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  1. Oct 2026
    1. Supplementary Data: S2 Table

      Case 130: Spanish, 14yo, 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, Next-gen sequencing panels of 55 or 78 genes

      Variant: NM_000257.3(MYH7):c.2167C>G (p.Arg723Gly)

      ClinVar: 42885, https://www.ncbi.nlm.nih.gov/clinvar/variation/42885/

      gnomAD: n/a

      MultipleGeneVariants:

      (1) TCAP Variant:

      Variant: NM_003673.3(TCAP):c.97C>T (p.Arg33Trp)

      ClinVar: 282451, https://www.ncbi.nlm.nih.gov/clinvar/variation/282451/

      gnomAD: 0.00007092, https://gnomad.broadinstitute.org/variant/17-37821709-C-T

    2. Supplementary Data: S2 Table

      Case 67: Spanish, 40yo, 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, Next-gen sequencing panels of 55 or 78 genes

      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

      MultipleGeneVariants:

      (1) TTN Variant:

      Variant: NM_133378.4(TTN):c.4396T>C (p.Phe1466Leu)

      ClinVar: 166320, https://www.ncbi.nlm.nih.gov/clinvar/variation/166320/

      gnomAD: 0.0006871, https://gnomad.broadinstitute.org/variant/2-179642515-A-G

    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.1532T>C (p.Ile511Thr)

      ClinVar: 42848, https://www.ncbi.nlm.nih.gov/clinvar/variation/42848/

      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.727C>T (p.Arg243Cys)

      ClinVar: 43101, https://www.ncbi.nlm.nih.gov/clinvar/variation/43101/

      gnomAD: 0.00003184, https://gnomad.broadinstitute.org/variant/14-23900799-G-A

    1. A person with Proband MYH7 R147S

      CaseR147S: 52 year old male

      DiseaseAssertion: HCM

      FamilyInfo: son was also diagnosed with HCM, but his younger daughter and granddaughter were genotype positive–phenotype negative.

      CaseHPOFreeText: asymmetric septal hypertrophy (ASH) with mid LV obstruction

      CasePreviousTesting: systematic mutation screening of eight sarcomeric genes: (MYH7), (MYBPC3), (TNNT2), (TNNI3), (MYL2), (MYL3), (TPM1), and (ACTC), using direct DNA sequencing

      GenotypingMethod: Genomic DNA was isolated from the leukocytes of the peripheral blood. Polymerase chain reaction was used to amplify the exons and flanking intronic bases of the eight genes, including MYH7, MYBPC3, TNNT2, TNNI3, MYL2, and MYL3. When no mutation was found, analysis of the TPM1 and ACTC genes was performed.

      Variant: NM_000257.4:c.441G>C

      ClinVar: 643664

      CAID: CA389052814

      gnomAD: not found

    1. Upon presentation of a 2-month-old infant

      Case: proband, 2mo

      DiseaseEntity: Left ventricular noncompaction (LVNC)

      CasePresentingHPOs: HP:0001635 (congestive heart failure)

      HPOsFreeText: required mechanical ventilation and inotropic support, depressed left ventricular function, deep left ventricle trabeculations

      FamilyInfo: sibling with fetal demise at 24wks gestation due to pulmonary hypoplasia and biventricular noncompaction with deep recesses in myocardial walls of both ventricles, right ventricular dilation, and widespread fibrosis; signs of LVNC also present in 4yo sibling and father, paternal grandfather had history of arrhythmia

      CaseGenotypingMethod: WES

      Variant: NM_000257.4(MYH7):c.1159C>T (p.Leu387Phe)

      ClinVar: 524975, https://www.ncbi.nlm.nih.gov/clinvar/variation/524975/

      gnomAD: absent from gnomAD

      MultipleGeneVariants:

      (1) MLK2 Variant

      Variant: NM_001308142.1:c.2010G>C

      CAID: CA394829003, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA394829003

      gnomAD: absent

      (2) NKX2-5 Variant

      Variant: NM_004387.4(NKX2-5):c.355G>T (p.Ala119Ser)

      ClinVar: 9018, https://www.ncbi.nlm.nih.gov/clinvar/variation/9018/

      gnomAD: 0.0009792, https://gnomad.broadinstitute.org/variant/5-172660192-C-A?dataset=gnomad_r2_1

    1. Supplementary Data Table S3

      Case: 231

      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.4472C>G (p.Ser1491Cys)

      ClinVar: 43020 https://www.ncbi.nlm.nih.gov/clinvar/variation/43020/

      gnomAD: 0.01265, https://gnomad.broadinstitute.org/variant/14-23886409-G-C

      MultipleGeneVariants:

      (1) LDB3 Variant

      Variant: NM_007078.3(LDB3):c.295C>T (p.Pro99Ser)

      ClinVar: 178059 https://www.ncbi.nlm.nih.gov/clinvar/variation/178059/

      gnomAD: 0.009200, https://gnomad.broadinstitute.org/variant/10-88439888-C-T

    2. Supplementary Data Table S3

      Case: 129

      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.1987C>T (p.Arg663Cys)

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

      gnomAD: Not in gnomAD

      MultipleGeneVariants:

      (1) LAMA4 Variant

      Variant: NM_001105206.3(LAMA4):c.3239G>A (p.Arg1080Gln)

      ClinVar: 44374 https://www.ncbi.nlm.nih.gov/clinvar/variation/44374/

      gnomAD: 0.02400, https://gnomad.broadinstitute.org/variant/6-112460365-C-T

    3. Supplementary Data Table S3

      Case: 13

      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) PLB1 Variant

      Variant: NM_153021.4:c.3967C>A

      CAID: CA1588921, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA1588921

      gnomAD: 0.01507, https://gnomad.broadinstitute.org/variant/2-28854972-C-A

      (2) TTN Variant

      Variant: c.33510_33512dupAGA, p.Glu11171dup Unregistered Variant

    4. Supplementary Data Table S3

      Case: 152

      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) CRYAB Variant

      Variant as listed does not exist on any transcript

      Variant: c.331G>A (p.Gly111Ser)

      ClinVar: N/A

      gnomAD: N/A

      (2) DSP Variant

      Variant: NM_004415.4(DSP):c.4372C>G (p.Arg1458Gly)

      ClinVar: 44906 https://www.ncbi.nlm.nih.gov/clinvar/variation/44906/

      gnomAD: 0.003556, https://gnomad.broadinstitute.org/variant/6-7580795-C-G

    5. Supplementary Data Table S3

      Case: 138

      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.2162G>A (p.Arg721Lys)

      CAID: CA389049002 http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA389049002

      gnomAD: Not in gnomAD

      MultipleGeneVariants:

      (1) CRYAB Variant

      Variant as listed does not exist on any transcript

      Variant: c.331G>A (p.Gly111Ser)

      ClinVar: N/A

      gnomAD: N/A

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

      (3) TCAP Variant

      Variant: NM_003673.3(TCAP):c.458G>A (p.Arg153His)

      ClinVar: 44710 https://www.ncbi.nlm.nih.gov/clinvar/variation/44710/

      gnomAD: 0.002296, https://gnomad.broadinstitute.org/variant/17-37822316-G-A

    1. Supplementary Material 4

      Case M-17: 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.2207T>C (p.Ile736Thr)

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

      gnomAD: n/a

    2. Supplementary Material 4

      Case M-13: 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.2011C>T (p.Arg671Cys)

      ClinVar: 164350, https://www.ncbi.nlm.nih.gov/clinvar/variation/164350/

      gnomAD: n/a

    3. Supplementary Material 4

      Case M-7: 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 2: NM_000257.3(MYH7):c.1357C>T (p.Arg453Cys)

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

      gnomAD: n/a

    4. Supplementary Material 4

      Case M-24: 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.2546T>C (p.Met849Thr)

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

      gnomAD: n/a

    5. Supplementary Material 4

      Case M-4: 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.746G>A (p.Arg249Gln)

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

      gnomAD: n/a

    1. 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.345C>T (p.Tyr115=)

      ClinVar: 42962, https://www.ncbi.nlm.nih.gov/clinvar/variation/42962/

      gnomAD: 0.0001061, https://gnomad.broadinstitute.org/variant/14-23902293-G-A

    1. In a small cohort of HCM patients (n = 8), we searched for mutations in the two most common genes responsible for HCM and found four missense mutations in the MYH7 gene encoding cardiac β-myosin heavy chain (R204H, M493V, R719W, and R870H) and three mutations in the myosin-binding protein C3 gene (MYBPC3) including one missense (A848V) and two frameshift mutations (c.3713delTG and c.702ins26bp).

      4 mutations in MYH7 reported but no case information

      (R204H, M493V, R719W, and R870H)

    1. III-4

      Case III-4: Female, 4yo

      DiseaseAssertion: Left ventricular hypertrophy

      CasePresentingHPOs: HP:0001712 (left ventricular hypertrophy)

      CaseHPOFreeText: myocardium lesion, suspected double-chambered left ventricle, asymptomatic, normal thickness of septum and left ventricle, fibromuscular tissues left ventricular apex, left ventricle ventricle end-diastolic diameter = 38.4mm, left ventricular ejection fraction = 64%

      CasePreviousTesting: same as proband

      CaseGenotypingMethod: segregation analysis using the results from Sanger sequencing

      Variant: NM_000257.3:c.998A>T

      CAID: CA389051586, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA389051586

      gnomAD: n/a

    1. Table 5

      Case EO32: Italian

      DiseaseAssertion: HCM (early-onset)

      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

      Variant1: NM_000257.3(MYH7):c.1988G>A (p.Arg663His)

      ClinVar: 42875, https://www.ncbi.nlm.nih.gov/clinvar/variation/42875/

      gnomAD: 0.00001414, https://gnomad.broadinstitute.org/variant/14-23896042-C-T

      MultipleGeneVariants:

      (1) MYPBC3 Variant:

      Variant: NM_000256.3(MYBPC3):c.3192dupC (p.Lys1065Glnfs)

      ClinVar: 42693, https://www.ncbi.nlm.nih.gov/clinvar/variation/42693/

      gnomAD: n/a

    1. Case377: Female, 0.0833 years onset, Japan, Asian

      DiseaseAssertion: Left ventricular noncompaction

      CasePresentingHPOs: HP:0030682, HP:0025169, HP:0001635 (Left ventricular noncompaction, Left ventricular systolic dysfunction, Heart failure)

      HPOsFreeText: Left Ventricular Ejection Fraction at 30%, LVDD-Z score at 1.3333

      CaseNotHPOs: HP:0011675 (Arrhythmia)

      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.2078T>G (p.Leu693Arg)

      CAID: CA389049168 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000257.3:c.2078T%3EG

      gnomAD: Not in gnomAD

    2. Case391: Female, 0.83 years onset, Japan, Asian

      DiseaseAssertion: Left ventricular noncompaction

      CasePresentingHPOs: HP:0030682, HP:0025169, HP:0001635 (Left ventricular noncompaction, Left ventricular systolic dysfunction, Heart failure)

      HPOsFreeText: Left Ventricular Ejection Fraction at 38%, LVDD-Z score at 2.6785

      CaseNotHPOs: HP:0011675 (Arrhythmia)

      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.5401G>A (p.Glu1801Lys)

      ClinVar: 43069 https://www.ncbi.nlm.nih.gov/clinvar/variation/43069/

      gnomAD: Not in gnomAD

    3. Case362: Female, 0.0833 years 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 40%, LVDD-Z score at -0.823

      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.689T>C (p.Phe230Ser)

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

      gnomAD: Not in gnomAD

    1. Cardiomyopathy Mutations in the Tail of β-Cardiac Myosin Modify the Coiled-coil Structure and Affect Integration into Thick Filaments in Muscle Sarcomeres in Adult Cardiomyocytes*

      PMID: 24047955

      Gene: MYH7

      HGNC: 7577

      "It is unclear why mutations in the filament-forming tail of myosin heavy chain (MHC) cause hypertrophic or dilated cardiomyopathy as these mutations should not directly affect contraction. To investigate this, we first investigated the impact of five hypertrophic cardiomyopathy-causing (N1327K, E1356K, R1382W, E1555K, and R1768K) and one dilated cardiomyopathy-causing (R1500W) tail mutations on their ability to incorporate into muscle sarcomeres in vivo."

      Results suggest that small effects of mutations on helicity translate into a reduced ability to incorporate into sarcomeres, which may elicit compensatory hypertrophy.

    1. a missense mutation in MYH7 and a nonsense variant in INS-IGF2 (patient 1)

      Case1: female, 15 years old at last clinical evaluation

      DiseaseAssertion: LVH, HCM

      FamilyInfo: n/a

      CasePresentingHPOs: n/a

      CaseHPOFreeText: cleft mitral valve during intrauterine life

      CaseNotHPOs: n/a

      CaseNotHPOFreeText: n/a

      CasePreviousTesting: evaluated previously by using a DHPLC/Sanger test to search for causative mutations within the exons of 8 sarcomeric genes: MYH7, MYBPBC3, TNNI3, TNNT2, TPM1, ACTC, MYL2, and MYL3

      GenotypingMethod: Next generation sequencing, High-Throughput Sequencing

      Variant: NM_000257.4:c.976G>C

      ClinVar: 43117

      CAID: CA017063

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

      0.0001627 European (non-Finnish)

  2. www.jstage.jst.go.jp www.jstage.jst.go.jp
    1. I-9 Female

      Case II-9: Female, 46yo, diagnosed at 14yo

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      CasePresentingHPOs: HP:0002875, HP:0100749, HP:0012250, HP:0005135, HP:0011713 (exertional dyspnea, chest pain, ST segment depression, abnormal T wave, left bundle branch block)

      CaseHPOFreeText: abnormal Q wave, Wide QRS, interventricular septum = 13mm, posterior wall of left ventricule = 9mm

      CasePreviousTesting: same as proband

      CaseGenotypingMethod: same as proband

      Variant: NM_000257.3:c.1172A>C

      CAID: CA389051191, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA389051191

      gnomAD: n/a

    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 two HCM probands

      Variant: NM_000257.4(MYH7):c.2722C>G (p.Leu908Val)

      ClinVar: 14097 https://www.ncbi.nlm.nih.gov/clinvar/variation/14097/

      gnomAD: 0.00006482, http://gnomad.broadinstitute.org/variant/14-23893316-G-C

    2. 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.3803G>A (p.Arg1268His)

      ClinVar: 42975 https://www.ncbi.nlm.nih.gov/clinvar/variation/42975/

      gnomAD: 0.0009786, http://gnomad.broadinstitute.org/variant/14-23888742-C-T

    1. CaseCM1856: Male, 15 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: Positive family history of cardiomyopathy or sudden death, Proband found in Supplementary Table 2, Mother with an ECG abnormality and 2 brothers with HCM tested positive for this variant, Father with no phenotypes tested negative for this variant


      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.2155C>T (p.Arg719Trp)

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

      gnomAD: European (Non-Finnish) 6.481e-5, Overall 3.185e-5 https://gnomad.broadinstitute.org/variant/14-23895180-G-A

    2. CaseCM1829: 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, Variant is asserted as novel, Mother and father are both negative for this variant


      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.2459C>A (p.Ala820Asp)

      CAID: CA389048368 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000257.3%3Ac.2459C%3EA

      gnomAD: Not in gnomAD

    1. Refinement of the American College of Medical Genetics and Genomics/ClinGen Guidelines for the DCM Precision Medicine Study

      PMID: 32160020

      Gene: MYH7

      HGNC: 7577

      The goal of this study was to adjust the framework for interpreting MHY7 variants. In 97 probands and 2059 variants, they found that "15/97 (15.5%) probands have likely pathogenic/P variants."

      Variant information found in Table 3.

    1. KMP 8

      Case KMP 8: Eastern Slovakia, Male, 62yo

      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. A previously healthy 12-year-old boy was admitted to ourhospital for an examination of thickened IVS.

      Case1: 12 year old boy

      DiseaseAssertion: hypertrophic cardiomyopathy

      FamilyInfo: parents were clinically normal, and there was no family history of HCM

      CasePresentingHPOs:

      CaseHPOFreeText:

      CaseNotHPOs:

      CaseNotHPOFreeText:

      CasePreviousTesting: Chest radiography showed protrusion of left third and fourth arches and the cardio-thoracic ratio was 0.50. Two-dimensional echocardiogram showed asymmetrical hypertrophy of the LV. Laboratory examinations showed elevated serum levels of brain natriuretic peptide. Cardiovascular magnetic resonance imaging revealed a markedly thickened IVS and decreased wall motion.

      GenotypingMethod: DNA samples were extracted from the peripheral blood ofthe patient and his parents for use as templates to identify mutations in the genes for sarcomeric proteins. All PCR products were analysed for sequence variations by direct DNA sequencing of both strands. Direct sequencing of coding exons of MYH7.

      Variant: NM_000257.4:c.2459C>A

      ClinVar: 657112

      CAID: CA389048368

      gnomAD: not found

    1. In patient 1 with HCM , we identified two known pathogenic missense variants in the two most frequently mutated sarcomeric genes MYH7 and MYBPC .

      Case1: patient 1, 68 years old, male

      DiseaseAssertion: HCM

      FamilyInfo: positive family history of SCD and end stage heart failure

      CasePresentingHPOs: n/a

      CaseHPOFreeText: n/a

      CaseNotHPOs: n/a

      CaseNotHPOFreeText: n/a

      CasePreviousTesting: n/a

      GenotypingMethod: multiplex targeted high‐throughput sequencing, DNA capture assay including all exons from 130 genes involved in cardiovascular Mendelian disorders and analysed simultaneously four samples by multiplexing

      VariantMYH7: NM_000257.4:c.4130C>A

      ClinVar: not found

      CAID: CA389040836

      gnomAD: not found

      VariantMYBPC3:

      ClinVar: 42813

      CAID: CA016212

      gnomAD: https://gnomad.broadinstitute.org/variant/11-47367871-C-T

      0.01364 European (Finnish)

    1. Supplementary Data: Table S3

      Case 64:

      DiseaseAssertion: left ventricular noncompaction

      CasePresentingHPOs: HP:0030682 (left ventricular noncompaction)

      CaseHPOFreeText: >7yo, able to hold breath, non compacted segment = distinct 2-layered appearance of trabeculated and compacted myocardium, NC/C ratio > 2.3:1

      CasePreviousTesting: Cardiac MRI using 17-segment model of LV segmentation, ECG, transthoracic echocardiography, full testing (MYBPC3, TNNT2, TNNI3, MYL2, MYL3, TPM1, ACTC1), additional testing listed in supplementary data tables S1 and S2.

      CaseGenotypingMethod: WES, variant enrichment analysis

      Variant: NM_000257.3(MYH7):c.3337-3dupC written in paper as g.23889445insG

      ClinVar: 42956, https://www.ncbi.nlm.nih.gov/clinvar/variation/42956/

      gnomAD: 0.02126, https://gnomad.broadinstitute.org/variant/14-23889445-T-TG

      MultipleGeneVariants:

      (1) - TTN Variant:

      Variant: g.179407388delC no ClinVar or CAID

    1. DW

      CaseDW: 16 years diagnosis, Australia

      DiseaseAssertion: Hypertrophic Cardiomyopathy

      FamilyInfo: One affected relative, Father, died suddenly

      CasePresentingHPOs: HP:0001639 (Hypertrophic cardiomyopathy)

      HPOsFreeText: Maximum left ventricular hypertrophy at 21 mm

      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.937A>T (p.Ile313Phe)

      CAID: CA389051713 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000257.3%3Ac.937A%3ET

      gnomAD: Not in gnomAD

      Multiple Gene Variants:

      MYBPC3 Variant

      Variant: NM_000256.3:c.2372_2373insG (p.Trp792Valfs)

      ClinVar: 42619 https://www.ncbi.nlm.nih.gov/clinvar/variation/42619/

      gnomAD: European (Non-Finnish) 4.277e-5, Overall 1.744e-5 https://gnomad.broadinstitute.org/variant/11-47359280-A-AC

    1. CasePT-111: 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.563C>A (p.Thr188Asn)

      CAID: CA016314 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000257.3%3Ac.563C%3EA

      gnomAD: Not in gnomAD

    1. 9-year-old boy

      Case#: a 9-year-old boy

      DiseaseAssertion: Hypertrophic obstructive cardiomyopathy (HOCM) during clinical screening, presence of the familial mutation in the MYL2 gene MYL2, c.487G > A [p.(Glu163Lys) as pathogenic.

      FamilyInfo: a family history of sarcomeric HCM who was diagnosed with hypertrophic obstructive cardiomyopathy (HOCM) during clinical screening. His father suffered from HCM and died 6 years ago in his 3rd decade due to a stroke. The paternal grandfather of the proband and his sister were also diagnosed with HCM. Other affected family members included a paternal uncle and his son as well as a paternal aunt and her son. Genetic testing of the latter family members revealed a mutation in the MYL2 gene.

      ParentalTesting: Yes the family members

      CasePresentingHPOs: HP:0034313, HP:0031666, HP:0001670

      CaseHPOFreeText: He was well and asymptomatic. His weight was 44.6 kg (93rd centile) and height was 150.5 cm (94th centile); heart rate was 60 b.p.m. and right arm blood pressure was 111/67 mmHg with a mean arterial pressure of 83 mmHg. On auscultation, a 2/6 systolic murmur in the 3rd intercostal space at the left sternal edge was audible. N-terminal prohormone of brain natriuretic peptide level was 434 ng/L (normal range <112 ng/L). The echocardiogram showed asymmetric septal hypertrophy (maximal wall thickness 18 mm) of the left ventricle (LV) with mild flow acceleration in the mid-LV cavity (peak systolic velocity 2.6 m/s) consistent with HOCM. Left ventricle systolic function was hyperdynamic with LVEF of 80%. Late gadolinium enhancement (LGE) imaging showed an area of patchy LGE at the level of the maximal LV wall thickness (Figure 4).

      CaseNotHPOs: HP:0001635 , HP:0001279, HP:0031656, HP:0001653

      CaseNotHPOFreeText: No signs of congestive heart failure and no history of syncope. No systolic anterior movement (SAM) and no mitral regurgitation.

      CasePreviousTesting: Clinical screening

      Genotyping Method: Genetic testing confirmed

      FunctionalAnalysis: NR

      Variant: NM_000432.4:c.487G>A

      ClinVar: 1051330

      CAID: CA386696712

      gnomAD: NR

      AdditionalInfo: NR

    1. For GAA (Pompe disease) screening

      CaseP4-GAA: female, ethnicity = European, country origin = Italy

      CasePresentingHPOs:

      HPOsFreeText: enzyme activity = 2.22

      CaseNotHPOs: HP:0010899, HP:0010916, HP:0003236

      CaseAddInfo: homozygous

      CasePreviousTesting: initial and confirmatory DBS, biochemical tests

      CaseGenotypingMethod: mutation analyses

      Variant: NM_000152.4(GAA):c.533G>A (p.Arg178His)

      ClinVar: 554969; https://www.ncbi.nlm.nih.gov/clinvar/variation/554969/

      gnomAD: 2.646e-05, http://exac.broadinstitute.org/variant/17-78078918-G-A

    1. 25

      Patient25: Male, 15 years report, 2 years onset

      CasePresentingHPOs: HP:0002527 (Falls)

      HPOsFreeText: GAA activity 5.6% from leukocyte

      CaseNotHPOs: HP:0002098, HP:0001324, HP:0001640, HP:0002240 (Respiratory distress, Muscle weakness, Cardiomegaly, Hepatomegaly)

      NotHPOsFreeText: No wheelchair needed, Respiratory Assistance not needed

      CaseAddInfo: LOPD

    1. 4

      Case#: Patient 4, Gender N/A, onset at 3-4 months. Died at 9 months, Southeast Asian

      DiseaseAssertion:Pompe disease

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0002094 HP:0001639. HP:0005165, HP:0001270 (Hypertrophic Cardiomyopathy, Dyspnea, Shortened PR interval, Motor delay )

      CaseHPOFreeText: BVH, Died from dehydration (diarrhea)

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: GAA activity in leukocytes was 0% of normal control value.

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

      Variant 1: c.1225dup (p.Asp409GlyfsX95)

      ClinVar: N/A

      CAID: CA923726362

      gnomAD: N/A

      Variant 2: c.2024_2026delACA (p.Asn675del)

      ClinVar: 189006

      CAID: CA274244

      gnomAD: Highest population MAF = 0.0001106 (East asians)

      ParentalGenotype: Father was carrier for Variant1 c.1226insG (p.Asp409GlyfsX95)

      Mother was carrier of Variant 2 c.2024_2026delACA (p.Asn675del)

      PreviouslyPublished: N/A

    2. 5

      Case#: Patient 5, Gender N/A, Onset at 5-6 months. Death at 1.5 years of age, Southeast Asian

      DiseaseAssertion: Pompe disease

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0002094 HP:0001639. HP:0005165, HP:0001270, HP:0001252, HP:0001714, HP:0002090

      (Hypertrophic Cardiomyopathy, Dyspnea, Shortened PR interval, Motor delay, Muscular hypotonia, Ventricular hypertrophy, Pneumonia )

      CaseHPOFreeText: Death from heart failure and pneumonia

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: GAA activity in leukocytes was 0% of normal control value.

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

      Variant 1: NM_000152.5(GAA):c.1538A>G (p.Asp513Gly)

      ClinVar: 638014

      CAID: CA401367134

      gnomAD: N/A

      ParentalGenotype: Both parents carried the .1538A>G (p.Asp513Gly) variant in the GAA gene. There was no parental consanguinity

      PreviouslyPublished: N/A

    1. #11

      Case#: Subject number 11, male, 51 years (report)

      DiseaseAssertion: Pompe disease

      FamilyInfo: No known family member with PD

      CasePresentingHPOs: HP:0001324 (muscle weakness), HP:0003326 (Myalgia), HP:0002015 (dysphagia), HP:0002153 (hyperkalemia)

      CaseHPOFreeText:

      CaseNotHPOs: HP:0003546 (Exercise intolerance), HP:0001252 (Hypotonia), HP:0001638 (cardiomyopathy), HP:0002098 (respiratory distress), HP:0002094 (dyspnoea)

      CaseNotHPOFreeText: no biopsy, not asymptomatic

      CasePreviousTesting: "Enzymatic activity was detected by fluorometric techniques" "The GAA sequence was performed in all patients whose enzyme activity measured in DBS and lymphocytes was decreased."

      glucosidase activity: GAA activity was 0.21 mol/Lh in dried blood spots (normal range >0.75).

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

      Variant 1 ClinVarID: 4027

      Variant 1 CAid: CA116606

      Variant 2: NM_000152.5(GAA):c.2104C>T (p.Arg702Cys)

      Variant 2 ClinVarID: 189040

      Variant 2 CAid: CA274304

      Zygosity: Compound heterozygous

      ParentalGenotype: N/A

      PreviouslyPublished: N/A

    2. #15

      Case#: Subject number 15, male, 58 years (report)

      DiseaseAssertion: Pompe disease

      FamilyInfo: No known family member with PD

      CasePresentingHPOs: HP:0001324 (muscle weakness), HP:0003546 (Exercise intolerance), HP:0002153 (hyperkalemia)

      CaseHPOFreeText:

      CaseNotHPOs: HP:0001252 (Hypotonia), HP:0002094 (dyspnoea), HP:0001638 (cardiomyopathy), HP:0003326 (Myalgia), HP:0002015 (dysphagia), HP:0002098 (respiratory distress)

      CaseNotHPOFreeText: no biopsy, not asymptomatic

      CasePreviousTesting: "Enzymatic activity was detected by fluorometric techniques" "The GAA sequence was performed in all patients whose enzyme activity measured in DBS and lymphocytes was decreased."

      glucosidase activity: GAA activity was 0.31 mol/Lh in dried blood spots (normal range >0.75).

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

      Variant 1 ClinVarID: 4027

      Variant 1 CAid: CA116606

      Variant 2: NM_000152.5(GAA):c.655G>A (p.Gly219Arg)

      Variant 2 ClinVarID: 189065

      Variant 2 CAid: CA274334

      Zygosity: Compound heterozygous

      ParentalGenotype: N/A

      PreviouslyPublished: N/A

    3. #14

      Case#: Subject number 14, female, 58 years (report)

      DiseaseAssertion: Pompe disease

      FamilyInfo: No known family member with PD

      CasePresentingHPOs: HP:0001324 (muscle weakness), HP:0001252 (Hypotonia)

      CaseHPOFreeText:

      CaseNotHPOs: HP:0003546 (Exercise intolerance), HP:0002094 (dyspnoea), HP:0001638 (cardiomyopathy), HP:0003326 (Myalgia), HP:0002015 (dysphagia), HP:0002153 (hyperkalemia), HP:0002098 (respiratory distress)

      CaseNotHPOFreeText: no biopsy, not asymptomatic

      CasePreviousTesting: "Enzymatic activity was detected by fluorometric techniques" "The GAA sequence was performed in all patients whose enzyme activity measured in DBS and lymphocytes was decreased."

      glucosidase activity: GAA activity was 0.33 mol/Lh in dried blood spots (normal range >0.75).

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

      Variant 1 ClinVarID: 4027

      Variant 1 CAid: CA116606

      Variant 2: NM_000152.5(GAA):c.-32-13T>C

      Variant 2 ClinVarID: 4027

      Variant 2 CAid: CA116606

      Zygosity: homozygous

      ParentalGenotype: N/A

      PreviouslyPublished: N/A

    4. #19

      Case#: Subject number 19, male, 63 years (report)

      DiseaseAssertion: Pompe disease

      FamilyInfo: No known family member with PD

      CasePresentingHPOs: HP:0002153 (hyperkalemia), HP:0001324 (muscle weakness)

      CaseHPOFreeText:

      CaseNotHPOs: HP:0001638 (cardiomyopathy), HP:0003546 (Exercise intolerance), HP:0001252 (Hypotonia), HP:0003326 (Myalgia), HP:0002015 (dysphagia), HP:0002098 (respiratory distress), HP:0002094 (dyspnoea)

      CaseNotHPOFreeText: no biopsy, not asymptomatic

      CasePreviousTesting: "Enzymatic activity was detected by fluorometric techniques" "The GAA sequence was performed in all patients whose enzyme activity measured in DBS and lymphocytes was decreased."

      glucosidase activity: GAA activity was 0.47 mol/Lh in dried blood spots (normal range >0.75).

      Variant 1: NM_000152.5(GAA):c.2065G>A (p.Glu689Lys)

      Variant 1 ClinVarID: 4030

      Variant 1 CAid: CA116612

      Variant 2: N/A

      Variant 2 ClinVarID: N/A

      Variant 2 CAid: N/A

      Zygosity: Heterozygous

      ParentalGenotype: N/A

      PreviouslyPublished: N/A

    5. #17

      Case#: Subject number 17, male, 64 years (report)

      DiseaseAssertion: Pompe disease

      FamilyInfo: No known family member with PD

      CasePresentingHPOs: HP:0002153 (hyperkalemia), HP:0001324 (muscle weakness), HP:0003326 (Myalgia), HP:0002015 (dysphagia)

      CaseHPOFreeText:

      CaseNotHPOs: HP:0001252 (Hypotonia), HP:0001638 (cardiomyopathy), HP:0002098 (respiratory distress), HP:0003546 (Exercise intolerance), HP:0002094 (dyspnoea)

      CaseNotHPOFreeText: no biopsy, not asymptomatic

      CasePreviousTesting: "Enzymatic activity was detected by fluorometric techniques" "The GAA sequence was performed in all patients whose enzyme activity measured in DBS and lymphocytes was decreased."

      glucosidase activity: GAA activity was 0.54 mol/Lh in dried blood spots (normal range >0.75).

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

      Variant 1 ClinVarID: 4027

      Variant 1 CAid: CA116606

      Variant 2: NM_000152.5(GAA):c.875A>G (p.Tyr292Cys)

      Variant 2 ClinVarID: 370577

      Variant 2 CAid: CA16041886

      Zygosity: Compound heterozygous

      ParentalGenotype: N/A

      PreviouslyPublished: N/A

    6. #12

      Case#: Subject number 12, male, 52 years (report)

      DiseaseAssertion: Pompe disease

      FamilyInfo: No known family member with PD

      CasePresentingHPOs: HP:0001324 (muscle weakness), HP:0002098 (respiratory distress)

      CaseHPOFreeText:

      CaseNotHPOs: HP:0003546 (Exercise intolerance), HP:0001252 (Hypotonia), HP:0001638 (cardiomyopathy), HP:0003326 (Myalgia), HP:0002015 (dysphagia), HP:0002153 (hyperkalemia), HP:0002094 (dyspnoea)

      CaseNotHPOFreeText: no biopsy, not asymptomatic

      CasePreviousTesting: "Enzymatic activity was detected by fluorometric techniques" "The GAA sequence was performed in all patients whose enzyme activity measured in DBS and lymphocytes was decreased."

      glucosidase activity: GAA activity was 0.48 mol/Lh in dried blood spots (normal range >0.75).

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

      Variant 1 ClinVarID: 4027

      Variant 1 CAid: CA116606

      Variant 2: NM_000152.5(GAA):c.1889-1G>A

      Variant 2 ClinVarID: N/A

      Variant 2 CAid: CA401369820

      Zygosity: Compound heterozygous

      ParentalGenotype: N/A

      PreviouslyPublished: N/A

    1. PD23

      Patient23: Male, Southern China

      CasePresentingHPOs:

      HPOsFreeText: IOPD

      CaseNotHPOs:

      NotHPOsFreeText:

      CaseAddInfo:

      CasePMIDs:

      CasePreviousTesting: same as group

      CaseGenotypingMethod: same as group

      Variant1: NM_000152.4(GAA):c.1411_1414delGAGA (p.Glu471Profs)

      ClinVar: 188874, https://www.ncbi.nlm.nih.gov/clinvar/variation/188874/

      gnomAD: 1.688e-05, http://exac.broadinstitute.org/variant/17-78083827-CGAGA-C

      Variant2: NM_000152.4(GAA):c.2024_2026delACA (p.Asn675del)

      ClinVar: 189006, https://www.ncbi.nlm.nih.gov/clinvar/variation/189006/

      gnomAD: 2.105e-05, http://exac.broadinstitute.org/variant/17-78086806-CACA-C

    2. PD10

      Patient10: Male, Southern China

      CasePresentingHPOs:

      HPOsFreeText: IOPD

      CaseNotHPOs:

      NotHPOsFreeText:

      CaseAddInfo:

      CasePMIDs:

      CasePreviousTesting: same as group

      CaseGenotypingMethod: same as group

      Variant1: NM_000152.4(GAA):c.2105G>A (p.Arg702His)

      ClinVar: 426278, https://www.ncbi.nlm.nih.gov/clinvar/variation/426278/

      gnomAD: 6.695e-05, http://exac.broadinstitute.org/variant/17-78087081-G-A

      Variant2: NM_000152.4(GAA):c.2297A>C (p.Tyr766Ser)

      ClinVar: 420102, https://www.ncbi.nlm.nih.gov/clinvar/variation/420102/

      gnomAD: 8.35e-06, http://exac.broadinstitute.org/variant/17-78090874-A-C

    3. PD11

      Patient11: Male, Southern China

      CasePresentingHPOs:

      HPOsFreeText: IOPD, survived beyond 2yo, left ventricular mass index and left ventricular posterior wall thickness decreased during ERT. Able to raise head, sit without support, stand, walk alone

      CaseNotHPOs: no significant respiratory problems during ERT

      NotHPOsFreeText:

      CaseAddInfo: homozygous, only patient to receive ERT treatment (rhGAA) every 2wks beginning at 5mo of age. ERT lasted for 90wks.

      CasePMIDs:

      CasePreviousTesting: same as group

      CaseGenotypingMethod: same as group

      Variant: 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

    4. PD17

      Patient17: 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.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

    5. PD14

      Patient14: Male, Southern China

      CasePresentingHPOs:

      HPOsFreeText: IOPD

      CaseNotHPOs:

      NotHPOsFreeText:

      CaseAddInfo:

      CasePMIDs:

      CasePreviousTesting: same as group

      CaseGenotypingMethod: same as group

      Variant1: NM_000152.4(GAA):c.1411_1414delGAGA (p.Glu471Profs)

      ClinVar: 188874, https://www.ncbi.nlm.nih.gov/clinvar/variation/188874/

      gnomAD: 1.688e-05, http://exac.broadinstitute.org/variant/17-78083827-CGAGA-C

      Variant2: NM_000152.3:c.2376_2377insCA

      CAID: CA913184735, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA913184735

    6. PD06

      Patient6: Male, northern China

      CasePresentingHPOs:

      HPOsFreeText: IOPD

      CaseNotHPOs:

      NotHPOsFreeText:

      CaseAddInfo:

      CasePMIDs:

      CasePreviousTesting: same as group

      CaseGenotypingMethod: same as group

      Variant1: NM_000152.4(GAA):c.1115A>T (p.His372Leu)

      ClinVar: 370483, https://www.ncbi.nlm.nih.gov/clinvar/variation/370483/

      gnomAD: n/a

      Variant2: NM_000152.3:c.2563G>C

      CAID: CA401326195, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA401326195

      gnomAD: 0.00003188, http://gnomad.broadinstitute.org/variant/17-78092073-G-C

    1. 26-year-old affected son

      Patient1: Male, 26 years report, Iranian, Iran

      CasePresentingHPOs: HP:0002098, HP:0001324, HP:0003236, HP:0002910 (Respiratory distress, Muscle weakness, Increased serum CK, Increased transaminases)

      HPOsFreeText: GAA measurement from dried blood specimen at pH 3.8 was 0.19 nmol/spot * 21 h (ref 0.9-7.2) with acarbose and 0.89 nmol/spot * 21 h (ref 1.5-10) without acarbose and 4.40 nmol/spot * 21 h at pH 7.0 (ref 1.8-17.1), AST levels at 211 (ref 0-45), ALT levels at 294 (ref 5-40), CPK levels at 1925 (ref 25-200), FEV1 at 0.81, FEV1/FVC at 89.25

      CaseAddInfo: Sibling of P2, Unsure of which second variant patient has since it is never specified

    1. CaseIP-1: Female, Taiwan, Birth diagnosis

      HPOsFreeText: 4MU enzyme activity at 0.45, GAA (MS/MS) enzyme activity at 0.01 umol/hr/L, Serum CK at 237 U/L

      GenotypingMethod: GAA Gene Sequencing and PCR Amplification


      Variant1: NM_000152.4:c.424_440del17 (p.Ser142Leufs*29)

      CAID: CA658795228 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.424_440del17

      gnomAD: Not in gnomAD


      Variant2: 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


      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


      CaseAddInfo: Infantile Onset Pompe Disease, Nomenclature indicates Variant 2 and 3 are in cis

    2. CaseLP2-8: Female, Taiwan, Birth diagnosis

      HPOsFreeText: GAA (MS/MS) enzyme activity at 0.01 umol/hr/L, Serum CK at 80 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.1075+1G>T

      CAID: CA401364842 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.1075%2B1G%3ET

      gnomAD: Not in gnomAD


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

    3. CaseLP2-4: Female, Taiwan, Birth diagnosis

      HPOsFreeText: GAA (MS/MS) enzyme activity at 0.10 umol/hr/L, Serum CK at 66 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


      CaseAddInfo: Late Onset Pompe Disease, Nomenclature indicates Variants 1 and 2 are in cis and patient is homozygous for this allele, 1 other patient has the same genotype

    4. CaseOPOPD-57: Female, Taiwan, Birth diagnosis

      HPOsFreeText: GAA (MS/MS) enzyme activity at 1.60 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.1958C>A (p.Thr653Asn)

      CAID: CA8815557 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.1958C%3EA

      gnomAD: East Asian 2.548e-4, Overall 1.825e-5 http://gnomad.broadinstitute.org/variant/17-78086744-C-A


      CaseAddInfo: One Pompe Mutation allele and One Pseudodeficency Mutation allele, 3 other people have this genotype

    5. CaseOPOPD-12: Female, Taiwan, Birth diagnosis

      HPOsFreeText: GAA (MS/MS) enzyme activity at 0.68 umol/hr/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.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: One Pompe Mutation allele and One Pseudodeficency Mutation allele, Nomenclature shows that Variants 1 and 2 are in cis, 25 other patients share the same genotype

    6. CaseIP2-10: Male, Taiwan, Birth diagnosis

      HPOsFreeText: GAA (MS/MS) enzyme activity at 0.09 umol/hr/L, Serum CK at 483 U/L

      GenotypingMethod: GAA Gene Sequencing and PCR Amplification


      Variant: 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: Infantile Onset Pompe Disease, Patient is homozygous for this variant

    7. CaseLP2-3: Female, Taiwan, Birth diagnosis

      HPOsFreeText: GAA (MS/MS) enzyme activity at 0.42 umol/hr/L, Serum CK at 140 U/L

      GenotypingMethod: GAA Gene Sequencing and PCR Amplification


      Variant1: NM_000152.4:c.671G>A (p.Arg224Gln)

      CAID: CA8814958 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.671G%3EA

      gnomAD: African 8.060e-5, Overall 2.549e-5 http://gnomad.broadinstitute.org/variant/17-78079672-G-A


      Variant2: 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


      Variant3: 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


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

    8. CasePDC-2: Male, Taiwan, Birth diagnosis

      HPOsFreeText: 4MU enzyme activity at 0.84, MS/MS ennzyme activity at 1.34

      GenotypingMethod: GAA Gene Sequencing and PCR Amplification


      Variant1: NM_000152.3:c.693-5C>T

      CAID: CA8814990 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.693-5C%3ET

      gnomAD: East Asian 3.516e-4, Overall 3.900e-5 http://gnomad.broadinstitute.org/variant/17-78081351-C-T


      Variant2: 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: Patient is either a carrier or has a pseudodeficency allele

    9. CaseOPOPD-71: Female, Taiwan, Birth diagnosis

      HPOsFreeText: GAA (MS/MS) enzyme activity at 0.99 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.2431dupC (p.Leu811Profs*?)

      CAID: CA658795289 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.2431dupC

      gnomAD: Not in gnomAD


      CaseAddInfo: One Pompe Mutation allele and One Pseudodeficency Mutation allele

    10. CaseOPTPD-77: Male, Taiwan, Birth diagnosis

      HPOsFreeText: GAA (MS/MS) enzyme activity at 0.61 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.2014C>T (p.Arg672Trp)

      ClinVar: 188773 https://www.ncbi.nlm.nih.gov/clinvar/variation/188773/

      gnomAD: South Asian 3.355e-5, Overall 8.290e-6 http://gnomad.broadinstitute.org/variant/17-78086800-C-T


      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

    11. CaseOPOPD-9: Female, Taiwan, Birth diagnosis

      HPOsFreeText: GAA (MS/MS) enzyme activity at 0.68 umol/hr/L

      GenotypingMethod: GAA Gene Sequencing and PCR Amplification


      Variant1: NM_000152.4:c.671G>A (p.Arg224Gln)

      ClinVar: CA8814958 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.671G%3EA

      gnomAD: African 8.060e-5, Overall 2.549e-5 http://gnomad.broadinstitute.org/variant/17-78079672-G-A


      Variant2: 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: One Pompe Mutation and One Pseudodeficency Mutation

    12. CaseLP-4: Female, Taiwan, Birth diagnosis

      HPOsFreeText: 4MU enzyme activity at 0.61, MS/MS ennzyme activity at 0.01

      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.1075+1G>T

      CAID: CA401364842 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.1075%2B1G%3ET

      gnomAD: Not in gnomAD


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

    1. 32

      Case#: Subject number 32, male, 39 years (diagnosis), 43 years (baseline visit)

      DiseaseAssertion: Pompe disease

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001324 (Muscle Weakness)

      CaseHPOFreeText:

      CaseNotHPOs: HP:0002098 (respiratory distress), HP:0003236 (Elevated circulating creatine kinase concentration), HP:0002870 (obstructive sleep apnea)

      CaseNotHPOFreeText: no mechanical ventilation at Baseline Visit, no mechanical ventilation at last visit

      CasePreviousTesting: "reduced enzymatic activity on fibroblasts, blood leukocytes or skeletal muscle and/or the presence of two known mutations in the GAA gene"

      PreviouslyPublished: N/A

    2. 14

      Case#: Subject number 14, male, 41 years (diagnosis), 51 years (baseline visit), 45 years (ERT), 50 (ventilation)

      DiseaseAssertion: Pompe disease

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001324 (Muscle Weakness), HP:0002098 (respiratory distress)

      CaseHPOFreeText: mechanical ventilation at Baseline Visit, mechanical ventilation at last visit

      CaseNotHPOs: HP:0003236 (Elevated circulating creatine kinase concentration), HP:0002870 (obstructive sleep apnea)

      CaseNotHPOFreeText:

      CasePreviousTesting: "reduced enzymatic activity on fibroblasts, blood leukocytes or skeletal muscle and/or the presence of two known mutations in the GAA gene"

      PreviouslyPublished: N/A

    3. 9

      Case#: Subject number 9, female, 29 years (diagnosis), 55 years (baseline visit), 48 years (ERT)

      DiseaseAssertion: Pompe disease

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001324 (Muscle Weakness)

      CaseHPOFreeText:

      CaseNotHPOs: HP:0003236 (Elevated circulating creatine kinase concentration), HP:0002870 (obstructive sleep apnea), HP:0002098 (respiratory distress)

      CaseNotHPOFreeText: no mechanical ventilation at Baseline Visit, no mechanical ventilation at last visit

      CasePreviousTesting: "reduced enzymatic activity on fibroblasts, blood leukocytes or skeletal muscle and/or the presence of two known mutations in the GAA gene"

      PreviouslyPublished: N/A

    4. 35

      Case#: Subject number 35, female, 35 years (diagnosis), 35 years (baseline visit)

      DiseaseAssertion: Pompe disease

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0003236 (Elevated circulating creatine kinase concentration)

      CaseHPOFreeText:

      CaseNotHPOs: HP:0002098 (respiratory distress), HP:0002870 (obstructive sleep apnea), HP:0001324 (Muscle Weakness)

      CaseNotHPOFreeText: no mechanical ventilation at Baseline Visit, no mechanical ventilation at last visit

      CasePreviousTesting: "reduced enzymatic activity on fibroblasts, blood leukocytes or skeletal muscle and/or the presence of two known mutations in the GAA gene"

      PreviouslyPublished: N/A

    1. 5

      Patient5: male, Romanian

      CasePresentingHPOs: HP:0003677, HP:0003236, HP:0003325, HP:0003418, HP:0008997

      HPOsFreeText: CK > 10x increase, CK = 1500 U/L, reduced alpha-glucosidase activity

      CaseNotHPOs: HP:0002093

      CaseAddInfo: onset in middle age, enzyme activity also reduced in daughter

      CasePreviousTesting: same as group

      CaseGenotypingMethod: same as group

      Variant1: NM_000152.4(GAA):c.2066_2070dupAGCCG (p.Ala691Serfs)

      ClinVar: 92471, https://www.ncbi.nlm.nih.gov/clinvar/variation/92471/

      gnomAD: n/a

      Variant2: 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

    2. 18

      Patient18: female, White British

      CasePresentingHPOs: HP:0003677, HP:0003236, HP:0003325, HP:0003701, HP:0003458, HP:0003715, HP:0030231

      HPOsFreeText: CK > 10x increase, CK = 599 U/L. Vacuolated, degenerated, and atrophic fibers. Vacuole periphery showed abnormal immunoreactivity for desmin and p62. Z-band streaming of fibers, granular material accumulation. Treated with ERT. Normal to low alpha-glucosidase activity.

      CaseNotHPOs: HP:0002093

      NotHPOsFreeText: no evidence of glycogenosis

      CaseAddInfo: onset after 50yo

      CasePreviousTesting: same as group, muscle biopsy, NADH-tetrazolim reductase staining

      CaseGenotypingMethod: same as group

      Variant1: 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

      Variant2: 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

    3. 8

      Patient8: Female, Serbian, mid 70s

      CasePresentingHPOs: HP:0003325

      HPOsFreeText: Normal CK levels

      CaseNotHPOs: HP:0003236, HP:0002093

      CaseAddInfo: late onset

      CasePreviousTesting: same as group

      CaseGenotypingMethod: same as group

      Variant1: NM_000152.3:c.2051C>G

      CAID: CA401370340, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA401370340

      gnomAD: n/a

      Variant2: 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. P6

      Patient6: Female, 19mo at diagnosis, 22.5mo at ERT

      CasePresentingHPOs:

      HPOsFreeText: classic IOPD, moderate response to ERT, Pompe muscle pathology score = 3.1, Glycogen = 38.5 Vv(PAS + /mf)%, larger empty vacuoles = 25.9 Vv (LEV/mf)%, Autophagic vacuoles = 0,13%/mf

      CaseNotHPOs:

      NotHPOsFreeText:

      CaseAddInfo: biopsy taken from  musculus vastus lateralis

      CasePMIDs:

      CasePreviousTesting: same as group

      CaseGenotypingMethod: same as group

      Variant1: NM_000152.4(GAA):c.1655T>C (p.Leu552Pro)

      ClinVar: 279811, https://www.ncbi.nlm.nih.gov/clinvar/variation/279811/

      gnomAD: 1.663e-05, http://exac.broadinstitute.org/variant/17-78085800-T-C

      Variant2: NM_000152.3:c.524_525del

      CAID: CA913184732, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA913184732

      gnomAD: n/a

    1. 21

      Patient21: 68yo

      CasePresentingHPOs: HP:0003325, HP:0002093, HP:0003141, HP:0001513, HP:0020038

      HPOsFreeText: GAA = 30%, BMI = 30.3, nucleo-capsular and subcortical white matter lacunes

      CaseNotHPOs:

      NotHPOsFreeText:

      CaseAddInfo: 30yr disease duration

      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

    2. 8

      Patient8: 47yo

      CasePresentingHPOs: HP:0003325, HP:0001513

      HPOsFreeText: GAA = 5%, BMI = 30.8, Normal CTA and CT

      CaseNotHPOs:

      NotHPOsFreeText:

      CaseAddInfo: 2yr 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

    3. 6

      Patient6: 47yo

      CasePresentingHPOs: HP:0003325, HP:0002093, HP:0020038

      HPOsFreeText: GAA = 7%, BMI = 27.5, normal CT

      CaseNotHPOs:

      NotHPOsFreeText: No cardiovascular risk

      CaseAddInfo: 14yr disease duration, variants in trans

      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_000152.3:c.2530_2541del

      CAID: CA658795292, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA658795292

      gnomAD: n/a

    4. 18

      Patient18: 40yo

      CasePresentingHPOs: HP:0003325

      HPOsFreeText: GAA = 5%, smoker, BMI = 16.3, normal CTA and CT

      CaseNotHPOs:

      NotHPOsFreeText:

      CaseAddInfo: 4yr disease duration, variants in trans

      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_000152.3:c.2530_2541del

      CAID: CA658795292, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA658795292

      gnomAD: n/a

    5. 2

      Patient2: 76yo

      CasePresentingHPOs: HP:0003325, HP:0002093, HP:0002315, HP:0004887, HP:0000822, HP:0002870, HP:0020038

      HPOsFreeText: morning headaches, GAA = 13%, BMI = 23.6, right vertebral artery dominant, nucleo-capsular lacunes

      CaseNotHPOs:

      NotHPOsFreeText:

      CaseAddInfo: 33yr disease duration

      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

    6. 9

      Patient9: 54yo

      CasePresentingHPOs: HP:0003325, HP:0002093, HP:0002315, HP:0004887, HP:0003141, HP:0002870

      HPOsFreeText: morning headache, GAA = 7%, smoker, BMI = 23.3, normal CTA, nucleo-capsular and subcortical white matter lacunes

      CaseNotHPOs:

      NotHPOsFreeText:

      CaseAddInfo: 29yr 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. 20 mg/kg (N = 16)

      Case11HPOsFreeText: 20 mg/kg GAA treatment, GAA activity at 1.4 pmol/punch/hr, GAA activity at 33.2% 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.1802C>A (p.Ser601Ter)

      CAID: CA401369436 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.1802C%3EA

      gnomAD: Not in gnomAD


      CaseAddInfo: Patient is homozygous for this variant

    2. 20 mg/kg (N = 16)

      Case7HPOsFreeText: 20 mg/kg GAA treatment, GAA activity at 14 pmol/punch/hr, GAA activity at 58.3% 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.525delT (p.Glu176Argfs)

      ClinVar: 4033 https://www.ncbi.nlm.nih.gov/clinvar/variation/4033/

      gnomAD: European (Non-Finnish) 1.880e-4, Overall 9.959e-5 https://gnomad.broadinstitute.org/variant/17-78078909-CT-C


      CaseAddInfo:

    3. 20 mg/kg (N = 16)

      Case13HPOsFreeText: 20 mg/kg GAA treatment, GAA activity at 0.5 mU/U hexosaminid, GAA activity at 17.5% 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: Patient is heterozygous for these variants

    1. c.2560C > T(p.Arg845*)

      Case14

      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.


      Variant: 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


      CaseAddInfo: Infantile Onset Pompe Disease, Patient is homozygous for this variant, 6 more patients have the same genotype

    2. c.1210G > A(p.Asp404Asn)

      Case50

      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.1210G>A (p.Asp404Asn)

      CAID: CA8815234 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.1210G%3EA

      gnomAD: African 6.318e-5, Overall 3.223e-5 http://gnomad.broadinstitute.org/variant/17-78082511-G-A


      Variant2: NM_000152.4:c.1924G>T (p.Val642Phe)

      CAID: CA401369892 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.1924G%3ET

      gnomAD: Not in gnomAD


      CaseAddInfo: Infantile Onset Pompe Disease

    3. c.546+2_5deltggg

      Case5

      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.546+2_5delTGGG

      CAID: CA502402612 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.546%2B2_546%2B5delTGGG

      gnomAD: European (Non-Finnish) 9.395e-6, Overall 4.224e-6 http://gnomad.broadinstitute.org/variant/17-78078930-CGGTG-C


      Variant2: NM_000152.4:c.1650dupG (p.Thr551Aspfs*85)

      CAID: CA8815425 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.1650dupG

      gnomAD: African 6.178e-5, Overall 3.992e-6 http://gnomad.broadinstitute.org/variant/17-78085789-T-TG


      CaseAddInfo: Infantile Onset Pompe Disease, Patient has a sibling with the same genotype with Pompe

    4. c.2481+102_2646+31del (p.Gly828_Asn882del)

      Case72

      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.-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, 4 other patients have the same genotype

    5. c.742delC(p.Leu248Profs*20)

      Case83

      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.742delC (p.Leu248Profs*20)

      CAID: CA658795236 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.742delC

      gnomAD: Not in gnomAD


      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

    6. c.2015G > T(p.Arg672Leu))

      Case52

      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.2015G>T (p.Arg672Leu)

      CAID: CA401370075 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.2015G%3ET

      gnomAD: Not in gnomAD


      Variant2: NM_000152.4:c.2783A>G (p.Tyr928Cys)

      CAID: CA401327377 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.2783A%3EG

      gnomAD: Not in gnomAD


      CaseAddInfo: Juvenile Late Onset Pompe Disease

    7. c.525delT(p.Glu176Argfs*45)

      Case45

      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.1880C>T (p.Ser627Phe)

      CAID: CA294896504 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.1880C%3ET

      gnomAD: Not in gnomAD


      CaseAddInfo: Infantile Onset Pompe Disease

    8. c.1396_1397insG(p.Val466fs*39)

      Case57

      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.1396_1397insG (p.Val466fs*39)

      CAID: CA627699396 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.1396_1397insG

      gnomAD: South Asian 3.271e-5, Overall 4.003e-6 http://gnomad.broadinstitute.org/variant/17-78083807-A-AG


      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

    9. c.877G > A(p.Gly293Arg)

      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

    1. Detailed characteristics of these patients

      Patient11: female, 49yo, adult onset

      CasePresentingHPOs:

      HPOsFreeText: LOPD, BMI = 21 / 19.4 / 20.2, WGMS = 2 / 2-3 / 3

      CaseNotHPOs: HP:0002355

      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_000152.3:c.1291_1299del

      CAID: CA658795248, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA658795248

      gnomAD: n/a

    2. Detailed characteristics of these patients

      Patient7: male, 40yo, adult onset

      CasePresentingHPOs:

      HPOsFreeText: LOPD, BMI = 25.1 / 22.9 / 22.9, WGMS = 3 / 3 / 3

      CaseNotHPOs: HP:0002355

      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_000152.3:c.1291_1299del

      CAID: CA658795248, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA658795248

      gnomAD: n/a

    1. Supplement Table 1)

      Patient10: 6yo

      CasePresentingHPOs: HP:0001638

      HPOsFreeText: rhGAA dosage = 40 EOW, independent walker

      CaseNotHPOs:

      NotHPOsFreeText:

      CaseAddInfo: homozygous variants, 34day old at ERT

      CasePMIDs:

      CasePreviousTesting: same as group

      CaseGenotypingMethod: same as group

      Variant: 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)

      Patient14: 3yo

      CasePresentingHPOs: HP:0001638

      HPOsFreeText: rhGAA dosage = 20 QW, independent walker

      CaseNotHPOs:

      NotHPOsFreeText:

      CaseAddInfo: homozygous variants, 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

    3. Supplement Table 1)

      Patient3: 4yo

      CasePresentingHPOs: HP:0001638

      HPOsFreeText: rhGAA dosage = 40 EOW, independent walker

      CaseNotHPOs:

      NotHPOsFreeText:

      CaseAddInfo: 14days old at ERT start, stopped albuterol during 4th month of trial

      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_000152.3:c.1197_1208del

      CAID: CA658795246, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA658795246

      gnomAD: n/a

    1. 4

      Case#: Patient 4, Female, 10 days old at diagnosis, African American

      DiseaseAssertion: Pompe disease

      FamilyInfo:N/A

      CasePresentingHPOs: HP:0009062, HP:0001638

      (Infantile axial hypotonia, Cardiomyopathy)

      CaseHPOFreeText: Before ERT patient withdraws extremities to stimulation, contractures of large joint of upper and lower extremities, weak grasp. Also patient was invasively ventilated. Baseline – G-tube feeds and continues

      Currently patient is off ventilator 10-12 hours a day. Sits with support; and has minimal capacity for weight bearing on lower extremities. G tube feed.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: No GAA measurement

      Variant 1: M_000152.5(GAA):c.525del (p.Glu176fs)

      ClinVar: 4033

      CAID: CA220406

      gnomAD: N/A

      Variant 2: NM_000152.5(GAA):c.2560C>T (p.Arg854Ter)

      ClinVar: 4034

      CAID: CA340130

      gnomAD: Highest population MAF= 0.001891 (African)

      ParentalGenotype:N/A

      PreviouslyPublished:N/A

    2. 6

      Case#: Patient 6, Female, 5.5 months old at diagnosis, Asian

      DiseaseAssertion: Pompe disease

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001252, HP:0001638

      (Muscular hypotonia, Cardiomyopathy)

      CaseHPOFreeText:

      Previous to ERT, patient was invasively ventilated, and had . Also Aspiration and penetration with feeding and started on NG tube feeds at baseline

      Current patient has marked axial and peripheral hypotonia, G-tube feeds and requires BiPAP at night. Patient has near-complete lower extremity immobility

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: Antigravity movement in arms

      CasePreviousTesting: N/A

      Variant: NM_000152.5(GAA):c.525_526del (p.Asn177fs) Please double check

      ClinVar: 189057

      CAID: CA274328

      gnomAD: N/A

      ParentalGenotype: N/A

      PreviouslyPublished: N/A

    1. 2

      Case2: Female, 42 years onset, 51 years diagnosis, Italy

      HPOsFreeText: See Group Phenotypes, ERT started at 32, GAA Activity at ~10 pmol/min/mg before ERT and ~11 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.1076-1G>C

      CAID: CA401364879 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.1076-1G%3EC

      gnomAD: Not in gnomAD


      CaseAddInfo: Late Onset Pompe Disease

    2. 17

      Case17: Female, 30 years onset, 39 years diagnosis, Italy

      HPOsFreeText: See Group Phenotypes, ERT started at 41

      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


      Paper does not specify what kind of mutation this is. Mentions only that it is a "Loss of transcript" mutation

      Variant2: NM_000152.4:c.2331+1

      ClinVar: N/A

      gnomAD: N/A


      CaseAddInfo: Late Onset Pompe Disease

    3. 12

      Case12: Female, 48 years onset, 58 years diagnosis, Italy

      HPOsFreeText: See Group Phenotypes, ERT started at 59, GAA Activity at ~17 pmol/min/mg before ERT and ~19 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.1561G>A (p.Glu521Lys)

      ClinVar: 4022 https://www.ncbi.nlm.nih.gov/clinvar/variation/4022/

      gnomAD: South Asian 3.266e-5, Overall 3.980e-6 http://gnomad.broadinstitute.org/variant/17-78084749-G-A


      CaseAddInfo: Late Onset Pompe Disease

    1. 20

      Case#: Subject number 20(L)

      DiseaseAssertion: Late Onset Pompe disease

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: CK testing: 204 U/L (60-305 U/L is normal), AST: 63 U/L (22-71 U/L is normal), ALT: 34 U/L (7-50 U/L is normal), BNP 65.4 pg/mL (0.0–100.0 pg/mL is normal)

      glucosidase activity: GAA activity #1 was 0.88 micromole/L/h and GAA activity #2 (NBS) 0.77 in dried blood spots (>2.10 micromole/L/h is normal). 3.50 in confirmatory testing (>3.88 is normal).

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

      Variant 1 ClinVarID: 4027

      Variant 1 CAid: CA116606

      Variant 2: NM_000152.5(GAA):c.-32-13T>G

      Variant 2 ClinVarID: 4027

      Variant 2 CAid: CA116606

      Zygosity: homozygous

      ParentalGenotype: N/A

      PreviouslyPublished: N/A

    2. 26

      Case#: Subject number 26(L)

      DiseaseAssertion: Late Onset Pompe disease

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      glucosidase activity: GAA activity #2 (NBS) 1.01 in dried blood spots (>2.10 micromole/L/h is normal).

      Variant 1: NM_000152.5(GAA):c.2238G>C

      Variant 1 ClinVarID: 265160

      Variant 1 CAid: CA8815665

      Variant 2: NM_000152.5(GAA):c.2238G>C

      Variant 2 ClinVarID: 265160

      Variant 2 CAid: CA8815665

      Zygosity: homozygous

      ParentalGenotype: N/A

      PreviouslyPublished: N/A

    3. 14

      Case#: Subject number 14(L)

      DiseaseAssertion: Late Onset Pompe disease

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: CK testing: 467 U/L (60-305 U/L is normal), AST: 166 U/L (20-64 U/L is normal), ALT: 73 U/L (12-42 U/L is normal), Hex4: 7.0 mmol/mol Creatinine (≤20 mmol/mol Creatinine is normal)

      glucosidase activity: GAA activity #1 was 1.68 micromole/L/h and GAA activity #2 (NBS) 0.79 in dried blood spots (>2.10 micromole/L/h is normal). 2.40 in confirmatory testing (>3.88 is normal).

      Variant 1: NM_000152.5(GAA):c.156_157delTC

      Variant 1 ClinVarID: N/A

      Variant 1 CAid: CA294886619

      Variant 2: NM_000152.5(GAA):c.-32-13T>G

      Variant 2 ClinVarID: 4027

      Variant 2 CAid: CA116606

      Zygosity: compound heterozygous

      ParentalGenotype: N/A

      PreviouslyPublished: N/A

    4. 1

      Case#: Subject number 1(I), male, 21 days (start of ERT), 31 months (report)

      DiseaseAssertion: Infantile Onset Pompe disease

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0002870 (obstructive sleep apnea), HP:0001639 (hypertrophic cardiomyopathy), HP:0200128 (biventricular hypertrophy), HP:0030234 (Highly elevated creatine kinase)

      CaseHPOFreeText: moderately to severely decreased left ventricular systolic wall motion, moderate hypertrophy of the left ventricle, severe right ventricular hypertrophy, requires BiPAP at night, patient receives physical, occupational, and speech therapies.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: CK testing: 923 U/L (60–305 U/L is normal), AST: 103 U/L (30–100 U/L is normal), BNP: 1080 pg/mL (0.0–100.0 pg/mL), Hex4: 24.7 mmol/mol Creatinine (≤20 mmol/mol Creatinine is normal)

      glucosidase activity: GAA activity #1 was 0.65 micromole/L/h and GAA activity #2 (NBS) 0.22 in dried blood spots (>2.10 micromole/L/h is normal). 4.4 in confirmatory testing (>6.7 is normal).

      Variant 1: NM_000152.5(GAA):c.759delC

      Variant 1 ClinVarID: 837937

      Variant 1 CAid: CA916082438

      Variant 2: NM_000152.5(GAA):c.1551+1G>C

      Variant 2 ClinVarID: 554983

      Variant 2 CAid: CA401367167

      Zygosity: Compound heterozygous

      ParentalGenotype: N/A

      PreviouslyPublished: N/A

    1. 5

      Patient5: Female, 38yo at diagnosis, 40yo at ERT

      CasePresentingHPOs:

      HPOsFreeText: anti rh-GAA antibodies titre = neg, enzyme (μmol/g/h) = 0.8 (3-20)

      CaseNotHPOs:

      NotHPOsFreeText: NIV and mobility aid not used

      CaseAddInfo: 26yr disease duration, variants in trans

      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_000152.3:c.482_483del

      CAID: CA8814879, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA8814879

      gnomAD: 1.729e-05, http://exac.broadinstitute.org/variant/17-78078864-TCC-T

    2. 1

      Patient1: Female, 37yo at diagnosis, 38yo at ERT

      CasePresentingHPOs:

      HPOsFreeText: anti rh-GAA antibodies titre = 1:800, Enzyme = 0.3 (3-20) μmol/g/h, NIV used before and after ERT, mobility aid required before and after ERT

      CaseNotHPOs:

      NotHPOsFreeText:

      CaseAddInfo: 23yr disease duration, variants in trans

      CasePMIDs:

      CasePreviousTesting: same as group

      CaseGenotypingMethod: same as group

      Variant1: NM_000152.4:c.1040C>G

      CAID: CA401364692, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.3%3Ac.1040C%3EG

      gnomAD: n/a

      Variant2: c.1559A > I believe this paper had a typo so I was unable to find this variant in both ClinVar and the allele registry

    3. 2

      Patient2: Male, 40yo at diagnosis, 63yo at ERT

      CasePresentingHPOs:

      HPOsFreeText: anti rh-GAA antibodies tire = 1:6400, enzyme (μmol/g/h) = 0.36 (3-20), NIV used before and after ERT

      CaseNotHPOs:

      NotHPOsFreeText: mobility aid not used

      CaseAddInfo: 23yr disease duration, variants in trans

      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_000152.3:c.2135T>C

      CAID: CA401370560, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.3%3Ac.2135T%3EC

      gnomAD: n/a

    1. Case25: Male, 67 years report

      HPOsFreeText: 4 years of ERT completed, 6 Minute Walking Test at 172 meters, Forced Vital Capacity at 49%

      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.-32-3C>G

      CAID: CA658795220 http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.-32-3C%3EG

      gnomAD: Not in gnomAD


      CaseAddInfo: Late Onset Pompe Disease

    2. Case21: Female, 49 years report

      HPOsFreeText: 8 years of ERT completed, Forced Vital Capacity at 59%

      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.1819_1836del (p.Gly607_His612del )

      CAID: CA658795266 http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.1819_1836del

      gnomAD: Not in gnomAD


      CaseAddInfo: Late Onset Pompe Disease

    3. Case7: Female, 58 years report

      HPOsFreeText: 9 years of ERT completed, Forced Vital Capacity at 14%

      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.2041-1G>A

      CAID: CA8815596 http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.2041-1G%3EA

      gnomAD: European (Non-Finnish) 1.012e-5, Overall 4.541e-6 http://gnomad.broadinstitute.org/variant/17-78087016-G-A


      CaseAddInfo: Late Onset Pompe Disease

    4. Case6: Male, 65 years report

      HPOsFreeText: 8 years of ERT completed, 6 Minute Walking Test at 95 meters, Forced Vital Capacity at 36%

      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

    5. Case20: Female, 63 years report

      HPOsFreeText: 9 years of ERT completed, 6 Minute Walking Test at 10 meters, Forced Vital Capacity at 57%

      GenotypingMethod: GAA Gene Sequencing


      Variant1: NM_000152.4:c.1748C>T (p.Ser583Phe)

      CAID: CA401369174 http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.1748C%3ET

      gnomAD: Not in gnomAD


      Variant2: NM_000152.4:c.2014C>T (p.Arg672Trp)

      ClinVar: 188773 https://www.ncbi.nlm.nih.gov/clinvar/variation/188773/

      gnomAD: South Asian 3.355e-5, Overall 8.290e-6 http://gnomad.broadinstitute.org/variant/17-78086800-C-T


      CaseAddInfo: Late Onset Pompe Disease

    1. LOPD patient #1

      Case#: LOPD patient #1, Male, 69, ethnicity unknown.

      DiseaseAssertion: Pompe disease

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0002094, HP:0006554, HP:0012378, HP:0001324 (Dyspnea, Acute respiratory failure, Fatigue, Lower Girdle Muscle Weakness and Upper Girdle Muscle Weakness)

      CaseHPOFreeText: Dyspnea was present during exercise, not at rest. Lower Girdle Muscle Weakness and Upper Girdle Muscle Weakness share the same HPO.

      CaseNotHPOs:

      CaseNotHPOFreeText: Patient has normal creatine phosphokinase levels, No Dyspnea at rest, No Ortopnea, No Airways infections, no myalgia

      CasePreviousTesting: GAA gene sequencing to asses genotype.

      GAA activity was reduced (0.36 microMol/L/h) in reference to standard (10.1 ± 6.6 microMol/L/h) This was measured by dried blood spot .

      GAA muscle activity was 3.6 pmol/min/mg, no reference range was provided

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

      ClinVar: 4027

      CAID: CA116606

      gnomAD: MAF= 0.005541 (Ashkenazi Jewish)

      Variant 2: NM_000152.5(GAA):c.1564C>G (p.Pro522Ala)

      ClinVar:371277

      CAID:CA16041893

      gnomAD: N/A

      ParentalGenotype: N/A

      PreviouslyPublished: N/A

    1. 1

      Patient1: male

      CasePresentingHPOs: HP:0004887, HP:0003698, HP:0002194, HP:0001522

      HPOsFreeText: ERT dosage = 20 mg/kg/2, HCM reversal

      CaseNotHPOs:

      NotHPOsFreeText:

      CaseAddInfo: Symptom onset at 2 days, diagnosis at 2 weeks, ERT at 3 weeks, ventilation required at 23mo. ERT lasted for 20mo, died at 24mo.

      CasePreviousTesting: same as group

      CaseGenotypingMethod: same as group

      Variant: NM_000152.3:c.1753_2799del

      CAID: CA913184762, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA913184762

      gnomAD: n/a

    1. P3

      Case#: Subject number 3, female, 47 months (onset), 49 months (first admission)

      DiseaseAssertion: Pompe disease

      FamilyInfo: Patients 2 and 3 are full siblings

      CasePresentingHPOs: HP:0012378 (fatigue), HP:0009046 (difficulty running), HP:0001609 (hoarse voice), HP:0000508 (ptosis), HP:0004887 (respiratory failure requiring assisted ventilation)

      CaseHPOFreeText: ambulatory (transport ventilator), juvenile-onset

      CaseNotHPOs:

      CaseNotHPOFreeText: no tracheostomy, no dysphagia at baseline, not on BiPAP

      CasePreviousTesting: “GAA activity in peripheral blood leukocytes lower than normal”; on enzyme replacement therapy

    2. P1

      Case#: Subject number 1, female, 15 months (onset), 32 months (first admission)

      DiseaseAssertion: Pompe disease

      FamilyInfo: "no family history of neuromuscular disorders"

      CasePresentingHPOs: HP:0002355 (difficulty walking), HP:0002205 (recurrent respiratory infections), HP:0002747 (respiratory insufficiency due to muscle weakness), HP:0004887 (respiratory failure requiring assisted ventilation)

      CaseHPOFreeText: Tracheostomy, on BiPAP, ambulatory (transport ventilator), juvenile-onset, assistive device (wheelchair)

      CaseNotHPOs:

      CaseNotHPOFreeText: no dysphagia at baseline

      CasePreviousTesting: “GAA activity in peripheral blood leukocytes lower than normal”; on enzyme replacement therapy

    1. 8

      Case#: P 8, Female, 3.7 months old when started ERT (Died at 36.8 months), German

      DiseaseAssertion: Pompe disease

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 , HP:0001252 , HP:0003701, HP:0006532

      (Hypertrophic cardiomyopathy, Muscular hypotonia, Proximal muscle weakness, Recurrent pneumonia)

      CaseHPOFreeText: Recurrent pneumonia and GER were complications during ERT

      Patient required ventilation and tube feeding

      The best and last motor status was sitting.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: CRIM status is positive in patient

      Antibody titer is 1:4,000

      Variant: NM_000152.5(GAA):c.266G>A (p.Arg89His)

      ClinVar: 283219

      CAID: CA8814833

      gnomAD: Highest population MAF= 0.001168 in Ashkenzai Jewish

      Variant: c.104T>C (p.Phe35Ser)

      ClinVar: N/A

      CAID: CA401360259

      gnomAD: N/A

      ParentalGenotype: The maternal allele carried the c.266G>A variant

      The paternal allele carried the c.104T>C variant

      PreviouslyPublished: N/A

    2. 15

      Case#: P 15, female. 4.7 months old when started ERT (Died at 8.1 months old)

      DiseaseAssertion: Pompe disease

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 , HP:0001252 , HP:0003701, HP:0100806

      (Hypertrophic cardiomyopathy, Muscular hypotonia, Proximal muscle weakness, Sepsis )

      CaseHPOFreeText: Sepsis, Asystolia, Port infection and AR IV were complications during ERT

      Required tube feeding

      No motor activity reached

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: Did not required ventilation

      CasePreviousTesting: CRIM status was negative

      Antibody titer was unknown

      Variant: NM_000152.5(GAA):c.1687C>T (p.Gln563Ter)

      ClinVar: 370357

      CAID: CA16041895

      gnomAD: N/A

      ParentalGenotype: Both the paternal and maternal allele carried the variant c.1687C>T (p.Gln563Ter)

      PreviouslyPublished: N/A

    3. 10

      Case#: P 10, Male, 7.0 months old when started ERT (Died at 21.1 months old)

      DiseaseAssertion: Pompe disease

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001639 , HP:0001252 , HP:0003701, HP:0006532

      (Hypertrophic cardiomyopathy, Muscular hypotonia, Proximal muscle weakness, Recurrent pneumonia )

      CaseHPOFreeText: Patient required tube feeding

      Recurrent pneumonia was a complication during ERT

      Patient did not achieved motor function

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: Patient was not ventilated

      CasePreviousTesting: CRIM status was unknown

      Antibody titer was not available

      Variant: NM_000152.5(GAA):c.2560C>T (p.Arg854Ter)

      ClinVar: 4034

      CAID: CA340130

      gnomAD: Highest population MAF = 0.001891 (African)

      ParentalGenotype: Both the paternal and maternal allele carried the c.2560C>T (p.Arg854Ter) Variant

      PreviouslyPublished: N/A

    1. 3.1 Description of the study population

      Patient6: IOPD Group, 13days old

      CasePresentingHPOs:

      HPOsFreeText: LDH = 767 U/L, CK = 709 U/L, ALT = 30 U/L, AST = 117 U/L, Mann-Whitney Test = 3

      CaseNotHPOs:

      NotHPOsFreeText:

      CaseAddInfo:

      CasePMIDs:

      CasePreviousTesting: same as group

      CaseGenotypingMethod: same as group

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

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

      gnomAD: 0.0001240, https://gnomad.broadinstitute.org/variant/17-78086721-C-A

    1. LOPD-10

      CaseLOPD-10: 2 weeks diagnosis

      HPOsFreeText: GAA activity 2.5 (nmol · h−1 · mg−1), Mean percentage of normal 3.6%

      GenotypingMethod: Newborn Screening Panels


      Variant1: NM_000152.4:c.517_519del (p.M173del)

      CAID: CA891862611 http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.3:c.517_519del

      gnomAD: Not in gnomAD


      Variant2: NM_000152.4:c.710C>T (p.Ala237Val)

      ClinVar: 4035 https://www.ncbi.nlm.nih.gov/clinvar/variation/4035/

      gnomAD: South Asian 1.307e-4, Overall 1.992e-5 http://gnomad.broadinstitute.org/variant/17-78081373-C-T


      CaseAddInfo: Late Onset Pompe Disease

    2. LOPD-13

      CaseLOPD-13: 2 weeks diagnosis

      HPOsFreeText: GAA activity 2.6 (nmol · h−1 · mg−1), Mean percentage of normal 3.7%

      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.2051C>T (p.Pro684Leu)

      ClinVar: 285821 https://www.ncbi.nlm.nih.gov/clinvar/variation/285821/

      gnomAD: European (Non-Finnish) 1.631e-4, Overall 8.195e-5 http://gnomad.broadinstitute.org/variant/17-78087027-C-T


      CaseAddInfo: Late Onset Pompe Disease

    3. LOPD-2

      CaseLOPD-2: 2 weeks diagnosis

      HPOsFreeText: GAA activity 3.2 (nmol · h−1 · mg−1), Mean percentage of normal 4.5%

      GenotypingMethod: Newborn Screening Panels


      Variant: 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


      CaseAddInfo: Late Onset Pompe Disease, Patient is homozygous for the above variant

    4. LOPD-6

      CaseLOPD-6: 32 years diagnosis

      HPOsFreeText: GAA activity 3.6 (nmol · h−1 · mg−1), Mean percentage of normal 5.1%

      CaseNotHPOs: HP:0003236 (Increased serum CK)

      GenotypingMethod: Newborn Screening Panels


      Variant: 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


      CaseAddInfo: Late Onset Pompe Disease, Patient is homozygous for the above variant

    5. PD/Pathogenic-5

      CasePD/Pathogenic-5: 4 weeks diagnosis

      HPOsFreeText: GAA activity 6.5 (nmol · h−1 · mg−1), Mean percentage of normal 9.1%

      GenotypingMethod: Newborn Screening Panels


      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.2065G>A (p.Glu689Lys)

      ClinVar: 4030 https://www.ncbi.nlm.nih.gov/clinvar/variation/4030/

      gnomAD: East Asian 0.2355, Overall 0.05524 http://gnomad.broadinstitute.org/variant/17-78087041-G-A


      Variant3: 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


      CaseAddInfo: Patient has one pseudodeficency allele and one pathogenic allele, Nomenclature claims Variant 1 and 2 are in cis

    6. IOPD-2

      CaseIOPD-2: 10 days diagnosis

      CasePresentingHPOs: HP:0003236, HP:0001638 (Increased serum CK, Cardiomyopathy)

      HPOsFreeText: GAA activity 1.8 (nmol · h−1 · mg−1), Mean percentage of normal 1.2%

      GenotypingMethod: Newborn Screening Panels


      Variant1: NM_000152.4:c.854C>G (p.Pro285Arg)

      ClinVar: 225114 https://www.ncbi.nlm.nih.gov/clinvar/variation/225114/

      gnomAD: European (Non-Finnish) 1.148e-5, Overall 5.109e-6 http://gnomad.broadinstitute.org/variant/17-78081517-C-G


      Variant2: NM_000152.4:c.2303C>T (p.P768L)

      CAID: CA401324900 http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.3:c.2303C%3ET

      gnomAD: Not in gnomAD


      CaseAddInfo: Infantile Onset Pompe Disease

    7. LOPD-5

      CaseLOPD-5: 2 weeks diagnosis

      HPOsFreeText: GAA activity 3.1 (nmol · h−1 · mg−1), Mean percentage of normal 4.4%

      GenotypingMethod: Newborn Screening Panels


      Variant: 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


      CaseAddInfo: Late Onset Pompe Disease, Patient is homozygous for the above variant

    8. LOPD-1

      CaseLOPD-1: 3 weeks diagnosis

      HPOsFreeText: GAA activity 3.2 (nmol · h−1 · mg−1), Mean percentage of normal 4.5%

      GenotypingMethod: Newborn Screening Panels


      Variant: 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


      CaseAddInfo: Late Onset Pompe Disease, Patient is homozygous for the above variant

    1. 5

      Case5: Male, 14 years onset, 17 years diagnosis, 42 years report, France

      CasePresentingHPOs: HP:0002540, HP:0002878, HP:0004887, HP:0011029 (Inability to walk, Respiratory failure, Respiratory failure requiring assisted ventilation, Internal haemorrhage)

      HPOsFreeText: Lost ambulation at 33 years, Started invasive ventilation at 19 years, Started ERT given every other week at a dose of 20 mg/kg at 41 years for 11 months, Peak Anti-rhGAA antibodies at 1:25,600, FVC at 0.31/6 (L / % expected), MIP at 1 (cm H2O), MEP at 2 (cm H2O), Time off ventilation stayed constant at 0, Total Motor Function Measure from 27 to 26, 6MWT at 0, Suffered from a tracheal haemorrhage

      CaseNotHPOs: HP:0030148 (Heart murmur)

      NotHPOsFreeText: No adverse reaction to ERT was recorded

      CaseAddInfo: Late Onset Pompe Disease, Patient died before publication

    2. 2

      Case2: Male, 46 years onset, 46 years diagnosis, 71 years report, France

      CasePresentingHPOs: HP:0002540, HP:0002878, HP:0004887 (Inability to walk, Respiratory failure, Respiratory failure requiring assisted ventilation)

      HPOsFreeText: Lost ambulation at 66 years, Started invasive ventilation at 47 years, Started ERT given every other week at a dose of 20 mg/kg at 66 years for 54 months, Peak Anti-rhGAA antibodies at 1:51,200, FVC at 0.63/16 (L / % expected), MIP at 28 (cm H2O), MEP at 33 (cm H2O), Time off ventilation decreased from 240 to 120 (min/24 h), Total Motor Function Measure from 41 to 44, 6MWT from 20 to 100 meters

      CaseNotHPOs: HP:0030148 (Heart murmur)

      NotHPOsFreeText: No adverse reaction to ERT was recorded

      CaseAddInfo: Late Onset Pompe Disease, Patient died before publication

    1. PD16

      Patient16: Male, Northern China

      CasePresentingHPOs:

      HPOsFreeText: IOPD

      CaseNotHPOs:

      NotHPOsFreeText:

      CaseAddInfo:

      CasePMIDs:

      CasePreviousTesting: same as group

      CaseGenotypingMethod: same as group

      Variant1: NM_000152.4(GAA):c.2662G>T (p.Glu888Ter)

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

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

      Variant2: NM_000152.3:c.1597T>G

      CAID: CA401367282, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA401367282

      gnomAD: n/a

    2. PD24

      Patient24: Female, Northern China

      CasePresentingHPOs:

      HPOsFreeText: IOPD

      CaseNotHPOs:

      NotHPOsFreeText:

      CaseAddInfo:

      CasePMIDs:

      CasePreviousTesting: same as group

      CaseGenotypingMethod: same as group

      Variant1: c.1151 + 2T > G no ClinVar or CAID, intronic position inside exon

      Variant2: NM_000152.3:c.1562A>T

      CAID: CA401367205, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA401367205

      gnomAD: 0.000003980, http://gnomad.broadinstitute.org/variant/17-78084750-A-T

    1. Case 2

      Case#: Case 2, Boy, Death at 7 months old, Hispanic

      DiseaseAssertion: Pompe disease

      FamilyInfo: Parents were carriers of the variant in Patient 2 (Figure 2.C)

      CasePresentingHPOs: HP:0002205, HP:0001945, HP:0000980, HP:0001290, HP:0000158, HP:0002791, HP:0002240, HP:0200128

      (Recurrent respiratory infections, Fever, Pallor, Generalized hypotonia, Macroglossia, Hypoventilation, Hepatomegaly, Biventricular hypertrophy )

      CaseHPOFreeText: Systolic and diastolic dysfunction.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Ejection fraction was 40%

      Serum Creatine Kinase levels were 650 IU/L

      GAA enzyme activity on dried blood spots was 0.6 pmol/L, below normal levels (normal range: 10.0- 49 pmol/L).

      Variant: c.1987delC

      ClinVar: N/A

      CAID: N/A

      gnomAD: N/A

      ParentalGenotype: Both parents are carriers of the variant c.1987delC

      PreviouslyPublished: N/A

    1. The patient

      Case1: Female, 7 years report, 5 months diagnosis, Hispanic

      CasePresentingHPOs: HP:0001639, HP:0004755, HP:0001714, HP:0002878, HP:0001635, HP:0002719, HP:0011968, HP:0001508, HP:0003236, HP:0002014, HP:0002583, HP:0100806, HP:0004302, HP:0011344, HP:0004887, HP:0001252, HP:0000508, HP:0000938, HP:0001371, HP:0011471, HP:0001250, HP:0025401, HP:0007738, HP:0000980 (Hypertrophic cardiomyopathy, Supraventricular tachycardia, Ventricular hypertrophy, Respiratory failure, Cardiac failure, Recurrent infections, Feeding difficulties, Failure to thrive, Increased serum CK, Diarrhea, Colitis, Sepsis, Functional motor deficit, Severe global developmental delay, Respiratory failure requiring assisted ventilation, Muscular hypotonia, Ptosis, Osteopenia, Contracture, Gastrostomy tube feeding in infancy, Seizures, Staring gaze, Uncontrolled eye movements, Pallor)

      HPOsFreeText: Elevated Glc4 urine levels present, She was antibody negative to rhGAA, Initially she tolerated ERT and ITI however complications occurred midway through the second round, Tracheostomy since age 7 months required, By about age 5 years, she communicated primarily via nonverbal means, gesturing with her right hand, and to a minimal extent, with closure of her eyes and movements of mouth, After degrading severely she was started on IVIG which led to a drop in antibody titers and improvement in her health over time

      CaseNotHPOs: HP:0002721 (Immunodeficiency)

      NotHPOsFreeText: N/A

      CaseAddInfo: CRIM-negative Infantile-Onset Pompe Disease diagnosed by muscle biopsy followed by GAA mutation analysis

    1. A 70-year-old female presented with a three-year history of evolving macroglossia causing dysphagia and dysarthria, with proximal muscle weakness.

      Case#: Subject number 1, female, 70 years (report), 67 years (onset), 70 years (diagnosis)

      DiseaseAssertion: Pompe disease

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0000158 (macroglossia), HP:0002015 (dysphagia), HP:0001260 (dysarthria), HP:0003701 (proximal muscle weakness), HP:0000224 (hypogeusia), HP:0002515 (waddling gait), HP:0030234 (highly elevated creatine kinase), HP:0025435 (Increased lactate dehydrogenase level), HP:0012544 (Elevated aldolase level)

      CaseHPOFreeText: adult-onset Pompe disease

      CaseNotHPOs: HP:0002317 (gait instability), HP:0031249 (parageusia), HP:0032043 (odynophagia), HP:0000458 (anosmia), HP:0000651 (diploplia), HP:0002607 (bowel incontinence)

      CaseNotHPOFreeText:

      CasePreviousTesting: (MRI) scan of the brain, "electromyogram revealed a myotonic myopathy with electrophysiological features supportive of inflammation, fiber splitting, vacuolization, and/or myonecrosis," liver function test was within normal limits, pulmonary function test showed mild-to-moderate restriction and reduced total lung capacity, acid alpha-glucosidase activity in blood was evaluated, and it was revealed to be 0.0 (normal: >0.5 nmol/h/mL)

    1. They were the parents of a baby girl (V.4) diagnosed at 7 months of life as having isolated severe concentric hypertrophy without outflow obstruction and an ejection fraction of 70%

      Case#: V.4, female, age of diagnosis 7 months, Moroccan

      DiseaseAssertion: Pompe disease

      FamilyInfo: Pedigree (figure 2). V.4 parents are cousins (IV.2 and IV.3). V.4 had a cousin (V.3) that died at 8 months of age and was diagnosed with HCM. V.3 parents (IV.1 and IV.4) are cousins. IV.2, IV.3, IV.1 and IV.4 were all heterozygous for the GAA mutation c.236_246del (p.Pro79ArgfsX13). V.4 was homozygous for the mutation.

      CasePresentingHPOs: HP:0005157, HP:0001290

      (Concentric hypertrophy, generalized hypotonia)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: hypotonia without facial dysmorphia or other associated abnormalities.

      The heart was structurally normal and no valvular anomalies were observed.

      CasePreviousTesting: whole exome sequencing (WES), Sanger sequencing. No metabolic screening was performed.

      Molecular analysis of SMN gene excluded Spinal muscular atrophy, one of the major causes of neonatal hypotonia in Morocco.

      Variant: NM_000152.5 c.236_246del (p.Pro79ArgfsX13)

      ClinVar: 371302

      CAID: CA16041880

      gnomAD: N/A

      ParentalGenotype: Both parents are heterozygous for .236_246del (p.Pro79ArgfsX13)

      PreviouslyPublished: N/A

    1. 3

      Case#: Patient 3, Gender unknown, age unknown, ethnicity unknown

      DiseaseAssertion: Pompe disease

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001638, HP:0003756

      (Cardiomyopathy, Skeletal myopathy)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Sequence analysis of the GAA gene was performed in a CLIA and CAP certified laboratory. Cross Reactive Immune reaction was indeterminate in peripheral blood mononuclear cells (PBMCs)

      Cross Reactive Immune reaction was negative in Dried blood spots.

      Variant: NM_000152.5(GAA):c.2560C>T (p.Arg854Ter)Cite this record

      ClinVar: 4034

      CAID: CA340130

      gnomAD: Highest population MAF= 0.001891 (African)

      ParentalGenotype: N/A

      PreviouslyPublished:N/A

    1. 6/a

      Case#: 5/a, age 29, no age of report

      DiseaseAssertion: N/A

      FamilyInfo: Family 6, no further information

      CasePresenting HPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Family Screening

      Variants:

      Variant 1: NM_000152.5:c.1921C>G

      ClinVar: N/A

      CAID: CA401369888

      Variant 2:NM_000152.5(GAA):c.-32-13T>G

      ClinVar: 4027

      ParentalGenotypes: N/A

      PreviouslyPublished: N/A

    1. 7

      Case#: Subject number 7, male, 50 years (report), 32 years (onset), 38 years (diagnosis)

      DiseaseAssertion: Pompe disease

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0000365 (hearing loss)

      CaseHPOFreeText: on BiPAP, ambulatory

      CaseNotHPOs: HP:0002650, HP:0000360, HP:0002617, HP:0000939, HP:0009830, HP:0100647, HP:0010788, HP:0000821, HP:0001638 (scoliosis, tinnitus, aneurysm, osteoporosis, peripheral neuropathy, Graves disease, Testicular cancer, hypothyroidism, cardiomyopathy)

      CaseNotHPOFreeText: No infusion reaction, no tracheostomy

      CasePreviousTesting: “documented deficiency of acid alpha-glucosidase enzyme activity”; on enzyme replacement therapy

      Variant 1: NM_000152.5(GAA):c.-32-13T>G (p.Tyr766Ser)

      Variant 1 ClinVarID: 4027

      Variant 1 CAid: CA116606

      Variant 2: NM_000152.5(GAA):c.925G>A (p.Gly309Arg)

      Variant 2 ClinVarID: 188797

      Variant 2 CAid: CA273972

      Zygosity: Compound heterozygous

      ParentalGenotype: N/A

      PreviouslyPublished: N/A

    2. 4

      Case#: Subject number 4, male, 34 years (report), 5 years (onset), 30 years (diagnosis)

      DiseaseAssertion: Pompe disease

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0002650 (scoliosis)

      CaseHPOFreeText: on BiPAP, ambulatory

      CaseNotHPOs: HP:0000360, HP:0000365, HP:0002617, HP:0000939, HP:0009830, HP:0100647, HP:0010788, HP:0000821, HP:0001638 (tinnitus, hearing loss, aneurysm, osteoporosis, peripheral neuropathy, Graves disease, Testicular cancer, hypothyroidism, cardiomyopathy)

      CaseNotHPOFreeText: No infusion reaction, no tracheostomy

      CasePreviousTesting: “documented deficiency of acid alpha-glucosidase enzyme activity”; on enzyme replacement therapy

      Variant 1: NM_000152.5(GAA):c.-32-13T>G (p.Tyr766Ser)

      Variant 1 ClinVarID: 4027

      Variant 1 CAid: CA116606

      Variant 2: NM_000152.5(GAA):c.258dupC (p.Asn87GlnfsTer9)

      Variant 2 ClinVarID: 282842

      Variant 2 CAid: CA8814826

      Zygosity: Compound heterozygous

      ParentalGenotype: N/A

      PreviouslyPublished: N/A

    3. 11

      Case#: Subject number 11, male, 68 years (report), 30s years (onset), 55 years (diagnosis)

      DiseaseAssertion: Pompe disease

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0000360 (tinnitus), HP:0002650 (scoliosis), HP:0000939 (osteoporosis), HP:0000821 (hypothyroidism)

      CaseHPOFreeText: on BiPAP, ambulatory, assistive device (walker, cane)

      CaseNotHPOs: HP:0000365, HP:0002617, HP:0009830, HP:0100647, HP:0010788, HP:0001638 (hearing loss, aneurysm, peripheral neuropathy, Graves disease, Testicular cancer, cardiomyopathy)

      CaseNotHPOFreeText: no infusion reaction, no tracheostomy

      CasePreviousTesting: “documented deficiency of acid alpha-glucosidase enzyme activity”; on enzyme replacement therapy

      Variant 1: NM_000152.5(GAA):c.-32-13T>G (p.Tyr766Ser)

      Variant 1 ClinVarID: 4027

      Variant 1 CAid: CA116606

      Variant 2: NM_000152.5(GAA):c.1951_1952delGGinsT (p.Gly651SerfsTer?)

      Variant 2 ClinVarID: 633225

      Variant 2 CAid: CA913191010

      Zygosity: Compound heterozygous

      ParentalGenotype: N/A

      PreviouslyPublished: N/A

    4. 13

      Case#: Subject number 13, male, 50 years (report), 42 years (onset), 45 years (diagnosis)

      DiseaseAssertion: Pompe disease

      FamilyInfo: N/A

      *CasePresentingHPOs:* HP:0000360 (tinnitus), HP:0002650 (scoliosis), HP:0001638 (cardiomyopathy), HP:0001638 (Graves disease), HP:0010788 (testicular cancer), HP:0000821 (hypothyroidism)

      CaseHPOFreeText: on BiPAP, ambulatory

      CaseNotHPOs: HP:0009830, HP:0000939, HP:0000365, HP:0002617 (peripheral neuropathy, osteoporosis, hearing loss, aneurysm)

      CaseNotHPOFreeText: no infusion reaction, no tracheostomy

      CasePreviousTesting: “documented deficiency of acid alpha-glucosidase enzyme activity”; on enzyme replacement therapy

      Variant 1: NM_000152.5(GAA):c.-32-13T>G (p.Tyr766Ser)

      Variant 1 ClinVarID: 4027

      Variant 1 CAid: CA116606

      Variant 2: NM_000152.5(GAA):c.525_526delTG (p.Asn177ProfsTer11)

      Variant 2 ClinVarID: 189057

      Variant 2 CAid: CA274328

      Zygosity: Compound heterozygous

      ParentalGenotype: N/A

      PreviouslyPublished: N/A

    1. P6a

      Patient6: Female, 53yo

      CasePresentingHPOs: HP:0000822, HP:0003077, HP:0001513,

      HPOsFreeText: LOPD, smoker

      CaseNotHPOs:

      NotHPOsFreeText:

      CaseAddInfo: 5yr follow-up MRI, 17yr disease duration, ERT lasted for 99mo

      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.1655T>C (p.Leu552Pro)

      ClinVar: 279811, https://www.ncbi.nlm.nih.gov/clinvar/variation/279811/

      gnomAD: n/a

    1. 5

      Case#: Patient 5, male, diagnosed 2010 (not given age of diagnosis), age 44 during study period

      DiseaseAssertion: Pompe Disease

      FamilyInfo: None given

      CasePresentingHPOs: None given

      CaseHPOFreeText: None given

      CaseNotHPOs: None given

      CaseNotHPOFreeText: None given

      CasePreviousTesting: None given

      Variant 1: NM_000152.5:c.-32-13T>A (unclear variant nomenclature)

      Variant 1 ClinVarID: N/A

      Variant 1 CAid: CA913184742

      Variant 2: NM_000152.5:c.2331+2T>G

      Variant 2 ClinVarID: N/A

      Variant 2 CAid: CA401324960

      ParentalGenotype: Not provided

    2. 9

      Case#: Patient 9, female, diagnosed 2014 (not given age of diagnosis), age 34 during study period

      DiseaseAssertion: Pompe Disease

      FamilyInfo: None given

      CasePresentingHPOs: None given

      CaseHPOFreeText: None given

      CaseNotHPOs: None given

      CaseNotHPOFreeText: None given

      CasePreviousTesting: None given

      Variant 1: NM_000152.5:c.-32-13T>G (unclear variant nomenclature)

      Variant 1 ClinVarID: 4027

      Variant 1 CAid: CA116606

      Variant 2: NM_000152.5:c.1802C>T

      Variant 2 ClinVarID: 194154

      Variant 2 CAid: CA274982

      ParentalGenotype: Not provided

    1. 2

      Family 2 - Patient 2

      FamilyPresentingHPOs: HP:0002355, HP:0003701, HP:0000467, HP:0009027, HP:0010628, HP:0002015, HP:0002111

      HPOsFreeText:

      FamilyNotHPOs: HP:0003691, HP:0003306, HP:0002650

      NotHPOsFreeText:

      Ethnicity: Iranian

      ProbandLabel: Patient 2, male

      FamilyAddInfo: 2yo at onset, 9yo at diagnosis MRC sum score = 73, NIV prescribed due to reduced FVC

      FamilyPreviousTesting: Respiratory evaluation: FVC = 23%, CK = 83 U/L, Normal muscle pathology exams, DBS enzyme activity (with inhibition) = 0.14 μmol/L/h

      FamilyGenotypingMethod: GAA analyzed with Sanger Sequencing for entire coding region and conserved exon-intron splice junctions, PCR performed for deletion screening

      Variant: NM_000152.3:c.2040+2dup

      ClinVar: n/a

      CAID: CA891834512, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA891834512

      gnomAD: n/a

    1. 19/M

      Patient19: Male

      CasePresentingHPOs: HP:0004887, HP:0011471, HP:0002546, HP:0001371

      HPOsFreeText: CRIM positive, Anti-rh GGA antibodies maximum titer = ≤ 1:400, tracheostomy, able to sit independently, heart normalization, moderate periventricular white matter abnormalities (hypomyelination)

      CaseNotHPOs: HP:0000365

      NotHPOsFreeText: infusion associated reaction

      CaseAddInfo: variants in trans, symptom onset at 10 days, diagnosis and ERT at 3 years

      CasePreviousTesting: same as group

      CaseGenotypingMethod: same as group

      Variant1: NM_000152.4(GAA):c.1802C>G (p.Ser601Trp)

      ClinVar: 501793, https://www.ncbi.nlm.nih.gov/clinvar/variation/501793/

      gnomAD: n/a

      Variant2: NM_000152.3:c.2800-1G>C

      CAID: CA401327625, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA401327625

      gnomAD: n/a

    1. We present the case of a Spanish man with late-onset Pompe disease and a novel allelic variant of GAA in heterozygosis

      Case: Male, Spanish, onset at 57yo with pelvic weakness

      CasePresentingHPOs: HP:0003236, HP:0002522, HP:0003184, HP:0012515, HP:0003749, HP:0003700, HP:0005144, HP:0002151, HP:0030232, HP:0009058

      HPOsFreeText: weakness of hip adduction and shoulder abduction, abolished lower limb reflexes. CK = 500-800 U/L, lactate = 27.0 U/L, GOT = 50 U/L, GPT = 69 U/L, LDH = 449 U/L, aldolase = 8.7 U/L, myopathic motor unit action potentials with early recruitment and spontaneous activity (mainly in quadriceps), asymmetric septal left ventricular hypertrophy with preserved ventricular function, atrophy of both biceps and deltoid muscles, fibrillary deposits in cytoplasm, focal disorganization of sarcomeres, decrease in GAA inhibitory activity (0.64-0.68 μmol/L/h)

      CaseNotHPOs: HP:0001283, HP:0002093, HP:0003326, HP:0002487

      NotHPOsFreeText:

      CaseAddInfo: daughter also underwent genetic testing which showed she was a heterozygous carrier for the same variant. She presented with decreased GAA activity in DBS and isolated lymphocytes.

      CasePreviousTesting: blood laboratory exams, electromyography study, echocardiogram, biopsy of biceps and deltoid muscles, histochemical staining which showed no abnormalities, electron microscopy, DBS, enzyme activity analyzed in isolated lymphocytes (confirmed decreased GAA activity)

      CaseGenotypingMethod: n/a

      Variant: NM_000152.3:c.1249A>C

      CAID: CA401365271, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA401365271

      gnomAD: n/a

    1. 2

      Case2: Male, Danish, 39 years report, 20 years onset

      CasePresentingHPOs: HP:0008956 (Thigh muscle atrophy)

      HPOsFreeText: 6-min walk test achieved 441 m, MRC score is 4/5 (thigh/calf), Forced vital capacity sitting/supine is 4.1/3.7 (L)

      NotHPOsFreetext: Not on ERT

      GroupGenotypingMethod: Mutation Analysis on the GAA Gene


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

      CAID: CA913184742 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA913184742

      gnomAD: Not in gnomAD


      Variant2: NM_000152.4:c.2331+2T>G

      CAID: CA401324960 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.2331%2B2T%3EG

      gnomAD: Not in gnomAD


      CaseAddInfo: Late Onset Pompe Disease

    2. 5

      Case5: Female, French, 30 years report, 27 years onset

      HPOsFreeText: 6-min walk test achieved 488 m, MRC score is 4/5 (thigh/calf), Forced vital capacity sitting/supine is 2.4/2.2 (L), Has started ERT

      CaseNotHPOs: HP:0008956 (Thigh muscle atrophy)

      GroupGenotypingMethod: Mutation Analysis on the GAA Gene


      Variant1: NM_000152.4:c.1655T>C (p.Leu552Pro)

      ClinVar: 279811 https://www.ncbi.nlm.nih.gov/clinvar/variation/279811/

      gnomAD: European (Non-Finnish) 7.053e-5, Overall 3.188e-5 http://gnomad.broadinstitute.org/variant/17-78085800-T-C


      Variant2: NM_000152.4:c.1688A>T (p.Gln563Leu)

      CAID: CA401368995 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.1688A%3ET

      gnomAD: Not in gnomAD


      CaseAddInfo: Late Onset Pompe Disease

    1. A male child, diagnosed with IOPD at the age of 3 months

      Case#: case 1, male, 3 months old at diagnosis, ethnicity unknown

      DiseaseAssertion: Pompe disease

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0001638, HP:0001252 (cardiomyopathy, muscular hypotonia)

      CaseHPOFreeText: (Associated with Pompe Disease): Interventricular septum hypertrophy, increased serum CK, increased serum tryptase

      CaseHPOFreeText: (Infussion associated reactions) Urticarial rash, unresponsive to antihistamines and corticosteroids

      CaseNotHPOs:

      CaseNotHPOFreeText: Infusion associated reactions are not associated with an IgE mediated mechanism.

      CasePreviousTesting:

      GAA activity on fibroblast is 0.8 nmol/mg prot/h with a reference range of 64.4 ± 22.9 nmol/mg prot/h

      GAA activity on lymphocytes is 2.2 nmol 4 Mu/mg prot/h with a reference range of 21.4 ± 6.2 nmol 4 Mu/mg prot/h

      Variants:<br /> Variant 1: NM_000152.5(GAA):c.236_246del (p.Pro79fs)

      ClinVar: 371302

      CAID: 16041880

      Variant 2: NM_000152.5(GAA):c.1655T>C (p.Leu552Pro)

      ClinVar:279811

      CAID: 8815429

      gnomAD: N/A

      ParentalGenotype: N/A

      PreviouslyPublished: N/A