenotype:N/A

      PreviouslyPublished:N/A