Case89

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.877G>A (p.Gly293Arg)

ClinVar: 4036 https://www.ncbi.nlm.nih.gov/clinvar/variation/4036/

gnomAD: Latino 5.704e-5, Overall 1.807e-5 http://gnomad.broadinstitute.org/variant/17-78081617-G-A

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

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

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

CaseAddInfo: Adult Late Onset Pompe Disease

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

Case30: Female, 10 yr onset, 11 yr diagnosis, 16.4 yr report

CasePresentingHPOs: HP:0002650 (Scoliosis)

HPOsFreeText: Wheelchair used at 16 yr, Respiratory support used at 12 yr, FVC z-score sitting -8.07 (13% pred), 72% MRC Scale, 1560 CK U/l, 3.4 GAA activity (nmol/h/mg)^h from cultured fibroblasts

Patient8: female, 51yo, adult onset

CasePresentingHPOs:

HPOsFreeText: LOPD, BMI = 26.6 / 27.2 / n-a, required use of wheelchair, WGMS = 4 / 4 / n-a

CaseNotHPOs:

NotHPOsFreeText: did not require respiratory support

CaseAddInfo:

CasePMIDs:

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.877G>A (p.Gly293Arg)

ClinVar: 4036, https://www.ncbi.nlm.nih.gov/clinvar/variation/4036/

gnomAD: 0.00001807, http://gnomad.broadinstitute.org/variant/17-78081617-G-A

Case#: Patient 8, Gender N/A, Onset at 1-2 months. Death at 13 months. Southeast Asian

DiseaseAssertion: Pompe disease

FamilyInfo: N/A

CasePresentingHPOs: HP:0002240, HP:0001252, HP:0002789, HP:0001698 (Hepatomegaly, Muscular hypotonia, Tachypnea, Pericardial effusion)

CaseHPOFreeText: Hepatomegaly is mild, Pericardial effusion is mild, BHV, SDD

CaseNotHPOs: N/A

CaseNotHPOFreeText: Normal PR Interval

CasePreviousTesting: GAA activity in leukocytes was 1.46% of normal control value.

PCR of all exons was performed and subsequently subjected to capillary Sanger sequencing in both directions

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

ClinVar: 4036

CAID: CA116622

gnomAD: Highest population MAF = 0.00005704 (Latino)

ParentalGenotype: Both parents were carriers of the variant c.877G>A (p.Gly293Arg)

PreviouslyPublished: N/A