5,406 Matching Annotations
  1. Oct 2026
    1. CaseOPOPD-48: Female, Taiwan, Birth diagnosis

      HPOsFreeText: GAA (MS/MS) enzyme activity at 1.02 umol/hr/L

      GenotypingMethod: GAA Gene Sequencing and PCR Amplification


      Variant1: NM_000152.4:c.1508_1510del (p.Val503del)

      CAID: CA627699576 https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NM_000152.4%3Ac.1508_1510del

      gnomAD: East Asian 5.438e-5, Overall 3.980e-6 http://gnomad.broadinstitute.org/variant/17-78084592-ATGG-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 allele and One Pseudodeficency Mutation allele, 1 other has the same genotype

    2. CaseOPOPD-53: Female, Taiwan, Birth diagnosis

      HPOsFreeText: GAA (MS/MS) enzyme activity at 0.80 umol/hr/L

      GenotypingMethod: GAA Gene Sequencing and PCR Amplification


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

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

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


      Variant2: NM_000152.4:c.1935C>A (p.Asp645Glu)

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

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


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

    1. 20 mg/kg (N = 16)

      Case9HPOsFreeText: 20 mg/kg GAA treatment, GAA activity at 0.6 pmol/punch/hr, GAA activity at 5.5% 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"


      Variant: 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


      CaseAddInfo: Patient is homozygous for this variant

    1. 4

      Case#: Patient 4, 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 not available in Dried blood spots.

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

      ClinVar: 4034

      CAID:CA340130

      gnomAD: Highest population MAF= 0.001891 (African)

      ParentalGenotype: N/A

    1. PD/Pathogenic-3

      CasePD/Pathogenic-3: 2 weeks diagnosis

      HPOsFreeText: GAA activity 4.9 (nmol · h−1 · mg−1), Mean percentage of normal 6.9%

      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.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


      Variant4: 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: Patient has one pseudodeficency allele and one pathogenic allele, Nomenclature claims Variant 1 and 2 are in cis, Nomenclature claims Variant 3 and 4 are in cis

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

      Case41

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

    1. 1

      Case#: Patient 1, male, diagnosed 2000 (not given age), age 62 during study period

      DiseaseAssertion: Pompe Disease

      FamilyInfo: None given

      CasePresentingHPOs: None given

      CaseHPOFreeText: Requires B-pap at night

      CaseNotHPOs: None given

      CaseNotHPOFreeText: None given

      CasePreviousTesting: None given

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

      Variant 1 ClinVarID: N/A

      Variant 1 CAid: CA913184742

      Variant 2: NM_000152.5:c.1003G>A

      Variant 2 ClinVarID: 972790

      Variant 2 CAid: CA501005

      ParentalGenotype: Not provided

    1. P1

      Patient1: Female, 3mo at diagnosis, 4mo at ERT

      CasePresentingHPOs:

      HPOsFreeText: classic IOPD, moderate response to ERT, Pompe muscle pathology score = 2.2 (a), 3.3(b), Glycogen = 59.4(a), 63.8(b) Vv(PAS + /mf)%, larger empty vacuoles = 6.2(a), 18.3(b) Vv (LEV/mf)%, autophagic vacuoles = 0,25; 0 %/mf

      CaseNotHPOs:

      NotHPOsFreeText:

      CaseAddInfo: biopsy taken from  musculus vastus lateralis

      CasePMIDs:

      CasePreviousTesting: same as group

      CaseGenotypingMethod: same as group

      Variant1: NM_000152.3:c.104T>C

      CAID: CA401360259, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA401360259

      gnomAD: n/a

      Variant2: c.266 C > A This is the variant listed in the paper, but I believe this is a typo as both Clinvar and the allele registry have this position listed as 'G' rather than 'C'

      NM_000152.4(GAA):c.266G>A (p.Arg89His)

      ClinVar: 283219, https://www.ncbi.nlm.nih.gov/clinvar/variation/283219/#summary-evidence

      gnomAD: 7.795e-05, http://exac.broadinstitute.org/variant/17-78078651-G-A

    1. PATIENT 2

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

      DiseaseAssertion: Pompe disease

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

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0003701, HP:0003445

      (Proximal muscle weakness, EMG:neuropathic changes

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

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

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      Staining for PAS and acid phosphatase was normal.

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

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

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

      ClinVar: 4027

      CAID: CA116606

      gnomAD: Highest population MAF= 0.005541 (Ashkenazi Jewish)

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

      ClinVar: 167113

      CAID: CA234050

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

      ParentalGenotype:N/A

      PreviouslyPublished:N/A

    1. In 1986, a preliminary report described a girl

      Case1: Female, 22 years old, ethnicity not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: See Fig 1

      ParentalGenotype: The patient's parents revealed reduced concentrations of glycoprotein llb-Illa and were considered to be heterozygotes. See Fig 1

      CasePresentingHPOs: HP:0000421, HP:0000225, HP:0000132, HP:0000978

      (Severe epistaxis, gingival bleeding, menorrhagia, spontaneous bruising)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      ProteinExpression: Platelets had much reduced alphaIIb3 when estimated by crossed immunoelectrophoresis

      PlateletAggregation: Platelet aggregation was absent with ADP, arachidonic acid, and collagen.

      CasePreviousTesting: Sequenced all exons and splice sites of ITGA2B and ITGB3

      Gene: ITGA2B

      Variant: NM_000419.3:c.1073G>A (p.Arg358His) and NM_000419.3:c.1234G>A (p.Gly412Arg)

      LegacyVariant: (p.Arg327His) and (p.Gly381Arg)

      ClinVar: 2896 and 381748

      CAiD: CA115839 and CA8603182

      gnomAD: MAF in the Latino population is 0.0001453 https://gnomad.broadinstitute.org/variant/17-42458406-C-T

      PreviouslyPublished: PMID: 3762006 proband is mentioned in this article

    1. M2

      Case2: Patient M2, Female, French Gypsy, age is not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: See Figure 2 for pedigree

      ParentalGenotype: Unaffected parents see pedigree Fig 2

      CasePresentingHPOs: N/A

      CaseHPOFreeText: France, GT is particularly frequent in the Gypsy population, mainly represented by the Manouche tribe. Their clinical phenotype is the same as for classic type I disease, with a moderate and occasional severe bleeding syndrome

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry analysis has shown that these patients' surface expresses <5% of normal GPIIIa and GPIIb levels (we are not given an exact value for each proband)

      PlateletAggregation: "Absent platelet aggregation" this is all the information we are given for platelet aggregation

      CasePreviousTesting: N/A

      Gene: ITGA2B

      Variant: NM_000419.3:c.1544+1G>A

      LegacyVariant: N/A

      ClinVar: 2895

      CAiD: CA10575473

      gnomAD: N/A

    1. RS

      Case37: Patient RS

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: HP:0000421, HP:0000225, HP:0000132

      (Epistaxis, gingival bleeding, menorrhagia)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: N/A

      PlateletAggregation: N/A

      CasePreviousTesting: N/A

      Gene: ITGB3

      Variant: NM_000212.2:c.1260G>A and the other variant won't show up in CAR

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA8623200

      gnomAD: MAF in the African population is 0.00004005 https://gnomad.broadinstitute.org/variant/17-45368454-G-A

      PreviouslyPublished: Reference 60

    2. Family I

      Case23: Family I from GT database, gender and age not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: N/A

      PlateletAggregation: N/A

      CasePreviousTesting: N/A

      Gene: ITGB3

      Variant: NM_000212.2:c.262C>T (p.Arg88Ter)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA400020703

      gnomAD: MAF in the Other population 0.0001385 https://gnomad.broadinstitute.org/variant/17-45360816-C-T

      PreviouslyPublished: Reference number 28

    3. Substitution41KWIHomozygoteIVS1

      Case1: Patient KW (this patient can be found in the GT database)

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: HP:0000421, HP:0000225

      (Epistaxis, gingival bleeding)

      CaseHPOFreeText: Blood transfusions needed

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Surface expression of GPIIb/GPIIIa not reported for this patient

      PlateletAggregation: N/A

      CasePreviousTesting: N/A

      Gene: ITGA2B

      Variant: 4.5-KB DEL, EX2-9

      LegacyVariant: N/A

      ClinVar: 2890

      CAiD: N/A

      gnomAD: N/A

      PreviouslyPublished: PMID: 1702098

    4. Substitution49CMVariantHomozygote718C

      Case30: Patient CM

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: HP:0000421, HP:0000225, HP:0000132

      (Epistaxis, gingival bleeding, menorrhagia)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: N/A

      PlateletAggregation: N/A

      CasePreviousTesting: N/A

      Gene: ITGB3

      Variant: NM_000212.2:c.718C>T (p.Arg240Trp)

      LegacyVariant: N/A

      ClinVar: 13555

      CAiD: CA123228

      gnomAD: MAF in the East Asian population is 0.00005437 https://gnomad.broadinstitute.org/variant/17-45363729-C-T

      PreviouslyPublished: Reference 48 and 49

    5. SH

      Case32: Patient SH

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: 20% GPIIIa and GPIIb surface expression

      PlateletAggregation: N/A

      CasePreviousTesting: N/A

      Gene: ITGB3

      Variant: NM_000212.2:c.725G>A (p.Arg242Gln)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA291224896

      gnomAD: N/A

      PreviouslyPublished: Reference number 5 in this article

    1. Supplementary Table S1:

      Case40: GT47, French, gender and age not specified

      DiseaseAssertion: Glanzmann thrombasthenia type I

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: All patients had a life-long history of mucocutaneous bleeding

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: All patients in this study met the clinical and platelet function requirements for GT-- this includes an absent or strongly reduced expression of alphaIIbBeta3 in platelets

      PlateletAggregation: All patients in this study met the clinical and platelet function requirements for GT-- this includes absent or severely reduced platelet aggregation with at least three physiological agonists

      CasePreviousTesting: Sanger sequencing was performed. Sanger sequencing ensured coverage of all exons and splice sties of the ITGA2B and ITGB3 genes and extended 300-500 bp into the introns as well as including the UTR. They sequenced 416 bp upstream of the ITGA2B promoter and 463 bp upstream of the ITGB3 promoter. In total they sequenced 51.2% of the ITGA2B gene and 19.4% of the larger ITGB3 gene

      Gene: ITGA2B

      Variant: NM_000419.3:c.832del (p.Asp278IlefsTer101)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA915940374

      gnomAD: N/A

    2. Supplementary Table S1:

      Case34: GT40, Canadian/Pakistani, gender and age not specified

      DiseaseAssertion: Glanzmann thrombasthenia type I

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: All patients had a life-long history of mucocutaneous bleeding

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: All patients in this study met the clinical and platelet function requirements for GT-- this includes an absent or strongly reduced expression of alphaIIbBeta3 in platelets

      PlateletAggregation: All patients in this study met the clinical and platelet function requirements for GT-- this includes absent or severely reduced platelet aggregation with at least three physiological agonists

      CasePreviousTesting: Sanger sequencing was performed. Sanger sequencing ensured coverage of all exons and splice sties of the ITGA2B and ITGB3 genes and extended 300-500 bp into the introns as well as including the UTR. They sequenced 416 bp upstream of the ITGA2B promoter and 463 bp upstream of the ITGB3 promoter. In total they sequenced 51.2% of the ITGA2B gene and 19.4% of the larger ITGB3 gene

      Gene: ITGA2B

      Variant: NM_000419.3:c.857T>A (p.Val286Asp)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA399805011

      gnomAD: N/A

    3. Supplementary Table S1:

      Case28: GT33a, USA/Laos, gender and age not specified or reported

      DiseaseAssertion: Glanzmann thrombasthenia type I

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: All patients had a life-long history of mucocutaneous bleeding

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: All patients in this study met the clinical and platelet function requirements for GT-- this includes an absent or strongly reduced expression of alphaIIbBeta3 in platelets

      PlateletAggregation: All patients in this study met the clinical and platelet function requirements for GT-- this includes absent or severely reduced platelet aggregation with at least three physiological agonists

      CasePreviousTesting: Sanger sequencing was performed. Sanger sequencing ensured coverage of all exons and splice sties of the ITGA2B and ITGB3 genes and extended 300-500 bp into the introns as well as including the UTR. They sequenced 416 bp upstream of the ITGA2B promoter and 463 bp upstream of the ITGB3 promoter. In total they sequenced 51.2% of the ITGA2B gene and 19.4% of the larger ITGB3 gene

      Gene: ITGB3

      Variant: NM_000212.2:c.262C>T (p.Arg88Ter) and NM_000212.2:c.2113del (p.Ley705Cysfs*4)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA400020703 and CA8623443

      gnomAD: MAF in the Other population is 0.0001385 for (p.Arg88Ter) https://gnomad.broadinstitute.org/variant/17-45360816-C-T and MAF in the East Asian population is 0.0001087 for (p.Ley705Cysfs*4) https://gnomad.broadinstitute.org/variant/17-45380183-TC-T

    4. Supplementary Table S1:

      Case6: GT7, French, gender and age not specified

      DiseaseAssertion: Glanzmann thrombasthenia type I

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: All patients had a life-long history of mucocutaneous bleeding

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: All patients in this study met the clinical and platelet function requirements for GT-- this includes an absent or strongly reduced expression of alphaIIbBeta3 in platelets

      PlateletAggregation: All patients in this study met the clinical and platelet function requirements for GT-- this includes absent or severely reduced platelet aggregation with at least three physiological agonists

      CasePreviousTesting: Sanger sequencing was performed. Sanger sequencing ensured coverage of all exons and splice sties of the ITGA2B and ITGB3 genes and extended 300-500 bp into the introns as well as including the UTR. They sequenced 416 bp upstream of the ITGA2B promoter and 463 bp upstream of the ITGB3 promoter. In total they sequenced 51.2% of the ITGA2B gene and 19.4% of the larger ITGB3 gene

      Gene: ITGB3

      Variant: NM_000212.2:c.187C>T (p.Arg63Cys) and NM_000212.2:c.505C>T (p.Arg169Ter)

      LegacyVariant: N/A

      ClinVar: 631774

      CAiD: CA8622892 and CA291224658

      gnomAD: MAF in the East Asian population is 0.00005012 https://gnomad.broadinstitute.org/variant/17-45360741-C-T

    5. Supplementary Table S1:

      Case55: GT65, French, gender and age not specified

      DiseaseAssertion: Glanzmann thrombasthenia type I

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: All patients had a life-long history of mucocutaneous bleeding

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: All patients in this study met the clinical and platelet function requirements for GT-- this includes an absent or strongly reduced expression of alphaIIbBeta3 in platelets

      PlateletAggregation: All patients in this study met the clinical and platelet function requirements for GT-- this includes absent or severely reduced platelet aggregation with at least three physiological agonists

      CasePreviousTesting: Sanger sequencing was performed. Sanger sequencing ensured coverage of all exons and splice sties of the ITGA2B and ITGB3 genes and extended 300-500 bp into the introns as well as including the UTR. They sequenced 416 bp upstream of the ITGA2B promoter and 463 bp upstream of the ITGB3 promoter. In total they sequenced 51.2% of the ITGA2B gene and 19.4% of the larger ITGB3 gene

      Gene: ITGA2B

      Variant: NM_000419.3:c.574+1G>A and NM_000419.3:c.1946+3G>T

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA399805691 and CA626121071

      gnomAD: MAF in the African population is 0.000 https://gnomad.broadinstitute.org/variant/17-42456008-C-A

    6. Supplementary Table S1:

      Case60: GT70, French/Arab, gender and ethnicity are not specified

      DiseaseAssertion: Glanzmann thrombasthenia type I

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: All patients had a life-long history of mucocutaneous bleeding

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: All patients in this study met the clinical and platelet function requirements for GT-- this includes an absent or strongly reduced expression of alphaIIbBeta3 in platelets

      PlateletAggregation: All patients in this study met the clinical and platelet function requirements for GT-- this includes absent or severely reduced platelet aggregation with at least three physiological agonists

      CasePreviousTesting: Sanger sequencing was performed. Sanger sequencing ensured coverage of all exons and splice sties of the ITGA2B and ITGB3 genes and extended 300-500 bp into the introns as well as including the UTR. They sequenced 416 bp upstream of the ITGA2B promoter and 463 bp upstream of the ITGB3 promoter. In total they sequenced 51.2% of the ITGA2B gene and 19.4% of the larger ITGB3 gene

      Gene: ITGB3

      Variant: M_000212.2:c.613_614+2del

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA915940309

      gnomAD: N/A

    7. Supplementary Table S1:

      Case9: French/Italian, gender and age not specified

      DiseaseAssertion: Glanzmann thrombasthenia type I

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: All patients had a life-long history of mucocutaneous bleeding

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: All patients in this study met the clinical and platelet function requirements for GT-- this includes an absent or strongly reduced expression of alphaIIbBeta3 in platelets

      PlateletAggregation: All patients in this study met the clinical and platelet function requirements for GT-- this includes absent or severely reduced platelet aggregation with at least three physiological agonists

      CasePreviousTesting: Sanger sequencing was performed. Sanger sequencing ensured coverage of all exons and splice sties of the ITGA2B and ITGB3 genes and extended 300-500 bp into the introns as well as including the UTR. They sequenced 416 bp upstream of the ITGA2B promoter and 463 bp upstream of the ITGB3 promoter. In total they sequenced 51.2% of the ITGA2B gene and 19.4% of the larger ITGB3 gene

      Gene: ITGA2B

      Variant: NM_000419.3:c.1440-13_1440-1del (p.Arg480Serfs*106) and NM_000419.3:c.3077G>A (p.Arg1026Gln)

      LegacyVariant: N/A

      ClinVar: 50232

      CAiD: CA913184940 and CA10575572

      gnomAD: MAF in the European (non-Finnish) population is 0.000008801 https://gnomad.broadinstitute.org/variant/17-42449775-C-T for (p.Arg1026Gln)

    1. The patient

      Case1: Female, 5 years old, Swiss (from Morocco)

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: Affected brother

      ParentalGenotype: Mother and father are heterozygous for the variant of interest

      CasePresentingHPOs: HP:0001250, HP:0001270, HP:0000967, HP:0001892

      (Seizures, retarded motor development, petechia, hemorrhagic diathesis)

      CaseHPOFreeText: Subepndymal hematomas, cortical tubera, hydrocephalus internus

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry protein expression results can be seen in Figure 1

      PlateletAggregation: Platelets failed to aggregate with ADP, collagen, or arachidonic acid; however, ristocetin induced platelet agglutination was normal

      CasePreviousTesting: Amplified DNA fragments containing exon 11 of the GPIIIa gene were purified by PCR preps DNA purification resin and wizard.

      Gene: ITGB3

      Variant: NM_000212.2:c.1702T>C (p.Cys568Arg)

      LegacyVariant: (p.Cys542Arg)

      ClinVar: N/A

      CAiD: CA400032350

      gnomAD: N/A

    1. GT38

      Case24: (GT38) Gender, age and ethnicity not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Inclusion criteria were patients with a history of mucocutaneous bleeding (Figure 1 shows a bar diagram of all the clinical manifestations in the patient cohort in this article)

      CaseNotHPOs: N/A

      ProteinExpression: Platelet receptor alphaIIbbeta3 protein was analyzed by flow cytometry followed by western blotting

      Platelet Aggregation: Inclusion criteria for probands was absent or reduced platelet aggregation with agonists such as ADP, adrenaline, arachidonic acid, and collagen (no mention of ristocetin here-- this article does not tell us the specific aggregation for each proband in the paper)

      CasePreviousTesting: For mutation analysis of ITGA2B and ITGB3 genes, DNA extraction from whole blood, PCR, heteroduplex PCR followed by CSGE and DNA sequencing were performed. All 30 exons of ITGA2B and 15 exons of ITGB3, as well as their promoters, were analyzed by CSGE following heteroduplex PCR.

      Gene: ITGA2B

      Variant: NM_000419.3:c.2338del

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA915940686

      gnomAD N/A

    2. GT23

      Case33: (GT23) Gender, age and ethnicity are not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: Both brothers are heterozygous for this mutation and sister is normal

      ParentalGenotype: Father is heterozygous for the NM_000419.3:c.800-2A>T mutation and mother does not harbor this mutation. Mother is heterozygous for the NM_000419.3:c.1210+4A>G mutation and father does not have this mutation.

      CasePresentingHPOs:

      CaseHPOFreeText: Inclusion criteria were patients with a history of mucocutaneous bleeding (Figure 1 shows a bar diagram of all the clinical manifestations in the patient cohort in this article)

      CaseNotHPOs: N/A

      ProteinExpression: Platelet receptor alphaIIbbeta3 protein was analyzed by flow cytometry followed by western blotting

      Platelet Aggregation: Inclusion criteria for probands was absent or reduced platelet aggregation with agonists such as ADP, adrenaline, arachidonic acid, and collagen (no mention of ristocetin here-- this article does not tell us the specific aggregation for each proband in the paper)

      CasePreviousTesting: For mutation analysis of ITGA2B and ITGB3 genes, DNA extraction from whole blood, PCR, heteroduplex PCR followed by CSGE and DNA sequencing were performed. All 30 exons of ITGA2B and 15 exons of ITGB3, as well as their promoters, were analyzed by CSGE following heteroduplex PCR.

      Gene: ITGA2B

      Variant: NM_000419.3:c.800-2A>T and NM_000419.3:c.1210+4A>G

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA399805150 and CA915940692

      gnomAD N/A

    3. 34

      Case5: (GT34), Gender, age and ethnicity not reported

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Inclusion criteria were patients with a history of mucocutaneous bleeding (Figure 1 shows a bar diagram of all the clinical manifestations in the patient cohort in this article)

      CaseNotHPOs: N/A

      ProteinExpression: Platelet receptor alphaIIbbeta3 protein was analyzed by flow cytometry followed by western blotting

      Platelet Aggregation: Inclusion criteria for probands was absent or reduced platelet aggregation with agonists such as ADP, adrenaline, arachidonic acid, and collagen (no mention of ristocetin here-- this article does not tell us the specific aggregation for each proband in the paper)

      CasePreviousTesting: For mutation analysis of ITGA2B and ITGB3 genes, DNA extraction from whole blood, PCR, heteroduplex PCR followed by CSGE and DNA sequencing were performed. All 30 exons of ITGA2B and 15 exons of ITGB3, as well as their promoters, were analyzed by CSGE following heteroduplex PCR.

      Gene: ITGA2B

      Variant: NC_000017.11:g.44393555C>T (g.951G>A promoter variant)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA913189168

      gnomAD N/A

    4. GT45

      Case10: (GT45) Gender, age and ethnicity not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Inclusion criteria were patients with a history of mucocutaneous bleeding (Figure 1 shows a bar diagram of all the clinical manifestations in the patient cohort in this article)

      CaseNotHPOs: N/A

      ProteinExpression: Platelet receptor alphaIIbbeta3 protein was analyzed by flow cytometry followed by western blotting

      Platelet Aggregation: Inclusion criteria for probands was absent or reduced platelet aggregation with agonists such as ADP, adrenaline, arachidonic acid, and collagen (no mention of ristocetin here-- this article does not tell us the specific aggregation for each proband in the paper)

      CasePreviousTesting: For mutation analysis of ITGA2B and ITGB3 genes, DNA extraction from whole blood, PCR, heteroduplex PCR followed by CSGE and DNA sequencing were performed. All 30 exons of ITGA2B and 15 exons of ITGB3, as well as their promoters, were analyzed by CSGE following heteroduplex PCR.

      Gene: ITGA2B

      Variant: NM_000419.3:c.1073G>A (p.Arg358His)

      LegacyVariant: N/A

      ClinVar: 2896

      CAiD: CA115839

      gnomAD N/A

    5. 41

      Case31: (GT41) Gender, age and ethnicity are not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Inclusion criteria were patients with a history of mucocutaneous bleeding (Figure 1 shows a bar diagram of all the clinical manifestations in the patient cohort in this article)

      CaseNotHPOs: N/A

      ProteinExpression: Platelet receptor alphaIIbbeta3 protein was analyzed by flow cytometry followed by western blotting

      Platelet Aggregation: Inclusion criteria for probands was absent or reduced platelet aggregation with agonists such as ADP, adrenaline, arachidonic acid, and collagen (no mention of ristocetin here-- this article does not tell us the specific aggregation for each proband in the paper)

      CasePreviousTesting: For mutation analysis of ITGA2B and ITGB3 genes, DNA extraction from whole blood, PCR, heteroduplex PCR followed by CSGE and DNA sequencing were performed. All 30 exons of ITGA2B and 15 exons of ITGB3, as well as their promoters, were analyzed by CSGE following heteroduplex PCR.

      Gene: ITGB3

      Variant: NM_000212.2:c.887_901del

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA626379036

      gnomAD MAF in the South Asian population is 0.00003266 https://gnomad.broadinstitute.org/variant/17-45364541-AATGACGGGCAGTGTC-A

    6. 26

      Case7: (GT26) Gender, age and ethnicity not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Inclusion criteria were patients with a history of mucocutaneous bleeding (Figure 1 shows a bar diagram of all the clinical manifestations in the patient cohort in this article)

      CaseNotHPOs: N/A

      ProteinExpression: Platelet receptor alphaIIbbeta3 protein was analyzed by flow cytometry followed by western blotting

      Platelet Aggregation: Inclusion criteria for probands was absent or reduced platelet aggregation with agonists such as ADP, adrenaline, arachidonic acid, and collagen (no mention of ristocetin here-- this article does not tell us the specific aggregation for each proband in the paper)

      CasePreviousTesting: For mutation analysis of ITGA2B and ITGB3 genes, DNA extraction from whole blood, PCR, heteroduplex PCR followed by CSGE and DNA sequencing were performed. All 30 exons of ITGA2B and 15 exons of ITGB3, as well as their promoters, were analyzed by CSGE following heteroduplex PCR.

      Gene: ITGA2B

      Variant: NM_000419.3:c.641T>C (p.Leu214Pro)

      LegacyVariant: N/A

      ClinVar: 2901

      CAiD: CA115848

      gnomAD N/A

    7. 18

      Case2: GT18, Gender, age, ethnicity not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: 1 brother is heterozygous for the g.951G>A promoter variant and does not have the other Leu343Pro mutation and one brother is normal and does not have the NM_000419.3:c.2915dup mutation

      ParentalGenotype: Father: homozygous for the g.951G>A promoter variant and the Leu343Pro Mother: is heterozyous for both those mutations and mother does not have NM_000419.3:c.2915dup while the father is heterozygous for NM_000419.3:c.2915dup

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Inclusion criteria were patients with a history of mucocutaneous bleeding (Figure 1 shows a bar diagram of all the clinical manifestations in the patient cohort in this article)

      CaseNotHPOs: N/A

      ProteinExpression: Platelet receptor alphaIIbbeta3 protein was analyzed by flow cytometry followed by western blotting

      Platelet Aggregation: Inclusion criteria for probands was absent or reduced platelet aggregation with agonists such as ADP, adrenaline, arachidonic acid, and collagen (no mention of ristocetin here-- this article does not tell us the specific aggregation for each proband in the paper)

      CasePreviousTesting: For mutation analysis of ITGA2B and ITGB3 genes, DNA extraction from whole blood, PCR, heteroduplex PCR followed by CSGE and DNA sequencing were performed. All 30 exons of ITGA2B and 15 exons of ITGB3, as well as their promoters, were analyzed by CSGE following heteroduplex PCR.

      Gene: ITGA2B

      Variant: NC_000017.11:g.44393555C>T (g.951G>A promoter variant) and NM_000419.3:c.1028T>C (p.Leu343Pro) and NM_000419.3:c.2915dup

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA913189168 (promoter variant) and CA399804619 (p.Leu343Pro) and CA8602531

      gnomAD MAF in the East Asian population is 0.0001088 https://gnomad.broadinstitute.org/variant/17-42452054-C-CG for the NM_000419.3:c.2915dup variant

    8. GT39

      Case12: (GT39) Gender, age and ethnicity not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Inclusion criteria were patients with a history of mucocutaneous bleeding (Figure 1 shows a bar diagram of all the clinical manifestations in the patient cohort in this article)

      CaseNotHPOs: N/A

      ProteinExpression: Platelet receptor alphaIIbbeta3 protein was analyzed by flow cytometry followed by western blotting

      Platelet Aggregation: Inclusion criteria for probands was absent or reduced platelet aggregation with agonists such as ADP, adrenaline, arachidonic acid, and collagen (no mention of ristocetin here-- this article does not tell us the specific aggregation for each proband in the paper)

      CasePreviousTesting: For mutation analysis of ITGA2B and ITGB3 genes, DNA extraction from whole blood, PCR, heteroduplex PCR followed by CSGE and DNA sequencing were performed. All 30 exons of ITGA2B and 15 exons of ITGB3, as well as their promoters, were analyzed by CSGE following heteroduplex PCR.

      Gene: ITGB3

      Variant: NM_000212.2:c.92G>A (p.Cys31Tyr)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA400031593

      gnomAD N/A

    1. TG

      Case13: Patient TG, gender, age and ethnicity not specified

      DiseaseAssertion: Glanzmann thrombasthenia type I

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Bleeding symptoms were evaluated by examining available hospital records. Mild bleeders were defined as those who had minor symptoms, such as epistaxis or gum bleeds, and moderate bleeders suffered, in addition, from bleeding complications after surgery and trauma. Severe bleeders were defined as those with a history of spontaneous or life-threatening hemorrhages, such as gastrointestinal bleeding, or who had repeated episodes requiring platelet transfusion. See Table 1.

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: See Table 6

      PlateletAggregation: See Table 6

      CasePreviousTesting: To ascertain the mutations, we sequenced the coding regions of the αIIb and β3 subunits including the exon/intron boundaries

      Gene: ITGA2B

      Variant: NM_000419.3:c.3060G>A

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA500261104

      gnomAD: N/A

    1. G

      Case7: Patient ID G, Female, 1 year old, ethnicity not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A (Table 1 does mention family history of bleeding)

      ParentalGenotype: N/A (Parents are consangenous)

      CasePresentingHPOs: HP:0000978, HP:0004406, HP:0000225)

      (Easy bruising, recurrent epistaxis, gingival bleeding)

      CaseHPOFreeText: Ear bleeding

      CaseNotHPOs: HP:0000967, HP:0000979, HP:0002239, HP:0002239, HP:0000790, HP:0005261, HP:0002248

      (Petechiae, purpura, GI bleeding, intracranial hemorrhage, hematuria, hemarthrosis, hematemesis)

      CaseNotHPOsFreeText: Hemorrage after dental, hemorrhage after trauma, hematoma

      ProteinExpression: N/A

      PlateletAggregation: Defective response to ADP, adrenaline, collagen, arachidonic acid, and normal response to ristocetin

      CasePreviousTesting: Exon PCR was used to amplify a;; coding regions of the ITGA2B and ITGB3 genes. PCR products were purified and Sanger sequenced. Segregation using parental samples was undertaken when available.

      Gene: ITGA2B

      Variant: NM_000419.3:c.1652G>A

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA8602986

      gnomAD: MAF in South Asian population is 0.00006536 http://gnomad.broadinstitute.org/variant/17-42457470-C-T

      PreviouslyPublished: PMID: 19172520

    2. A

      Case1: Patient ID A, Male, 6 years old, ethnicity not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A (Parents are consangenous)

      CasePresentingHPOs: HP:0000978, HP:0002239

      (Easy bruising, gastrointestinal bleeding)

      CaseHPOFreeText: N/A

      CaseNotHPOs: HP:0000967, HP:0000979, HP:0004406, HP:0000225, HP:0002239, HP:0000790, HP:0005261

      (Petechiae, purpura, recurrent epistaxis, gingival bleeding, intracranial hemorrhage, hematuria, hemarthrosis)

      CaseNotHPOsFreeText: Hemhorrage after dental, hemhorrage after trauma, ear bleeding, hematoma

      ProteinExpression: N/A

      PlateletAggregation: Defective response to ADP, adrenaline, collagen, arachidonic acid, and normal response to ristocetin

      CasePreviousTesting: Exon PCR was used to amplify a;; coding regions of the ITGA2B and ITGB3 genes. PCR products were purified and Sanger sequenced. Segregation using parental samples was undertaken when available.

      Gene: ITGA2B

      Variant: NM_000419.3:c.435C>A (p.Asn145Lys) and NM_000419.3:c.531T>A (p.Cys177Ter)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA399805991 and CA290955739

      gnomAD: N/A

      PreviouslyPublished: PMID: 20020534

    3. N

      Case14: Patient ID N, Male, 7 years old, ethnicity not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: HP:0000967, HP:0000979, HP:0000978, HP:0004406, HP:0000225

      (Petechiae, purpura, easy bruising, recurrent epistaxis, gingival bleeding)

      CaseHPOFreeText: Hemorrhage after dental, hemorrhage after trauma

      CaseNotHPOs: HP:0002239, HP:0002239, HP:0000790, HP:0005261, HP:0002248

      (GI bleeding, intracranial hemorrhage, hematuria, hemarthrosis, hematemesis)

      CaseNotHPOsFreeText: Ear bleeding

      ProteinExpression: N/A

      PlateletAggregation: Defective response to ADP, adrenaline, collagen, arachidonic acid, and normal response to ristocetin

      CasePreviousTesting: Exon PCR was used to amplify coding regions of the ITGA2B and ITGB3 genes. PCR products were purified and Sanger sequenced. Segregation using parental samples was undertaken when available

      Gene: ITGB3

      Variant: NM_000212.2:c.774T>A (p.Cys258Ter)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA400023704

      gnomAD: N/A

    4. E

      Case5: Patient ID E, Female, 1 year old, ethnicity not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: HP:0000978, HP:0000225

      (Easy bruising, gingival bleeding)

      CaseHPOFreeText: N/A

      CaseNotHPOs: HP:0000967, HP:0000979, HP:0004406, HP:0002239, HP:0002239, HP:0000790, HP:0005261, HP:0002248

      (Petechiae, purpura, recurrent epistaxis, GI bleeding, Intracranial hemorrhage, hematuria, hemarthrosis, hematemesis)

      CaseNotHPOsFreeText: Hemorrhage after dental, hemorrhage after trauma, ear bleeding, hematoma

      ProteinExpression: N/A

      PlateletAggregation: Defective response to ADP, adrenaline, collagen, arachidonic acid, and normal response to ristocetin

      CasePreviousTesting: Exon PCR was used to amplify a;; coding regions of the ITGA2B and ITGB3 genes. PCR products were purified and Sanger sequenced. Segregation using parental samples was undertaken when available.

      Gene: ITGA2B

      Variant: c.1460insAGGT (p.Ser477Gfs*111)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: Unregistered Variant

      gnomAD: N/A

    1. Patient 2

      Case2: Female, 28 years old, ethnicity not specified

      DiseaseAssertion: Glanzmann thrombasthenia type 1

      FamilyInfo: N/A

      ParentalGenotype: Parents were heterozygous for this mutation and did not show bleeding symptoms

      Note: There is parental consanguinity

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Severe haemorrhagia and haematomas associated with prolonged in vivo bleeding time

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry analysis revealed 3.5 % of αIIbβ3 was detected on the platelet surface from patient 2.

      PlateletAggregation: Article states agonist-induced platelet aggregation and binding of exogenous fibrinogen was pathological, too but does not mention specific agonists used or response to ristocetin

      CasePreviousTesting: Molecular genetic analysis was done; however, no other information mentioned. In addition, the global proteome of highlight purified washed platelets was quantified by liquid chromatography-mass spectrometry and targeted MS-methods.

      Gene: ITGA2B

      Variant: NM_000419.3:c.2374del

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA915940267

      gnomAD: N/A

    1. GT1-III2

      Case#: GT1-III2 male, 11 years old

      Disease: Glazmann's Thrombasthenia

      CasePresentingHPOs: (found in appendix) HP:0001892, HP:0000421, HP:0000225, HP:0000967, HP:0000979, HP:0031364, HP:0006298,

      ExpressionEvidence: Not done

      FamilyInfo: Positive consanguinity, parents heterozygous carriers, 2 affected siblings, one deceased. Pedigree figure 1.

      GenotypingMethod: Sanger DNA sequencing to identify causative mutations in each case

      ClinVar: 1691482

      CAID: CA400021881

      Variant: NM_000212.3:c.422A>G

      GnomAD: Not Found

    2. GT3

      Case#: GT3 male, 17 years old

      Disease: Glazmann's Thrombasthenia

      CasePresentingHPOs: (found in appendix) HP:0001892, HP:0000421, HP:0000225, HP:0000967, HP:0000979, HP:0031364, HP:0006298

      ExpressionEvidence: Flow Cytometry of platelet αIIbβ3: 0%CD41, .43% CD61

      FamilyInfo: Positive consanguinity

      GenotypingMethod: Sanger DNA sequencing to identify causative mutations in each case

      ClinVar: 1691476

      CAID: CA400030171

      Variant: NM_000212.3:c.1641C>G

      GnomAD: Not Found

    1. Supplementary Tables 1 and 2 combined information:

      Case30: GT30, Female, 13

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: Not available per supplementary table 1

      ParentalGenotype: Parents are not consanguineous, no other genotype information available

      CasePresentingHPOs: HP:0000978, HP:0000979, HP:0031364, HP:0000421, HP:0000225, HP:0000132

      (Bruising, purpura, ecchymosis, epistaxis, gingival bleeding, menorrhagia)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Showed <5% of αIIbβ3 expression measured by flow cytometry

      PlateletAggregation: Platelet aggregation showed no response to ADP and collagen but normal response to ristocetin

      CasePreviousTesting: All exons from ITGA2B and ITGB3 genes were amplified by PCR using intronic primers. DNA sequencing was determined by Sanger sequencing.

      Gene: ITGA2B

      Variant: NM_000419.3:c.2330C>A (p.Ala777Asp) and NM_000419.3:c.2602-3C>G (no protein notation given)

      LegacyVariant: N/A

      ClinVar: 2893 (c.2602-3C>G)

      CAiD: CA399796685 (p.Ala777Asp) and CA10575472 (c.2602-3C>G)

      gnomAD: MAF for East Asian population: 0.00006523 https://gnomad.broadinstitute.org/variant/17-42453087-G-C

    2. Supplementary Tables 1 and 2 combined information:

      Case17a: GT17a, Female, 14 years old, sister of GT17b proband

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: Available per supplementary table 1

      ParentalGenotype: Parents are not consanguineous, no other genotype information available

      CasePresentingHPOs: HP:0000978, HP:0000979, HP:0031364, HP:0000421

      (Bruising, purpura, ecchymosis, epistaxis)

      CaseHPOFreeText: Post traumatic hemorrhage

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Showed <5% of αIIbβ3 expression measured by flow cytometry

      PlateletAggregation: Platelet aggregation showed a small response to ADP and collagen but normal response to ristocetin

      CasePreviousTesting: All exons from ITGA2B and ITGB3 genes were amplified by PCR using intronic primers. DNA sequencing was determined by Sanger sequencing.

      Gene: ITGA2B

      Variant: NM_000419.3:c.799+2T>C and NM_000419.3:c.2671C>T (p.Gln891Ter)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA399805155 (c.799 +2 T>C) and CA8602626 (p.Gln891Ter)

      gnomAD: N/A

    3. Supplementary Tables 1 and 2 combined information:

      Case25: GT25, Female, 26 years old

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: Not available per supplementary table 1

      ParentalGenotype: Parents are not consanguineous, no other genotype information available

      CasePresentingHPOs: HP:0000421, HP:0000225, HP:0000132, HP:0000789,

      (Epistaxis, gingival bleeding, menorrhagia, infertility)

      CaseHPOFreeText: Rupture of corpus luteum

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Showed <5% of αIIbβ3 expression measured by flow cytometry

      PlateletAggregation: Platelet aggregation showed no response to ADP and collagen but normal response to ristocetin

      CasePreviousTesting: All exons from ITGA2B and ITGB3 genes were amplified by PCR using intronic primers. DNA sequencing was determined by Sanger sequencing.

      Gene: ITGB3

      Variant: NM_000212.2:c.1495T>C (p.Cys499Arg)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA400029525

      gnomAD: N/A

    4. Supplementary Tables 1 and 2 combined information:

      Case37: GT37, Female, 1 year old

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: Not available per supplementary table 1

      ParentalGenotype: Parents are not consanguineous, no other genotype information available

      CasePresentingHPOs: HP:0000978, HP:0000979, HP:0031364

      (Bruising, purpura, ecchymosis)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Showed <5% of αIIbβ3 expression measured by flow cytometry

      PlateletAggregation: Platelet aggregation showed no response to ADP and collagen but normal response to ristocetin

      CasePreviousTesting: All exons from ITGA2B and ITGB3 genes were amplified by PCR using intronic primers. DNA sequencing was determined by Sanger sequencing.

      Gene: ITGA2B

      Variant: NM_000419.3:c.1993C>T (p.Gln665Ter)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA399801004

      gnomAD: MAF in East Asian population: 0.00005461 https://gnomad.broadinstitute.org/variant/17-42455831-G-A

    5. Supplementary Tables 1 and 2 combined information:

      Case19: GT19, Female, 32 years old

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: Not available per Table 1.

      ParentalGenotype: Parents are consanguineous, no other genotype information available

      CasePresentingHPOs: HP:0000421, HP:0000225, HP:0000790, HP:0000132

      (Epistaxis, gingival bleeding, hematuria, menorrhagia)

      CaseHPOFreeText: Post traumatic hemorrhage

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Showed <5% of αIIbβ3 expression measured by flow cytometry

      PlateletAggregation: Platelet aggregation showed no response to ADP and collagen but normal response to ristocetin

      CasePreviousTesting: All exons from ITGA2B and ITGB3 genes were amplified by PCR using intronic primers. DNA sequencing was determined by Sanger sequencing.

      Gene: ITGA2B

      Variant: NM_000419.3:c.1234G>A (p.Gly412Arg)

      LegacyVariant: N/A

      ClinVar: 381748

      CAiD: CA8603182 (p.Gly412Arg)

      gnomAD: MAF in Latino population: 0.0001453 https://gnomad.broadinstitute.org/variant/17-42458406-C-T

    1. GT 02

      Case1: GT02, Female, India, age of onset is 18 years old

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: HP:0000225, HP:0031364 Gingival bleeding and ecchymosis

      CaseHPOFreeText: Patients were recruited as they presented consecutively from 1996 to 1998 for evaluation of a mucocutaneous bleeding disorder

      CaseNotHPOs: Menorrhagia HP:0000132

      CaseNotHPOsFreeText: N/A

      ProteinExpression: N/A

      PlateletAggregation: All patients examined had defective ADP, epinephrine, and collagen induced aggregation and normal ristocetin induced aggregation

      CasePreviousTesting: Mutations were detected by the method of single strand conformation polymorphism (SSCP) analysis, followed by nucleotide sequencing and confirmation by restriction fragment length polymorphism (RFLP) assays. The sequences of the primers employed and the reaction conditions for PCR amplification of the exons, adjacent intronic regions, and 50 and 30 untranslated regions of the aIIb and b3 gene

      Gene: ITGA2B

      Variant: NM_000419.3:c.2459del (p.Asn820MetfsX5)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA915940722

      gnomAD: N/A

    2. GT 38

      Case11: GT38, Male, India, age of onset is 8 years old

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Patients were recruited as they presented consecutively from 1996 to 1998 for evaluation of a mucocutaneous bleeding disorder

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: N/A

      PlateletAggregation: All patients examined had defective ADP, epinephrine, and collagen induced aggregation and normal ristocetin induced aggregation

      CasePreviousTesting: Mutations were detected by the method of single strand conformation polymorphism (SSCP) analysis, followed by nucleotide sequencing and confirmation by restriction fragment length polymorphism (RFLP) assays. The sequences of the primers employed and the reaction conditions for PCR amplification of the exons, adjacent intronic regions, and 50 and 30 untranslated regions of the aIIb and b3 gene

      Gene: ITGA2B

      Variant: NM_000419.3:c.2953C>T (p.Gln985Ter)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA399790170

      gnomAD: N/A

    3. GT 26

      Case7: GT26, Female, India, age of onset is 4 years old

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Patients were recruited as they presented consecutively from 1996 to 1998 for evaluation of a mucocutaneous bleeding disorder

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: N/A

      PlateletAggregation: All patients examined had defective ADP, epinephrine, and collagen induced aggregation and normal ristocetin induced aggregation

      CasePreviousTesting: Mutations were detected by the method of single strand conformation polymorphism (SSCP) analysis, followed by nucleotide sequencing and confirmation by restriction fragment length polymorphism (RFLP) assays. The sequences of the primers employed and the reaction conditions for PCR amplification of the exons, adjacent intronic regions, and 50 and 30 untranslated regions of the aIIb and b3 gene

      Gene: ITGA2B

      Variant: NM_000419.3:c.2929_2930del (p.Glu979SerfsTer28)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA915940726

      gnomAD: N/A

    4. GT16

      Case20: GT16, Female, India, age of onset is 11 years old

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Patients were recruited as they presented consecutively from 1996 to 1998 for evaluation of a mucocutaneous bleeding disorder

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: N/A

      PlateletAggregation: All patients examined had defective ADP, epinephrine, and collagen induced aggregation and normal ristocetin induced aggregation

      CasePreviousTesting: Mutations were detected by the method of single strand conformation polymorphism (SSCP) analysis, followed by nucleotide sequencing and confirmation by restriction fragment length polymorphism (RFLP) assays. The sequences of the primers employed and the reaction conditions for PCR amplification of the exons, adjacent intronic regions, and 50 and 30 untranslated regions of the aIIb and b3 gene

      Gene: ITGB3

      Variant: NM_000212.2:c.428T>G (p.Leu143Trp)

      LegacyVariant: N/A

      ClinVar: 13567

      CAiD: CA123252

      gnomAD: MAF in the Other population is 0.0001629 https://gnomad.broadinstitute.org/variant/17-45361875-T-G

    5. GT 60-2

      Case36: GT60-2, Female, India, age of onset is 25 years old

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Patients were recruited as they presented consecutively from 1996 to 1998 for evaluation of a mucocutaneous bleeding disorder

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: N/A

      PlateletAggregation: All patients examined had defective ADP, epinephrine, and collagen induced aggregation and normal ristocetin induced aggregation

      CasePreviousTesting: Mutations were detected by the method of single strand conformation polymorphism (SSCP) analysis, followed by nucleotide sequencing and confirmation by restriction fragment length polymorphism (RFLP) assays. The sequences of the primers employed and the reaction conditions for PCR amplification of the exons, adjacent intronic regions, and 50 and 30 untranslated regions of the aIIb and b3 gene

      Gene: ITGB3

      Variant: NM_000212.2:c.428T>G (p.Leu143Trp)

      LegacyVariant: N/A

      ClinVar: 13567

      CAiD: CA123252

      gnomAD: MAF in the Other population is 0.0001629 https://gnomad.broadinstitute.org/variant/17-45361875-T-G

    6. GT 33

      Case26: GT33, Female, India, age of onset is 18 years old

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Patients were recruited as they presented consecutively from 1996 to 1998 for evaluation of a mucocutaneous bleeding disorder

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: N/A

      PlateletAggregation: All patients examined had defective ADP, epinephrine, and collagen induced aggregation and normal ristocetin induced aggregation

      CasePreviousTesting: Mutations were detected by the method of single strand conformation polymorphism (SSCP) analysis, followed by nucleotide sequencing and confirmation by restriction fragment length polymorphism (RFLP) assays. The sequences of the primers employed and the reaction conditions for PCR amplification of the exons, adjacent intronic regions, and 50 and 30 untranslated regions of the aIIb and b3 gene

      Gene: ITGB3

      Variant: NM_000212.2:c.428T>G (p.Leu143Trp)

      LegacyVariant: N/A

      ClinVar: 13567

      CAiD: CA123252

      gnomAD: MAF in the Other population is 0.0001629 https://gnomad.broadinstitute.org/variant/17-45361875-T-G)

    7. GT 25

      Case24: GT25, Female, India, age of onset is 5 years old

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Patients were recruited as they presented consecutively from 1996 to 1998 for evaluation of a mucocutaneous bleeding disorder

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: N/A

      PlateletAggregation: All patients examined had defective ADP, epinephrine, and collagen induced aggregation and normal ristocetin induced aggregation

      CasePreviousTesting: Mutations were detected by the method of single strand conformation polymorphism (SSCP) analysis, followed by nucleotide sequencing and confirmation by restriction fragment length polymorphism (RFLP) assays. The sequences of the primers employed and the reaction conditions for PCR amplification of the exons, adjacent intronic regions, and 50 and 30 untranslated regions of the aIIb and b3 gene

      Gene: ITGB3

      Variant: NM_000212.2:c.921C>A (p.Tyr307Ter)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA400025209

      gnomAD: N/A

    1. Supplementary Table S1 & S2 Proband and Variant Information:

      Case68: GT72, Female, 56 years old, French

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: HP:0000421, HP:0031364, HP:0000225, HP:0000132, HP:0002239, HP:0006298

      (Epistaxis, ecchymosis, gingival bleeding, menorrhagia, GI bleeding, prolonged bleeding after dental extraction)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry showed <5% expression of αIIbβ3 (See Supplementary Table 1)

      PlateletAggregation: Absent platelet aggregation (See Supplementary Table 1)

      CasePreviousTesting: Sanger sequencing of ITGA2B and ITGB3

      Gene: ITGA2B

      Variant: NM_000419.3:c.2951C>A (P.Thr984Lys)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA399790180

      gnomAD: N/A

    2. Supplementary Table S1 & S2 Proband and Variant Information:

      Case52: GT52, Male, 24 years old, Argentenian/Brazil

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: HP:0000421

      (Epistaxis)

      CaseHPOFreeText: Hematomas

      (Proband's symptoms decreased during adolescence)

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry showed <5% expression of αIIbβ3 (See Supplementary Table 1)

      PlateletAggregation: Absent platelet aggregation (See Supplementary Table 1)

      CasePreviousTesting: Sanger sequencing of ITGA2B and ITGB3

      Gene: ITGA2B

      Variant: NM_000419.3:c.601G>A (p.Gly201Ser)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA399805612

      gnomAD: N/A

    3. Supplementary Table S1 & S2 Proband and Variant Information:

      Case40: GT41a, Female, 15 years old, Chinese

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: Affected brother is proband 41b in this study (See Supplemental Table S1)

      ParentalGenotype: N/A

      CasePresentingHPOs: HP:0004406, HP:0000978

      (Recurrent epistaxis, easy bruising)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry showed <5% expression of αIIbβ3 (See Supplementary Table 1)

      PlateletAggregation: Absent platelet aggregation (See Supplementary Table 1)

      CasePreviousTesting: Sanger sequencing of ITGA2B and ITGB3

      Gene: ITGA2B

      Variant: NM_000419.3:c.91del (p.Ala31Profs2) and NM_000419.3:c.2915dup (p.Leu973Alafs63)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA913203486 and CA8602531

      gnomAD: MAF in the East Asian population is 0.0001088 http://gnomad.broadinstitute.org/variant/17-42452054-C-CG

    4. Supplementary Table S1 & S2 Proband and Variant Information:

      Case37: GT39a, Female, 23 years old, Swedish/American

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: Affected brother who is proband 39b in this study (See Supplemental Table S1)

      ParentalGenotype: N/A

      CasePresentingHPOs: HP:0000978, HP:0000421, HP:0006298, HP:0000132

      (Bruising susceptibility, epistaxis, prolonged bleeding after dental extraction, menorrhagia)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry showed <5% expression of αIIbβ3 (See Supplementary Table 1)

      PlateletAggregation: Absent platelet aggregation (See Supplementary Table 1)

      CasePreviousTesting: Sanger sequencing of ITGA2B and ITGB3

      Gene: ITGA2B

      Variant: NM_000419.3:c.1882C>T (p.Arg628Ter)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA399801310

      gnomAD: MAF in the Latino population 0.00003983 http://gnomad.broadinstitute.org/variant/17-42456075-G-A

    5. Supplementary Table S1 & S2 Proband and Variant Information:

      Case38: GT39b, Male, 18 years old, Swedish/American

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: Affected sister who is proband 39a in this study (See Supplemental Table S1)

      ParentalGenotype: N/A

      CasePresentingHPOs: HP:0000978, HP:0000421, HP:0006

      (Bruising susceptibility, epistaxis)

      CaseHPOFreeText: Hematomas after minor trauma

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry showed <5% expression of αIIbβ3 (See Supplementary Table 1)

      PlateletAggregation: Absent platelet aggregation (See Supplementary Table 1)

      CasePreviousTesting: Sanger sequencing of ITGA2B and ITGB3

      Gene: ITGA2B

      Variant: NM_000419.3:c.1882C>T (p.Arg628Ter)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA399801310

      gnomAD: MAF in the Latino population 0.00003983 http://gnomad.broadinstitute.org/variant/17-42456075-G-A

    6. Supplementary Table S1 & S2 Proband and Variant Information:

      Case14: GT15, Female, 35, French

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: HP:0031364, HP:0000967, HP:0000421, HP:0000225

      (Ecchymosis, petechiae, epistaxis, gingival bleeding)

      CaseHPOFreeText: Bleeding from birth and hematomas from excersize

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry showed <5% variant expression of αIIbβ3 (See Supplementary Table 1)

      PlateletAggregation: Absent platelet aggregation (See Supplementary Table 1)

      CasePreviousTesting: Sanger sequencing of ITGA2B and ITGB3

      Gene: ITGA2B

      Variant: NM_000419.3:c.2095-19T>A and NM_000419.3:c.2770C>T (p.Gln924Ter)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA915940312 and CA399792054

      gnomAD: N/A

    7. Supplementary Table S1 & S2 Proband and Variant Information:

      Case28: GT33a, Male, age not specified, USA/Laos

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: Affected sister who is proband 33b in this article

      ParentalGenotype: N/A

      CasePresentingHPOs: HP:0000421, HP:0002239

      (Epistaxis, GI bleeding)

      CaseHPOFreeText: Life-threatening bleeding at onset of menses

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry showed <5% expression of αIIbβ3 (See Supplementary Table 1)

      PlateletAggregation: Absent platelet aggregation (See Supplementary Table 1)

      CasePreviousTesting: Sanger sequencing of ITGA2B and ITGB3

      Gene: ITGB3

      Variant: NM_000212.2:c.262C>T (p.Arg88Ter) and NM_000212.2:c.2113del (p.Leu705Cysfs*4)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA400020703 and CA8623443

      gnomAD: MAF in the Other population is 0.0001385 http://gnomad.broadinstitute.org/variant/17-45360816-C-T and MAF in the East Asian population is 0.0001087 http://gnomad.broadinstitute.org/variant/17-45380183-TC-T

    8. Supplementary Table S1 & S2 Proband and Variant Information:

      Case21: GT24, Female, 45, French (Gypsy)

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: HP:0000421, HP:0000132

      (Epistaxis, menorrhagia)

      CaseHPOFreeText: Post-traumatic hematoma

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry showed <5% expression of αIIbβ3 (See Supplementary Table 1)

      PlateletAggregation: Absent platelet aggregation (See Supplementary Table 1)

      CasePreviousTesting: Sanger sequencing of ITGA2B and ITGB3

      Gene: ITGA2B

      Variant: NM_000419.3:c.1544+1G>A (p.Val513Leufs*71)

      LegacyVariant: N/A

      ClinVar: 2895

      CAiD: CA10575473

      gnomAD: N/A

    9. Supplementary Table S1 & S2 Proband and Variant Information:

      Case60: GT62, Female, 58 years old, French

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: Affected sister (that is all the information we are given)

      ParentalGenotype: N/A

      CasePresentingHPOs: HP:0000978, HP:0000225, HP:0000132, HP:0006298

      (Easy bruising, gingival bleeding, menorrhagia, bleeding after dental extraction)

      CaseHPOFreeText: Esophageal bleeding

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry showed <5% expression of αIIbβ3 (See Supplementary Table 1)

      PlateletAggregation: Absent platelet aggregation (See Supplementary Table 1)

      CasePreviousTesting: Sanger sequencing of ITGA2B and ITGB3

      Gene: ITGB3

      Variant: NM_000212.2:c.31T>C (p.Trp11Arg)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA291240306

      gnomAD: N/A

    10. Supplementary Table S1 & S2 Proband and Variant Information:

      Case15: GT18, Male, 20, French

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: HP:0031364, HP:0000978

      (Ecchymosis, easy bruising)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry showed 10% expression of αIIbβ3 (See Supplementary Table 1)

      PlateletAggregation: Residual platelet aggregation (See Supplementary Table 1)

      CasePreviousTesting: Sanger sequencing of ITGA2B and ITGB3

      Gene: ITGA2B

      Variant: NM_000419.3:c.1201G>T (pGly401Cys) andNM_000419.3:c.2800G>T (p.Val934Phe)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA399804280 and CA290946484

      gnomAD: N/A

    11. Supplementary Table S1 & S2 Proband and Variant Information:

      Case31: GT35a, Female, 18 years old, USA

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: Affected sister who is 35 b in this study (See Supplementary Table S1)

      ParentalGenotype: N/A

      CasePresentingHPOs: HP:0000421, HP:0002239

      (Epistaxis, GI bleeding)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry showed <5% expression of αIIbβ3 (See Supplementary Table 1)

      PlateletAggregation: Absent platelet aggregation (See Supplementary Table 1)

      CasePreviousTesting: Sanger sequencing of ITGA2B and ITGB3

      Gene: ITGA2B and ITGB3

      Variant: ITGB3: NM_000212.2:c.392G>C (p.Arg131Pro) and NM_000212.2:c.777+1G>A ITGA2B: NM_000419.3:c.2264G>A (p.Arg755Gln)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA8622954, CA8623036, CA8602771

      gnomAD: MAF in the African population is 0.00006152 http://gnomad.broadinstitute.org/variant/17-45361839-G-C, MAF in the Latino population is 0.0006774 http://gnomad.broadinstitute.org/variant/17-45363789-G-A, MAF in the Latino population is 0.0001903 http://gnomad.broadinstitute.org/variant/17-42454380-C-T

    12. Supplementary Table S1 & S2 Proband and Variant Information:

      Case53: GT53, Male, 16 years old, Argentenian/Brazilian

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: HP:0000421

      (Epistaxis)

      CaseHPOFreeText: Hematomas

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry showed <5% expression of αIIbβ3 (See Supplementary Table 1)

      PlateletAggregation: Absent platelet aggregation (See Supplementary Table 1)

      CasePreviousTesting: Sanger sequencing of ITGA2B and ITGB3

      Gene: ITGB3

      Variant: NM_000212.2:c.356G>A (p.Gly201Ser) and NM_000212.2:c.1697G>A (p.Arg119Gln)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA8622925 and CA400032338

      gnomAD: MAF in the African population is http://gnomad.broadinstitute.org/variant/17-45360910-G-A

    13. Supplementary Table S1 & S2 Proband and Variant Information:

      Case46: GT45, Male, 86 years old, French

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: HP:0000421, HP:0000225, HP:0002239

      (Epistaxis, gingival bleeding, GI bleeding)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry showed <5% expression of αIIbβ3 (See Supplementary Table 1)

      PlateletAggregation: Absent platelet aggregation (See Supplementary Table 1)

      CasePreviousTesting: Sanger sequencing of ITGA2B and ITGB3

      Gene: ITGA2B

      Variant: NM_000419.3:c.551_626del (p.Arg184_Gln208del) and LR deletion

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA915940373

      gnomAD: N/A

    14. Supplementary Table S1 & S2 Proband and Variant Information:

      Case45: GT44, Female, 10 years old, French

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry showed <5% expression of αIIbβ3 (See Supplementary Table 1)

      PlateletAggregation: Absent platelet aggregation (See Supplementary Table 1)

      CasePreviousTesting: Sanger sequencing of ITGA2B and ITGB3

      Gene: ITGA2B

      Variant: NM_000419.3:c.1357C>T (p.Arg453Ter)

      LegacyVariant: N/A

      ClinVar: 631773

      CAiD: CA399803529

      gnomAD: N/A

    15. Supplementary Table S1 & S2 Proband and Variant Information:

      Case48: GT48, Male, 10 years old, French

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: HP:0031364, HP:0000421, HP:0001934

      (Ecchymosis, epistaxis, persistent bleeding after trauma)

      CaseHPOFreeText: Frequent hematomas

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: No serious episode of spontaneous bleeding

      ProteinExpression: Flow cytometry showed <5% expression of αIIbβ3 (See Supplementary Table 1)

      PlateletAggregation: N/A (Not available for this proband see Supp Table S1)

      CasePreviousTesting: Sanger sequencing of ITGA2B and ITGB3

      Gene: ITGB3

      Variant: NM_000212.2:c.1094A>G (p.Asn365Ter) and NM_000212.2:c.1522del (p.Gln508Serfs*161)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA400026292 and CA772541579

      gnomAD: N/A

    16. Supplementary Table S1 & S2 Proband and Variant Information:

      Case23: GT26, Male, 45, French

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: HP:0000421, HP:0000978

      (Epistaxis, easy bruising)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry showed <5% expression of αIIbβ3 (See Supplementary Table 1)

      PlateletAggregation: Much reduced platelet aggregation (See Supplementary Table 1)

      CasePreviousTesting: Sanger sequencing of ITGA2B and ITGB3

      Gene: ITGA2B

      Variant: NM_000419.3:c.1073G>A (p.Arg358His)

      LegacyVariant: N/A

      ClinVar: 2896

      CAiD: CA115839

      gnomAD: N/A

    1. 8

      Case8: Female, age not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Mild bleeding

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: N/A

      PlateletAggregation: Minimal information, not specific enough

      CasePreviousTesting: Sanger sequencing identified disease-causing variants in 18 out of 20 patients (Probands 6 and 14 excluded) with istoantibodies to αIIbβ3. The mutations were evenly distributed between ITGB3 and ITGA2B.

      Gene: ITGB3 and ITGA2B

      Variant: NM_000419.3:c.682C>T (p.Gln228Ter) and NM_000419.3:c.1750C>T (p.Arg584Ter)

      LegacyVariant: N/A

      ClinVar: 2892 (p.Arg584Ter)

      CAiD: CA115834 (p.Arg584Ter) and CA399805421

      gnomAD: MAF in East Asian population 0.0002176 (p.Arg584Ter) http://gnomad.broadinstitute.org/variant/17-42457372-G-A

    2. 3.

      Case2: Female, Spanish, age not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Mild bleeding

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: N/A

      PlateletAggregation: Minimal information, not specific enough

      CasePreviousTesting: Sanger sequencing identified disease-causing variants in 18 out of 20 patients (Probands 6 and 14 excluded) with istoantibodies to αIIbβ3. The mutations were evenly distributed between ITGB3 and ITGA2B.

      Gene: ITGB3

      Variant: NM_000212.2:c.1031A>C (p.Tyr344Ser)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA400025814

      gnomAD: N/A

    3. 5.

      Case5: Male, age or ethnicity not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Severe bleeding

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: N/A

      PlateletAggregation: Minimal information, not specific enough

      CasePreviousTesting: Sanger sequencing identified disease-causing variants in 18 out of 20 patients (Probands 6 and 14 excluded) with istoantibodies to αIIbβ3. The mutations were evenly distributed between ITGB3 and ITGA2B.

      Gene: ITGB3

      Variant: NM_000212.2:c.892C>G (p.Gln298Ter)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA400025097

      gnomAD: N/A

    1. 4

      Case2: 9 years old, Female, Jewish Iraqi

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: HP:0004406

      (Recurrent epistaxis)

      CaseHPOFreeText: Mucocutaneous bleeding

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: All patients demonstrated lack of αIIbβ3 surface expression." No specifics are given on the percentage, but test was performed

      PlateletAggregation: Presented with mucocutaneous bleeding, absence of platelet aggregation in response to all physiological agonists in contrast to normal aggregation with ristocetin

      CasePreviousTesting: "Molecular analysis disclosed that patient 2 was homozygous for an out of frame mutation (c.2031–2041 del, exon 13) in ITGB3, and patient 4 was compound heterozygote for the same deletion and a large deletion of 11.2Kb del"

      Gene: ITGB3

      Variant: NM_000212.2:c.2031_2041del (p.Asp677Glufs) and 11.2Kb del (IVS9aluc.2183–6)

      LegacyVariant: N/A

      ClinVar: N/A and 13563

      CAiD: CA915940605 and NA

      gnomAD: N/A

    1. Patient‐III4

      Case1: Male, Israeli-Arab, (age is either 10 or 14)

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: See Fig 1C for pedigree

      ParentalGenotype: See Fig 1C for pedigree

      CasePresentingHPOs: HP:0000421, HP:0031364, HP:0000967

      (Severe epistaxis, ecchymosis, petechiae)

      CaseHPOFreeText: Decline of hemoglobin levels to 5 g dl each time epistaxis occurred

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      ProteinExpression: No surface expression of αIIbβ3 was found in patients’ platelets (See Fig 3)

      PlateletAggregation: N/A

      CasePreviousTesting: DNA fragments containing exons and flanking intronic regions of the aIIb and B3 genes were amplified by PCR using primers

      Gene: ITGA2B

      Variant: NM_000419.3:c.97A>G (p.Asn2Asp)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA399806951

      gnomAD: N/A

    1. brother (3years younger) was quickly shown also to have both GT and MTP (Figure1A) with epistaxis the main cause of his bleedin

      Case2:

      DiseaseAssertion: Glanzmann Thrombesthenia and Macrothrombocytopenia (MTP)

      FamilyInfo: Case1 (his older sister) and no parental information.

      ParentalGenotype: N/A

      CasePresentingHPOs: HP:0000421, HP:0011877

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: No information for the brother on protein expression.

      CasePreviousTesting: As a part of an initial testing of this patient's gene panel (not specified which genes), DNA from this patient was submitted to ThromboGenetics in Cambridge UK. While confirming the two ITGB3 mutations described, an additional finding was a heterozygous mutation in TUBB1.

      Gene: ITGB3

      Variant: NM_000212.2:c.565C>T and NM_000212.2:c.629G>C

      LegacyVariant: N/A

      ClinVar: 2890

      CAiD: CA291224669 and CA400023389, respectively as written in variant section.

      gnomAD: Maximum allele frequency for the variant NM_000212.2:c.565C>T: 0.00002638 https://gnomad.broadinstitute.org/variant/17-45362012-C-T

    1. Case 3

      Case3: Female, 8 years old, Japanese

      DiseaseAssertion: Thrombocytopenia

      FamilyInfo: Information on mother and grandfather available in Table 1(minimal information on other family members)

      ParentalGenotype: Mother: ITGB3 (p.Asp621_Glu660del heterozygous) See Table 1

      CasePresentingHPOs: HP:0000978 (Bruising)

      CaseHPOFreeText: Subaponeurotic hematoma

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Surface expression levels of αIIbβ3 in platelets of patient were decreased to around 65% of normal subjects with increase of CD42b (See Table 1)

      PlateletAggregation: N/A

      CasePreviousTesting: Sequence analysis of DNA revealed the patient's mutation. RT-PCR was also performed. The entire coding sequence of exons and exon-intron boundaries of ITGA2B and ITGB3 and the whole coding regions of ITGA2B and ITGB3 cDNA obtained from platelets were sequenced.

      Gene: ITGB3

      Variant: NM_000212.2:c.2134+1G>A (p.Asp621_Glu660del)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA400033344

      gnomAD: N/A

    1. Patient LD

      Case1: (Patient LD) Female, 3 years old, ethnicity not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: See Fig 4 for family pedigree

      ParentalGenotype: Father is heterozygous for GC867-G and Mother is heterozygous for T882C (See Fig 4)

      CasePresentingHPOs: HP:0000967, HP:0031364, HP:0000978, HP:0000225

      (Petechiae, ecchymosis, bruising, gingival bleeding)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Fig 2A shows reduced expression (See Fig2A)

      PlateletAggregation: Platelets did not aggregate in response to ADP, epinephrine, or arachidonic acid and showed only shape change in response to collagen. Platelets did agglutinate with ristocetin.

      CasePreviousTesting: Genomic DNA was prepared from peripheral blood leukocytes and amplified by polymerase chain reaction (PCR) with Taq polymerase by using oligonucleotide primers from intronic flanking sequences of αIIb and β3. All exons of both genes were sequenced at least twice to exclude Taq errors.

      Gene: ITGB3

      Variant: NM_000212.2:c.863T>C (p.Leu288Pro) and NM_000212.2:c.847_848del

      LegacyVariant: (p.Leu262Pro)

      ClinVar: N/A

      CAiD: CA400024958 and CA8623068

      gnomAD: for c.847_848del https://gnomad.broadinstitute.org/variant/17-45364504-AGC-A

    1. Case10: Patient PL, gender and age are not specified, all of these patients are Caucasian (either Italian or European)

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: All patients presented with a current or past history of bleeding and a bleeding time >15 min. Bleeding symptoms were evaluated by examining available hospital records. Mild bleeders were defined as those who bled only after trauma or surgery or had minor symptoms, such as epistaxis. Moderate/severe bleeders were defined as those with a history of spontaneous or life threatening hemorrhages, such as gastrointestinal bleeding, or who had repeated episodes requiring platelet transfusions

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: See Table 1

      PlateletAggregation: See Table 1

      CasePreviousTesting: To identify point mutations responsible for GT, we have sequenced all coding regions of Ib and 3 genes and intron/exon boundaries.

      Gene: ITGA2B

      Variant: NM_000419.3:c.1742C>A (p.Ala581Asp)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA399802112

      gnomAD: N/A

    2. Case15: Patient CE, gender and age are not specified, all of these patients are Caucasian (either Italian or European)

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: All patients presented with a current or past history of bleeding and a bleeding time >15 min. Bleeding symptoms were evaluated by examining available hospital records. Mild bleeders were defined as those who bled only after trauma or surgery or had minor symptoms, such as epistaxis. Moderate/severe bleeders were defined as those with a history of spontaneous or life threatening hemorrhages, such as gastrointestinal bleeding, or who had repeated episodes requiring platelet transfusions

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: See Table 1

      PlateletAggregation: See Table 1

      CasePreviousTesting: To identify point mutations responsible for GT, we have sequenced all coding regions of Ib and 3 genes and intron/exon boundaries.

      Gene: ITGA2B

      Variant: NM_000419.3:c.2113T>C (p.Cys705Arg)

      LegacyVariant: (p.Arg674Arg)

      ClinVar: N/A

      CAiD: CA8602816

      gnomAD: MAF in the European (non-Finnish) population is 0.000008792 https://gnomad.broadinstitute.org/variant/17-42455140-A-G

    1. GT-55

      Case44: (GT-54) Male, age or ethnicity not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Bleeding severity: Moderate (See Supplementary Table 3)

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry performed and CD41 and CD61 were observed (See Supplementary Table 3)

      PlateletAggregation: Minimal information (See Supplementary Table 3)

      CasePreviousTesting: DNA was extracted from peripheral blood samples from patients and family members, and Sanger sequencing and PCR was performed. Samples were processed for targeted sequencing using the available SHGp heme panel of 393 genes.

      Gene: ITGB3

      Variant: NM_000212.2:c.2113del (p.Leu705Cysfs*4)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA8623443

      gnomAD: MAF in East Asian population: 0.0001087 http://gnomad.broadinstitute.org/variant/17-45380183-TC-T

    2. GT-30

      Case25: (GT-30) Female, age or ethnicity not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: Proband GT30 is related to GT29

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Bleeding severity: Moderate (See Supplementary Table 3)

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry performed and CD41 and CD61 were observed (See Supplementary Table 3)

      PlateletAggregation: Minimal information (See Supplementary Table 3)

      CasePreviousTesting: DNA was extracted from peripheral blood samples from patients and family members, and Sanger sequencing and PCR was performed. Samples were processed for targeted sequencing using the available SHGp heme panel of 393 genes.

      Gene: ITGA2B

      Variant: NM_000419.3:c.1651C>T (p.Arg551Trp)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA399802348

      gnomAD: MAF in the East Asian population is 0.00005045 http://gnomad.broadinstitute.org/variant/17-42457471-G-A

    3. GT-44b

      Case34: (GT-44) Female, age or ethnicity not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: Proband GT43-GT44 are related

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Bleeding severity: Information not available (See Supplementary Table 3)

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry performed and CD41 and CD61 were observed (See Supplementary Table 3)

      PlateletAggregation: Minimal information (See Supplementary Table 3)

      CasePreviousTesting: DNA was extracted from peripheral blood samples from patients and family members, and Sanger sequencing and PCR was performed. Samples were processed for targeted sequencing using the available SHGp heme panel of 393 genes.

      Gene: ITGA2B

      Variant: NM_000419.3:c.1620G>C (p.Gln540His) and NM_000419.3:c.1616T>G (p.Leu539Arg)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA399802407 and CA399802416

      gnomAD: N/A

    4. GT-73c

      Case54: (GT-73) Gender, age, or ethnicity not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Bleeding severity: Information not given (See Supplementary Table 3)

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry performed and CD41 and CD61 were observed (See Supplementary Table 3)

      PlateletAggregation: Minimal information (See Supplementary Table 3)

      CasePreviousTesting: DNA was extracted from peripheral blood samples from patients and family members, and Sanger sequencing and PCR was performed. Samples were processed for targeted sequencing using the available SHGp heme panel of 393 genes.

      Gene: ITGB3

      Variant: NM_000212.2:c.985A>G (p.Asn329Asp)

      LegacyVariant: N/A

      ClinVar: 323865

      CAiD: CA8623107

      gnomAD: MAF in Other population 0.0005534 http://gnomad.broadinstitute.org/variant/17-45367092-A-G

    5. GT-25

      Case21: (GT-25) Female, age or ethnicity not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: Proband GT-26 is related to GT-25 see Table 1

      ParentalGenotype: Parents may be included in Table 1; however, not specified so no information

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Bleeding severity: Mild (See Supplementary Table 3)

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry performed and CD41 and CD61 were observed (See Supplementary Table 3)

      PlateletAggregation: Minimal information (See Supplementary Table 3)

      CasePreviousTesting: DNA was extracted from peripheral blood samples from patients and family members, and Sanger sequencing and PCR was performed. Samples were processed for targeted sequencing using the available SHGp heme panel of 393 genes.

      Gene: ITGA2B

      Variant: NM_000419.3:c.1879-2A>G

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA290949031

      gnomAD: N/A

    6. GT-32

      Case27: (GT-32) Female, age or ethnicity not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: Proband GT31-GT34 are related

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Bleeding severity: Moderate (See Supplementary Table 3)

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry performed and CD41 and CD61 were observed (See Supplementary Table 3)

      PlateletAggregation: Minimal information (See Supplementary Table 3)

      CasePreviousTesting: DNA was extracted from peripheral blood samples from patients and family members, and Sanger sequencing and PCR was performed. Samples were processed for targeted sequencing using the available SHGp heme panel of 393 genes.

      Gene: ITGB3

      Variant: NM_000212.2:c.2113del (p.Leu705Cysfs*4)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA8623443

      gnomAD: MAF in the East Asian population is 0.0001087 http://gnomad.broadinstitute.org/variant/17-45380183-TC-T

    7. GT-21

      Case19: (GT-21) Male, age or ethnicity not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: Proband GT-22 is related to GT-21 see Table 1

      ParentalGenotype: Parents may be included in Table 1; however, not specified so no information

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Bleeding severity: Moderate (See Supplementary Table 3)

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry performed and CD41 and CD61 were observed (See Supplementary Table 3)

      PlateletAggregation: Minimal information (See Supplementary Table 3)

      CasePreviousTesting: DNA was extracted from peripheral blood samples from patients and family members, and Sanger sequencing and PCR was performed. Samples were processed for targeted sequencing using the available SHGp heme panel of 393 genes.

      Gene: ITGB3

      Variant: NM_000212.2:c.2302-1G>A

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA400034626

      gnomAD: N/A

    8. GT-14b

      Case12: (GT-14) Female, carrier, age or ethnicity not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: Probands GT11 -GT13 are related to GT-14 see Table 1

      ParentalGenotype: Parents may be included in Table 1; however, not specified so no information

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Bleeding severity: Not available (See Supplementary Table 3)

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry performed and CD41 and CD61 were observed (See Supplementary Table 3)

      PlateletAggregation: Minimal information (See Supplementary Table 3)

      CasePreviousTesting: DNA was extracted from peripheral blood samples from patients and family members, and Sanger sequencing and PCR was performed. Samples were processed for targeted sequencing using the available SHGp heme panel of 393 genes.

      Gene: ITGB3

      Variant: NM_000212.2:c.727G>C (p.Asp243His)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA400023600

      gnomAD: N/A

    9. GT-27

      Case23: (GT-27) Male, age or ethnicity not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: Proband GT28 is related to this proband GT 27; however, no DNA was available for testing for GT28.

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Bleeding severity: Moderate (See Supplementary Table 3)

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry performed and CD41 and CD61 were observed (See Supplementary Table 3)

      PlateletAggregation: Minimal information (See Supplementary Table 3)

      CasePreviousTesting: DNA was extracted from peripheral blood samples from patients and family members, and Sanger sequencing and PCR was performed. Samples were processed for targeted sequencing using the available SHGp heme panel of 393 genes.

      Gene: ITGB3

      Variant: NM_000212.2:c.1835G>A

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA400032647

      gnomAD: N/A

    10. GT-58

      Case47: (GT-58) Female, age or ethnicity not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Bleeding severity: Severe (See Supplementary Table 3)

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry performed and CD41 and CD61 were observed (See Supplementary Table 3)

      PlateletAggregation: Minimal information (See Supplementary Table 3)

      CasePreviousTesting: DNA was extracted from peripheral blood samples from patients and family members, and Sanger sequencing and PCR was performed. Samples were processed for targeted sequencing using the available SHGp heme panel of 393 genes.

      Gene: ITGB3

      Variant: NM_000212.2:c.1543del (p.Ser513fs)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA500651429

      gnomAD: N/A

    11. GT-35

      Case30: (GT-35) Female, age or ethnicity not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: Proband GT31-GT34 are related

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Bleeding severity: Severe (See Supplementary Table 3)

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry performed and CD41 and CD61 were observed (See Supplementary Table 3)

      PlateletAggregation: Minimal information (See Supplementary Table 3)

      CasePreviousTesting: DNA was extracted from peripheral blood samples from patients and family members, and Sanger sequencing and PCR was performed. Samples were processed for targeted sequencing using the available SHGp heme panel of 393 genes.

      Gene: ITGA2B

      Variant: NM_000419.3:c.1879-2A>G

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA290949031

      gnomAD: N/A

    1. A gastrointestinal patient

      Case1: Male, 6 years old, ethnicity not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo:

      ParentalGenotype: "No platelet sample from the patient's mother and father were available"

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Mild spontaneous mucocutaneous bleeding

      CaseNotHPOs: N/A

      ProteinExpression: Assessment of surface expression of αIIBβ3 D217 and αIIBβ3 V217 by flow cytometry was performed. αIIb and β3 were expressed at normal levels.

      Platelet Aggregation: Absence of platelet aggregation in response to agonists such as ADP, epinephrine, or collagen and a normal response to ristocetin

      CasePreviousTesting: Sequencing of αIIb and β3 genes revealed a homozygous missense A>T point mutation in the β3 gene leading to a D217Val substitution.

      Gene: ITGB3

      Variant: NM_000212.2:c.728A>T (p.Asp243Val)

      LegacyVariant: (p.Asp217Val)

      ClinVar: N/A

      CAiD: CA400023604

      gnomAD N/A

    1. 2CabGT-2

      Case2: (Proband CabGT-2), Female, age not specified, European Caucasian

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      ProteinExpression: N/A

      Platelet Aggregation: N/A

      CasePreviousTesting: Promoter and exon sequences of aIIb and b3 genes were amplified and directly sequence

      Gene: ITGA2B

      Variant: NM_000419.3:c.917dup (p.Arg307GlufsTer22) and NM_000419.3:c.1912dup (p.Cys639MetfsTer22)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA290954352 (p.Arg307GlufsTer22) and CA915940678 (p.Cys639MetfsTer22)

      gnomAD N/A

    1. haematuria21

      Case21: Male, Iraq, age not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: Table 1 mentions family history available for the proband, however no specific details about family provided in paper

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: N/A

      PlateletAggregation: N/A

      CasePreviousTesting: N/A

      Gene: ITGB3

      Variant: NM_000212.2:c.2031_2041del (p.Asp677Glufs)

      LegacyVariant: (p.Asp651Glufs*3)

      ClinVar: N/A

      CAiD: CA915940605

      gnomAD: N/A

    2. 17

      Case17: Female, Arab, age not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: Table 1 mentions family history available for the proband, however no specific details about family provided in paper

      ParentalGenotype: N/A

      CasePresentingHPOs: HP:0000421, HP:0000225, HP:0031364, HP:0000132, HP:0000132)

      (Epistaxis, gingival bleeding, ecchymosis, menorrhagia, melena)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: N/A

      PlateletAggregation: N/A

      CasePreviousTesting: N/A

      Gene: ITGA2B

      Variant: NM_000419.3:c.409-2_419del

      LegacyVariant: N/A

      ClinVar: 2889

      CAiD: CA10575471

      gnomAD: N/A

    3. 15

      Case15: Male, Arab, age not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: Table 1 mentions family history available for the proband, however no specific details about family provided in paper

      ParentalGenotype: N/A

      CasePresentingHPOs: HP:0000421, HP:0000225

      (Epistaxis, gingival bleeding)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: N/A

      PlateletAggregation: N/A

      CasePreviousTesting: N/A

      Gene: ITGA2B

      Variant: NM_000419.3:c.409-2_419del

      LegacyVariant: N/A

      ClinVar: 2889

      CAiD: CA10575471

      gnomAD: N/A

    1. GT13

      Case#: 33 year old, female

      Disease: Glazmann's Thrombasthenia

      CasePresentingHPOs: HP:0000967, HP:0000978, HP:0006298

      PlateletAgreggation: Defective response to ADP, Adrenaline, Collagen, Arachidonic acid. Normal response to Ristocetin.

      GenotypingMethod: Genomic DNA was extracted from peripheral blood leukocytes for mutational analysis of the αIIb and β3 genes by DNA sequencing

      ClinVar:

      CAID: CA8603182

      Variant: NM_000419.5:c.1234G>A

      GnomAD: Latino 0.0001453 (5/34414)

      ExpressionEvidence:Flow Cytometry of platelet integrin: 1.3% B3 expression, .3% A2B expression

    2. GT5

      Case#: 19, female

      Disease: Glazmann's Thrombasthenia

      CasePresentingHPOs: HP:0000967, HP:0000978, HP:0000225, HP:0006298, HP:0001892

      PlateletAgreggation: Defective response to ADP, Adrenaline, Collagen, Arachidonic acid. Normal response to Ristocetin.

      GenotypingMethod: Genomic DNA was extracted from peripheral blood leukocytes for mutational analysis of the αIIb and β3 genes by DNA sequencing

      Allele 1:

      ClinVar: 1330339

      CAID: CA400024922

      Variant: NM_000212.3:c.856G>A

      GnomAD: Not Found

      Allele 2

      ClinVar: 1330314

      CAID: CA400028591

      Variant: NM_000212.3:c.1288C>T

      GnomAD: Highest in European non-Finnish population 0.000008801 (1/113622)

      ExpressionEvidence: Flow Cytometry of platelet integrin: 10% B3 expression, 86.6% A2B expression

    3. GT8

      Case#: 1 year old, Female

      Disease: Glazmann's Thrombasthenia

      CasePresentingHPOs: HP:0000967, HP:0000978, HP:0004406, HP:0002239

      PlateletAgreggation: Defective response to ADP, Adrenaline, Collagen, Arachidonic acid. Normal response to Ristocetin.

      GenotypingMethod: Genomic DNA was extracted from peripheral blood leukocytes for mutational analysis of the αIIb and β3 genes by DNA sequencing

      ClinVar: 1330328

      CAID: CA399801004

      Variant: NM_000419.5:c.1993C>T

      GnomAD:Found in East Asian population at rate of 0.00005461 (1/18310)

      ExpressionEvidence: Flow Cytometry of platelet integrin: 2.8% B3 expression, 36.5% A2B expression

    4. GT9

      Case#: 13 year old, male

      Disease: Glazmann's Thrombasthenia

      CasePresentingHPOs: HP:0000967, HP:0000978, HP:0004406, HP:0000225, HP:0006298, HP:0001892, HP:0002239

      PlateletAgreggation: Defective response to ADP, Adrenaline, Collagen, Arachidonic acid. Normal response to Ristocetin.

      GenotypingMethod: Genomic DNA was extracted from peripheral blood leukocytes for mutational analysis of the αIIb and β3 genes by DNA sequencing

      Allele 1:

      ClinVar: 996212

      CAID: CA399803786

      Variant: NM_000419.5:c.1229C>G

      GnomAD: European non-Finnish at rate of 0.0000089411 (1/111846)

      Allele 2:

      ClinVar: 225393

      CAID: CA290947544

      Variant: NM_000419.5:c.2333A>C

      GnomAD: East Asian population at rate of 0.0001087 (2/18394)

      ExpressionEvidence: Flow Cytometry of platelet integrin: 92.9% B3 expression, 2.1% A2B expression

    1. The patient,

      Case1: (Patient JO) Female, 38 years old, Japanese

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: Parents shown Fig 6

      CasePresentingHPOs: HP:0000978, HP:000042, HP:0000132

      (Easy bruising, epistaxis, menorrhagia)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      ProteinExpression: Figure 6 shows surface expression

      Platelet Aggregation: Absent aggregation in response to ADP, epinephrine, collagen and thrombin however normal response to ristocetin

      CasePreviousTesting: Total cellular RNA was obtained, and aIIbb3 mRNAs were specifically amplified by reverse transcription PCR (RT-PCR) as previously described (41).

      Gene: ITGA2B

      Variant: NM_000419.3:c.575_576insGGACAA (went over with Shruthi)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA915940650

      gnomAD N/A

    1. GT1

      Case1: GT-1, Female, Catalan, age not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: Affected sister (GT-1) and brother (GT-3)

      ParentalGenotype: N/A

      CasePresentingHPOs: HP:0000421

      (Epistaxis)

      CaseHPOFreeText: Hemorrhage associated with deciduous tooth loss

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Standard glycoprotein analysis confirmed the absence of αIIbβ3 in their platelets but while western blotting failed to reveal αIIb, residual β3 was at about 10% of usual levels and of normal migration (illustrated for GT1 in supplemental Figure 1).

      PlateletAggregation: Platelets of all 3 patients failed to aggregate in response to a range of physiologic agonists but were agglutinated by ristocetin. Clot retraction was also defective.

      CasePreviousTesting: Screened ITGA2B and ITGB3 genes of all three probands. Direct sequencing of all coding regions and splice sites of ITGA2B (30 exons) showed mutation.

      Gene: ITGA2B

      Variant: NM_000419.3:c.131G>T and NM_000419.3:c.1440-13_1440-1del

      LegacyVariant: (p.Gly13Val)

      ClinVar: N/A

      CAiD: CA399806881 and CA913184940

      gnomAD: N/A

    1. M/14

      Case6: Male, 14 years old, Tamil Nadu India

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: HP:0000225, HP:0006298, HP:0000967

      (Gingival bleeding, prolonged bleeding after tooth extraction, petechiae)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: See Table 1 for values

      PlateletAggregation: See Table 1 for values

      CasePreviousTesting: PCR amplification of ITAG2B and ITGB3

      Gene: ITGA2B

      Variant: NM_000419.3:c.1651C>T (p.Arg551Trp)

      LegacyVariant: (p.Arg520Trp)

      ClinVar: N/A

      CAiD: CA399802348

      gnomAD: MAF in the East Asian population is 0.00005045https://gnomad.broadinstitute.org/variant/17-42457471-G-A

    2. F/12

      Case10: Female, 12 years old, Tamil Nadu India

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: HP:0000225, HP:0006298

      (Gingival bleeding, prolonged bleeding after dental extraction)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: See Table 1 for values

      PlateletAggregation: See Table 1 for values

      CasePreviousTesting: PCR amplification of ITAG2B and ITGB3

      Gene: ITGB3

      Variant: 330_336TCCCCAGdel is not showing up in CAR noting it as Unregistered

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: Unregistered

      gnomAD: N/A

    1. 3/M

      Case#: Patient ID 7, Male 3 years old. North Indian

      Disease: Glazmann's Thrombasthenia

      CasePresentingHPOs: HP:0003540, HP:0000421, HP:0031364

      Impaired platelet aggregation, Epistaxis, Ecchymosis

      PlateletAgreggation: LTA with ADP, Epi, Coll, AA, and Ristocetin: Impaired with all except Ristocetin

      FamilyInfo: Brother affected confirmed GT.

      GenotypingMethod: Next generation sequencing. Sanger sequencing used to confirm pathogenic variants

      ClinVar: 1691487

      CAID: CA400029054

      Variant: NM_000212.3:c.1388G>C

      GnomAD: NA

      ExpressionEvidence:Flow Cytometry for platelet expression of GPIIb/IIIa in CD41a .5% and CD61 1.7%.

    1. VI:5

      Case#: Male, Saudi

      Disease: Glazmann's Thrombasthenia, 9 affected family members including proband. Figure 1.

      Family: Large six-generation consanguineous

      CasePresentingHPOs: HP:0000978, HP:0001892

      Bruising susceptibility, Abnormal bleeding

      PlateletAgreggation: No platelet aggregation to adenosine-di-phosphate, epinephrine, collagen, and arachidonic acid

      GenotypingMethod: Wide Exome sequencing identified pathogenic mutation. Sanger sequencing validated segregation of mutation in family.

      ClinVar: 953051

      CAID:CA8623443

      Variant: NM_000212.3:c.2113del

      GnomAD: East Asian at rate of (0.0001087) 2/18394

      ExpressionEvidence: Affected individuals were found negative for CD41 and CD61 surface antigens; however, CD42a and CD42b antigens were found positive. Used to test presence and absence of integrin αIIbβ3 complex

    1. 9-year-old boy

      Case1: Male, 9 years old,

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: One brother, with no signs of bleeding diathesis

      ParentalGenotype: Father is heterozygous for the c.2268C>T mutation and the mother is compound heterozygous with the c.2268C>T variant and c.2330C>T variant

      CasePresentingHPOs: HP:0000421 Epistaxis

      CaseHPOFreeText: Submucosal bleeding, hematomas, excessive achilles tendon bleeding

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: The patient's αIIbβ3 receptor count was estimated approximately 50% of that measured in a healthy age-matched control by quantitative flow cytometry

      PlateletAggregation: Complete absense of platelet aggregation in response to ADP, arachidonic acid, epinephrine, collagen

      CasePreviousTesting: Direct sequencing of the patients αIIb and β3 genes was perforemed

      Gene: ITGB3

      Variant: NM_000212.2:c.2248C>T (p.Arg750Ter)

      LegacyVariant: (p.Arg724Ter)

      ClinVar: 13564

      CAiD: CA123246 (p.Arg750Ter)

      gnomAD: N/A

    1. GT1

      Case1: (GT1), Male, 60 years old, French Gypsy

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Mucocutaneous bleeding defects

      CaseNotHPOs: N/A

      ProteinExpression: <5% surface expression levels of αIIbβ3

      Platelet Aggregation: Absent platelet aggregation to all agonists (no mention for which agonists or response to ristocetin)

      CasePreviousTesting: All the information we are given is "mutation screening of the ITGA2B and ITGB3 genes" the method for sequencing etc. was not stated

      Gene: ITGB3

      Variant: NM_000212.2:c.1031A>C (p.Tyr344Ser)

      LegacyVariant: (p.Tyr318Ser) (The paper gives legacy and current nomenclature)

      ClinVar: N/A

      CAiD: CA400025814

      gnomAD N/A

    2. M5

      Case13: (M5) Male, 9 years old, French Gypsy

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Mucocutaneous bleeding

      CaseNotHPOs: N/A

      ProteinExpression: Failed to express alphaIIbbeta3 on the surface of their platelets

      Platelet Aggregation: Absent platelet aggregation to all agonists (no mention for which agonists or response to ristocetin)

      CasePreviousTesting: All the information we are given is "mutation screening of the ITGA2B and ITGB3 genes" the method for sequencing etc. was not stated

      Gene: ITGA2B

      Variant: NM_000419.3:c.1544+1G>A

      LegacyVariant: N/A

      ClinVar: 2895

      CAiD: CA10575473

      gnomAD N/A

    3. M11

      Case19: (M11), Male, 63 years old, French Gypsy

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Mucocutaneous bleeding

      CaseNotHPOs: N/A

      ProteinExpression: Failed to express alphaIIbbeta3 on the surface of their platelets

      Platelet Aggregation: Absent platelet aggregation to all agonists (no mention for which agonists or response to ristocetin)

      CasePreviousTesting: All the information we are given is "mutation screening of the ITGA2B and ITGB3 genes" the method for sequencing etc. was not stated

      Gene: ITGA2B

      Variant: NM_000419.3:c.1544+1G>A

      LegacyVariant: N/A

      ClinVar: 2895

      CAiD: CA10575473

      gnomAD N/A

    4. GT8

      Case8: (GT-8) Female, 10 years old, French

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Mucocutaneous bleeding

      CaseNotHPOs: N/A

      ProteinExpression: <5% surface expression levels of αIIbβ3

      Platelet Aggregation: Absent platelet aggregation to all agonists (no mention for which agonists or response to ristocetin)

      CasePreviousTesting: All the information we are given is "mutation screening of the ITGA2B and ITGB3 genes" the method for sequencing etc. was not stated

      Gene: ITGA2B

      Variant: NM_000419.3:c.682C>T (p.Gln228Ter) and NM_000419.3:c.1750C>T (p.Arg584Ter)

      LegacyVariant: (p.Gln197Ter) and (p.Arg558Ter) (The paper gives legacy and current nomenclature)

      ClinVar: 2892 (p.Arg584Ter)

      CAiD: CA399805421 (p.Gln228Ter) CA115834 (p.Arg584Ter)

      gnomAD MAF in the East Asian population is 0.0002176 https://gnomad.broadinstitute.org/variant/17-42457372-G-A

    5. M2

      Case10: (M2) Female, 4 years old, French Gypsy

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Mucocutaneous bleeding

      CaseNotHPOs: N/A

      ProteinExpression: Failed to express alphaIIbbeta3 on the surface of their platelets

      Platelet Aggregation: Absent platelet aggregation to all agonists (no mention for which agonists or response to ristocetin)

      CasePreviousTesting: All the information we are given is "mutation screening of the ITGA2B and ITGB3 genes" the method for sequencing etc. was not stated

      Gene: ITGA2B

      Variant: NM_000419.3:c.1544+1G>A

      LegacyVariant: N/A

      ClinVar: 2895

      CAiD: CA10575473

      gnomAD N/A

    6. GT3

      Case3: (GT3) Male, 82 years old, French

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Mucocutaneous bleeding

      CaseNotHPOs: N/A

      ProteinExpression: 8-10% surface expression levels of αIIbβ3

      Platelet Aggregation: Absent platelet aggregation to all agonists (no mention for which agonists or response to ristocetin)

      CasePreviousTesting: All the information we are given is "mutation screening of the ITGA2B and ITGB3 genes" the method for sequencing etc. was not stated

      Gene: ITGA2B

      Variant: NM_000419.3:c.2348+5G>C

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA290947484

      gnomAD N/A

    1. Supplemental Table S1:

      Case2: Female, India, age not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: N/A

      PlateletAggregation: Absent platelet aggregation (all the information that is provided in Supp. Table S1)

      CasePreviousTesting: Sanger sequencing of exons, splice sites and untranslated regions of the ITGA2B and ITGB3 genes was performed

      Gene: ITGA2B

      Variant: NM_000419.3:c.1520C>G (p.Pro507Arg)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA399802643

      gnomAD: N/A

      PreviouslyPublished: PMID: 16463284

    2. Supplemental Table S1:

      Case4: Male, India, age not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Bleeding from multiple sites

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: >5% αIIbβ3 expression

      PlateletAggregation: Absent platelet aggregation (all the information that is provided in Supp. Table S1)

      CasePreviousTesting: Sanger sequencing of exons, splice sites and untranslated regions of the ITGA2B and ITGB3 genes was performed

      Gene: ITGA2B

      Variant: NM_000419.3:c.1651C>T (p.Arg551Trp)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA399802348

      gnomAD: MAF in the East Asian population is 0.00005045 https://gnomad.broadinstitute.org/variant/17-42457471-G-A

      PreviouslyPublished: PMID: 16879215

    1. The patient

      Case1: Female, 21 years old, ethnicity not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: Blood samples collected from brother, no other information provided

      ParentalGenotype: Father heterozygous: NM_000419.3:c.258G>C and mother heterozygous: NM_000419.3:c.2334A>C

      CasePresentingHPOs: HP:0000421, HP:0000979

      (Epistaxis, purpura)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry analysis and western blot analysis showed a remarkable reduction in aIIb b3 and aIIb, and a moderate reduction in b3 in the platelets of the patient (data not shown)

      PlteletAggregation: N/A

      CasePreviousTesting: Nucleotide sequences of aIIb cDNA and b3 cDNA amplified by reverse transcription polymerase chain reaction (RT-PCR) were analyzed

      Gene: ITGA2B

      Variant: NM_000419.3:c.258G>C (p.Leu86Pro) and NM_000419.3:c.2334A>C

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA500624524 and CA399796662

      gnomAD: N/A

    1. GT3

      Disease: Glazmann's Thrombasthenia

      Case: 19 year old female French Gypsy

      CasePresentingHPOs: HP:0001975

      (Decreased platelet glycoprotein IIb-IIIa)

      GenotypingMethod:Genotyping analysis of the HPA-1 system by high resolution melting analysis (methods not provided, cited article I don't have access too)

      ClinVar: 2895

      CAID: CA10575473

      Variant: NM_000419.5:c.1544+1G>A

      GnomAD: Not found

      ExpressionEvidence: Failed to express αIIbβ3 integrin on their platelet surface (methods not provided cited article no access too)

    2. GT2

      Disease: Glazmann's Thrombasthenia

      Case: 8 year old female French Gypsy

      CasePresentingHPOs: HP:0001975

      (Decreased platelet glycoprotein IIb-IIIa)

      GenotypingMethod:Genotyping analysis of the HPA-1 system by high resolution melting analysis (methods not provided, cited article I don't have access too)

      ClinVar: 2895

      CAID: CA10575473

      Variant: NM_000419.5:c.1544+1G>A

      GnomAD: Not found

      ExpressionEvidence: Failed to express αIIbβ3 integrin on their platelet surface (methods not provided cited article no access too)

    3. GT6

      Case: 37 year old male French Gypsy

      CasePresentingHPOs: HP:0001975

      (Decreased platelet glycoprotein IIb-IIIa)

      GenotypingMethod:Genotyping analysis of the HPA-1 system by high resolution melting analysis (methods not provided, cited article I don't have access too)

      ClinVar: 2895

      CAID: CA10575473

      Variant: NM_000419.5:c.1544+1G>A

      GnomAD: Not found

      ExpressionEvidence: Failed to express αIIbβ3 integrin on their platelet surface (methods not provided cited article no access too)

    1. 2

      Case2: No assertion made on age, gender or ethnicity

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: Table 1 states family history is available.

      ParentalGenotype: The identified variants were heterozygote in parents and were not present as homozygote in their healthy members of the family as expected in cases where mutations are deleterious.

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Bleeding time is greater than 20 minutes and prolonged clotting time

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: N/A

      CasePreviousTesting: Genetic study of patient was conducted using direct sequencing of entire coding and exon-intron boundaries of the ITGA2B and ITGB3 genes.

      Gene: ITGB3

      Variant: NM_000212.2:c.1658_1660del (p.Ser553del)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA626684826 (p.Ser553del)

      gnomAD: MAF in Latino population: 0.0001158 https://gnomad.broadinstitute.org/variant/17-45369899-TCTC-T

    1. Patient TK

      Case1: (Patient TK) Male, 5 years old, Japanese

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: The (p.His280Pro) mutation was inherited from his mother and the (p.Gly579Ser) mutation was inherited from his father

      CasePresentingHPOs: N/A

      CaseHPOFreeText: All patients (3 in this study) had suffered from a bleeding diathesis since early childhood

      CaseNotHPOs: NA

      ProteinExpression: The surface expression of the alphaIIbbeta complex on the patients' platelets was quantitated by flow cytometry. The level of antigen expression for TK was 19.9%

      Platelet Aggregation: Absent platelet aggregation in response to ADP, collagen, and epinephrine, but normal platelet agglutination in response to ristocetin

      CasePreviousTesting: The nucleotide sequences of the aIIb and b3 coding regions were determined by direct sequencing of RT-PCR products from platelet RNA

      Gene: ITGB3

      Variant: NM_000212.2:c.917A>C (p.His206Pro) and NM_000212.2:c.1813G>A (p.Gly605Ser) (See Table 1 to see zygosity statement, "double heterozygote for both variants")

      LegacyVariant: (p.His280Pro) and (p.Gly579Ser)

      ClinVar: N/A

      CAiD: CA291224999 and CA291227621

      gnomAD MAF in the East Asian population for (p.His206Pro) is 0.00005437 https://gnomad.broadinstitute.org/variant/17-45364575-A-C and MAF in East Asian population for (p.Gly605Ser) is 0.00005437 https://gnomad.broadinstitute.org/variant/17-45376796-G-A

    1. DN

      Case6: Patient DN

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs:

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: N/A

      PlateletAggregation: N/A

      CasePreviousTesting: The amplification of DNA fragments using PCR and their electrophoretic migration through a denaturing gradient was used to scan the entire coding region, splice site junctions and promoter regions of the GPIIb and GPIIIa genes for all 20 patients in this study

      Gene: ITGA2B

      Variant: NM_000419.3:c.1544+1G>A

      LegacyVariant: N/A

      ClinVar: 2895

      CAiD: CA10575473

      gnomAD N/A

    1. Table 3 Molecular Diagnosis of Patients with Glanzmann Thrombasthenia:

      Case1: GT-1, age, gender, ethnicity not specified

      DiseaseAssertion: Glanzmann thrombasthenia type II

      FamilyInfo: Segregation analysis confirmed in presence of heterozygous mutations in this proband.

      ParentalGenotype: Although segregation analysis confirmed, we do not know which variant in particular came from mom or dad.

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Patients presented with a variable bleeding diathesis; most patients had epistaxis (54%), cutaneous bleeding (58%), and menorrhagia (100% of women) while other common symptoms (oral cavity, GI, following dental extraction of mild injuries, postpartum, or hematomas) were in general milder. There is no specific phenotypes attached to probands in this paper.

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry showed that αIIbβ3 expression was between 5% and 20%

      PlateletAggregation: There was severely impaired aggregation in response to all physiological agonists, and ristocetin induced platelet agglutination was normal or reduced to some extent.

      CasePreviousTesting: Total RNA from peripheral blood was used for cDNA synthesis for RT-PCR. Then, using specific oligonucleotides and conditions, they amplified and sequenced ITGA2B and ITGB3 by Sanger sequencing. Every mutation found in cDNA was confirmed in DNA samples.

      Gene: ITGB3

      Variant: NM_000212.2:c.448A>G (p.Met124Val) and NM_000212.2:c.774_775del (p.Cys258Ter)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA8622961 and CA915940285

      gnomAD: MAF in South Asian population is 0.00003266 http://gnomad.broadinstitute.org/variant/17-45361895-A-G

    1. The patient is a 1‐year‐old female from Morocco

      Case1: Female, 1 year old, ethnicity not specified (patient from Morocco)

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: Her brother is asymptomatic. Her first cousin, (male) died as a result of some unknown bleeding disorder

      ParentalGenotype: Parents fully sequenced and

      CasePresentingHPOs: HP:0000967, HP:0000978

      (Petechia, bruising)

      CaseHPOFreeText: Mucocutaneous hemorrhages

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry showed less than 10% of ITGA2B and ITGB3 complexes

      PlateletAggregation: Platelet aggregation in response to ADP, thrombin, collagen and epinephrine was less than 10% of normal platelets and risotcetin induced platelet agglutination was normal

      CasePreviousTesting: Complete analysis of ITGA2B and ITGB3 coding sequences were performed (PCR)

      Gene: ITGA2B

      Variant: NM_000419.3:c.188G>A

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA8603528

      gnomAD: MAF in the European (non-Finnish) population is 0.000008803 http://gnomad.broadinstitute.org/variant/17-42466654-C-T

    1. GT13

      Case13: GT-13, Swiss, gender or age not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Bleeding symptoms are moderate (See Table 1) Abstract mentions patients' bleeding signs include epistaxis, mucocutaneous bleeding, haematomas, petechiae, GI bleeding and menorrhagia; however, not specified per proband.

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry was performed and expression is stated as pathogenic in Table 1

      PlateletAggregation: Platelet aggregation was performed and is stated as pathogenic in Table 1; however, no specific agonists mentioned

      CasePreviousTesting: All exons of ITGA2B and ITGB3 genes as well as surrounding intron regions were amplified by PCR using intronic primers as pre-viously described (12). The purified DNA fragments were then di-rectly sequenced.

      Gene: ITGA2B

      Variant: NM_000419.3:c.555T>G and NM_000419.3:c.1882C>T

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA399805736 and CA399801310

      gnomAD: MAF in the Latino population is 0.00003983 http://gnomad.broadinstitute.org/variant/17-42456075-G-A

    2. GT3

      Case3: GT-3, Turkish, gender or age not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Bleeding symptoms are severe and bleeding time is pathogenic (See Table 1) Abstract mentions patients' bleeding signs include epistaxis, mucocutaneous bleeding, haematomas, petechiae, GI bleeding and menorrhagia; however, not specified per proband.

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry was performed and expression is stated as pathogenic in Table 1

      PlateletAggregation: Platelet aggregation was performed and is stated as pathogenic in Table 1; however, no specific agonists mentioned

      CasePreviousTesting: All exons of ITGA2B and ITGB3 genes as well as surrounding intron regions were amplified by PCR using intronic primers as pre-viously described (12). The purified DNA fragments were then di-rectly sequenced.

      Gene: ITGB3

      Variant: NM_000419.3:c.310+3_310+6del

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA915940325

      gnomAD: N/A

  2. www.researchgate.net www.researchgate.net
    1. Patient 1

      Case1: Patient 1, Male, 6 years old

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: Affected brother is Patient 2

      ParentalGenotype: Mother and father revealed heterozygosity for c.1878G>C mutation. (Parents are consanguineous)

      CasePresentingHPOs: HP:0000967, HP:0000421, HP:0000225

      (Petechiae, epistaxis, gingival bleeding)

      CaseHPOFreeText: Hematomas,

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry analysis showed that there was no surface expression of GPIIb/IIIa detectable on patient 1's platelets, indicating a lack of platelet GPIIb/IIIa expression

      PlateletAggregation: All patients' platelets showed severely reduced platelet aggregation after stimulation with collagen and ADP in contrast to the normal range (See Table 1). Stimulation with epinephrine and arachidonic acid also demonstrated decreased platelet aggregation. In contrast, ristocetin-induced platelet aggregation was within normal range for patient 1

      CasePreviousTesting: Sequenced ITGA2B and ITGB3 genes from one patient of each family (Patient 2 and 3) and Patient 1 and 4 were screened for the identified mutation in the corresponding family.

      Gene: ITGA2B

      Variant: NM_000419.3:c.1878G>C (p.Gln626His)

      LegacyVariant: N/A

      ClinVar: 2903

      CAiD: CA115852

      gnomAD: N/A

    1. Patient Osaka-12

      Case1: Female, 21 years old, Japanese (Named Osaka-12 in this study)

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: The substitution was inherited from her father. The molecular genetic defect inherited from her mother remains determined.

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Moderate mucocutaneous bleeding in childhood

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry showed revealed a significant reduction in the expression of αIIbβ3 on Osaka-12 platelets

      PlateletAggregation: Absent platelet aggregation in response to ADP, epinephrine, and collagen but a normal response to ristocetin

      CasePreviousTesting: To identify the molecular genetic defect for the proband of interest, all coding regions of ITGA2B and ITGB3 cDNA amplified by RT-PCR were analyzed

      Gene: ITGA2B

      Variant: NM_000419.3:c.520T>C (p.Tyr174His)

      LegacyVariant: (p.Tyr143His)

      ClinVar: N/A

      CAiD: CA399805805

      gnomAD: N/A

    1. Two male patients

      Case1: Male, age not specified, ethnicity not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: See Fig 3

      ParentalGenotype: Both mutations were found to be heterozygous in all family members that includes parents

      CasePresentingHPOs:

      (Gum bleeding, ecchymosis, epistaxis)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry showed that the surface expression of GPIIb/IIIa in patients was 0% and both parents also showed reduced expression as well.

      PlateletAggregation: Platelet aggregation in response to all the agonists except risocetin was completely absent in the patient

      CasePreviousTesting: Mutation screening by conformational sensitive gel electrophoresis was performed in all the 30 exons of ITGA2B and 15 exons of ITGB3 gene in this patient

      Gene: ITGA2B

      Variant: NM_000419.3:c.1028T>C (p.Leu343Pro) and a promoter variant g.951G>A

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA399804619 and need to ask about second variant--made note in google doc to ask

      gnomAD: N/A

    1. The proband is a 35-day old female infant born from a twin delivery.

      Case1: Female, 35 day old, ethnicity not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: The proband’s mother and father carry heterozygous c.512delC and c.1686delG mutations, respectively. Other parameters for parents are shown in Table 1.

      CasePresentingHPOs: HP:0031364, HP:0000967

      (Ecchymosis, petechiae)

      CaseHPOFreeText: Large parietal and cervical cephalohaematoma, severe anemia

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry of platelet surface antigens revealed the absence of the αIIbβ3 complex.

      PlateletAggregation: Prolonged closure time at PFA-100, absent ADP, adrenaline, collagen induced platelet aggregation, and ristocetin induced platelet aggregation at the lower limit of normal

      CasePreviousTesting: Sequencing of ITGA2B and ITGB3 genes showed that proband is compound het.

      Gene: ITGA2B

      Variant: Can not conclusively determine if c.481delC and c.1654delG are the variants intended by the authors based on the available information.

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: N/A

      gnomAD: N/A

    1. 4

      Case4: Gender or age not specified, Thai ethnicity

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: Parental information available in Table 2

      ParentalGenotype: Father: p.Gln508Hisfs*3/WT and Mother: No mutations in the coding region

      Note: No parental consanguinity

      CasePresentingHPOs: N/A

      CaseHPOFreeText: The article does not mention specific bleeding phenotypes for each of the 4 probands in the article, rather, there is a general statement that says: "The common presentations included recurrent epistaxis, bleeding in oral cavity, and easy-bruising spontaneously or after trauma"

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinEpression: General statement from the article that states that flow cytometry to assess the surface GPIIb/IIIa complex showed reduced expression for all probands.

      PlateletAggregation: The platelet aggregation test was typically defective with all physiological agonists except ristocetin, for all patients.

      CasePreviousTesting: Whole exome sequencing was performed on the 30 exons of ITGA2B and 15 exons in ITGB3. PCR and direct sequencing were then performed in the DNA samples of the patients and their available parents to verify the presence of the identified mutations.

      Gene: ITGA2B

      Variant: NM_000419.3:c.1524_1533del (p.Gln508Hisfs*3)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA915940265

      gnomAD: N/A

    1. Thepatient(M.S.)

      Case1: (M.S) Female, 19 years old, Caucasian

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: The mutation has been inherited from proband's parents who are heterozygous for the same mutation the proband has.

      CasePresentingHPOs: HP:0000978 (Bruising)

      CaseHPOFreeText: Intracerebral hematoma

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: See Fig 4 for flow cytometry analysis of protein expression

      PlateletAggregation: Absence of platelet aggregation in response to all agonists tested i.e. ADP, collagen, platelet activating factor acether thrombin, and arachidonic acid; however, ristocetin induced platelet aggregation was normal

      CasePreviousTesting: Sequenced patient's GPIIIa exons encompasing a highlight conserved reion of GPIIIa.

      Gene: ITGB3

      Variant: NM_000212.2:c.718C>T (p.Arg240Trp)

      LegacyVariant: (p.Arg214Trp)

      ClinVar: 13555

      CAiD: CA123228

      gnomAD: MAF in the East Asian population is 0.00005437 http://gnomad.broadinstitute.org/variant/17-45363729-C-T

    1. The proband was a 2‐year‐old man

      Case1: Male. 2 years old, Gypsy

      DiseaseAssertion: Glanzmann's thrombasthenia

      FamilyInfo: See Fig 3 and 4 for family pedigree

      ParentalGenotype: Parents are heterozygous for the variant of interest

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Mucocutaneous hemorrhages and spontaneous bruising

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Protein expression results can be found in Table 1

      PlateletAggregation: Platelets aggregated in response to agonists although they reacted positively to ristocetin (See Case History section for this sentence

      CasePreviousTesting: Analyzed the amplification of products of all exons of GPII and their intronic flanking regions by single stranded conformational polymorphism analysis. All GPIIIa exons were also analyzed by SSCP and gave results identical to controls

      Gene: ITGA2B

      Variant: NM_000419.3:c.1063G>A (p.Glu355Lys)

      LegacyVariant: N/A

      ClinVar: 2899

      CAiD: CA115844

      gnomAD: MAF in the European (non-Finnish) population is 0.00001978 http://gnomad.broadinstitute.org/variant/17-42461008-C-T

  3. watermark.silverchair.com watermark.silverchair.com
    1. The patient (L.W.)

      Case1: (Patient L.W) Male, 55 years old, ethnicity not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: Father passed away and mother has not yet been studied

      CasePresentingHPOs: HP:0004406, HP:0006298, HP:0002239

      (Recurrent epistaxis, prolonged bleeding following dental extraction, gastrointestinal bleeding,

      CaseHPOFreeText: Pharyngeal bleeding

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      ProteinExpression: Surface expression levels found in Table 2

      PlateletAggregation: Absent platelet aggregation tests in response to ADP but a normal initial response to ristocetin

      CasePreviousTesting: Sequence analysis of GPIIb RNA was performed. Using 10 pairs of primers that hybridize to sequences specific for GPIIb cDNA, PCR products were generated by RT-PCR from total RNA of the patient and a normal control

      Gene: ITGA2B

      Variant: NM_000419.3:c.641T>C (p.Leu214Pro)

      LegacyVariant: N/A

      ClinVar: 2901

      CAiD: CA115848

      gnomAD: N/A

    1. A 3‐year‐old Cypriot girl

      Case1: Female, 3 years old, Cypriot

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: Father and paternal uncle were also affected with same mutation (See Figure 3 for family pedigree)

      ParentalGenotype: Father is homozygous for the mutation and the mother is heterozygous for the mutation (See Discussion)

      CasePresentingHPOs: HP:0000225, HP:0000421, HP:0031364

      (Gingival bleeding, epistaxis, ecchymosis)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry showed decreased surface expression of αIIb and β3 in patients' platelets

      PlateletAggregation: Absent platelet aggregation in response to ADP, epineprhine, collagen but normal ristocetin induced platelet aggregation

      CasePreviousTesting: SSCP analysis of the αIIb gene in the three patients revealed an altered pattern of migration of the DNA fragment containing exons 5 and 6 and their flanking intronic regions.

      Gene: ITGA2B

      Variant: NM_000419.3:c.605T>G (p.Phe202Cys)

      LegacyVariant: (p.Phe171Cys) + 31= (p.Phe202Cys)

      ClinVar: N/A

      CAiD: CA399805605

      gnomAD: N/A

    1. patient (GT-1

      Case1: GT-1, gender, age, ethnicity not specified

      DiseaseAssertion: Glanzmann thrombasthenia

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Relatively mild bleeding syndrome and does not routinely require treatment except for iron supplementation

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      ProteinExpression: Flow cytometry showed that this patient lacked integrin αIIbβ3 expression

      PlateletAggregation: Platelets failed to aggregate with physical agonists

      CasePreviousTesting: N/A

      Gene: ITGA2B

      Variant: NM_000419.3:c.2933G>T (p.Gly978Val) and NM_000419.3:c.2994G>A (p.Trp998Ter)

      LegacyVariant: N/A

      ClinVar: N/A

      CAiD: CA399790478 and CA399789759

      gnomAD: N/A

    1. 1874

      Case1874(T.C.) Female, 5yo diagnosis, Irish

      CasePresentingHPOs HP:0010864, HP:0000939, HP:0002942, HP:0000766, HP:0000276, HP:0000275, HP:0000218, HP:0000689, HP:0002857, HP:0001166, HP:0001634, HP:0001263, HP:0000750, HP:0002240, HP:0002353

      (Severe intellectual disability, Osteoporosis, Thoracic kyphosis, Sternal anomaly, Long face, Thin face, High palate, Malocclusion, Genu valgum, Arachnodactyly, Lens dislocation, Mitral valve prolapse, Delayed milestones, Speech delay, Enlarged liver, EEG abnormality)

      HPOsFreeText Patient had severe intellectual disability. Her spine was normal, but long bones were osteoporotic. Upon exam at 5yo, she had mild kyphosis of upper thoracic spine, mild sternal depression, marked genu valgum, and arachnodactyly. Patient was also myopic with bilateral lens dislocation. She had prominent recurrent malar flush, long and thin face, high-arched palate, malocclusion and mitral valve prolapse.

      (PMID: 20329304): Patient was born at term after normal pregnancy weighing 3.4kg. Normal neonatal course, but with delayed milestones. Speech at 5yo was monosyllabic , but verbal comprehension was good. No convulsions at this time. She had a palpable liver, 2cm below margin, but had normal consistence. She had an abnormal EEG with non-specific diffuse changes and excess slow-wave activity. Patient's IQ was 36.

      CaseNotHPOs HP:0001250, HP:0002086, HP:0000707

      (Seizures, Respiratory abnormality, Neurologic abnormality)

      NotHPOsFreeText n/a

      CasePreviousTesting Plasma homocysteine was 70μM pretreatment. Pyroxidine treatment reduced those levels to trace amounts. In patient fibroblasts, no CBS protein was detect on Western blot and CBS assay detected no activity. (PMID: 20329304): "Full hemogram, routine urine analysis, liver function tests, serum ion and iron-binding capacity, plasma magnesium, serum calcium, inorganic phosphate, fasting blood sugars, blood urea nitrogen, and bone marrow examination were all normal". Heavy homocysteine spot shown on chromatogram of urinary amino acids.

      CaseMethod1 PCR

      CaseMethod2 Sanger

      CaseGenotypingMethod Created a bacteria expression system in E.coli by substituting one of three fragments of (PCR amplified)patient cDNA into WT CBS sequence already subcloned in expression plasmids. Bacteria were screened based on which ones did not have CBS activity. Those that did not have activity were thought to have LOF variants in CBS. Plasmids containing the inactivating fragments, ones cut with NcoI/XmaI, were sequenced.

      Variant 1. NM_000071.2:c.233C>G (p.Pro78Arg);2. NM_000071.2:c.306G>C (p.Lys102Asn) - 1&2 in cis

      ClinVar 1. 188988;2. 188989

      gnomAD 1. MAF=0.0001631(Other), no homozygotes, 2. MAF=0.0001630(Other), no homozygotes

      CaseAddInfo n/a

      CasePMIDs 20329304

    2. 75) w

      Case1875(M.C.) Female, 22yo died, Irish

      CasePresentingHPOs HP:0001263, HP:0001249, HP:0001250, HP:0002650, HP:0002625, HP:0005625, HP:0002857, HP:0000545, HP:0000276, HP:0000275, HP:0000218, HP:0000678, HP:0002878, HP:0001695, HP:0002240

      (Developmental delay, Intellectual disability, Seizures, Scoliosis, Deep vein thrombosis, Osteoporosis of vertebrae, Genu valgum, Myopia, Long face, Narrow face, High palate, Crowded teeth, Respiratory failure, Cardiac arrest, Enlarged liver)

      HPOsFreeText Diagnosed with homocystinuria after exam for developmental delay at 13mo. Patient had severe intellectual disability and seizures. At 14yo she had surgery for scoliosis, postsurgery she had a popliteal vein thrombosis. In addition to osteoporosis of the spine, she had genu valgum and myopia. The patient also had a long and narrow face, high-arched palate and crowded teeth. Respiratory failure and cardiac arrest at 22yo likely due to overuse of antiasthmatic medication.

      (PMID:20329304): She was delivered normally at term, weighed 3kg, made uncomplicated neonatal progress, no history of convulsions,reached early milestones at expected times but did not sit up until 13mo. On report she was well fed and well developed, but with persistent shadow in right upper load on roentgenogram, enlarged liver of normal consistence, spleen was not palpable, negative neurological exam, mental age was 9mo. Aortogram was negative for vascular abnormalities in upper left chest. Skull and long bones were normal but osteoporosis of the spine was detected by roentgenogram.

      CaseNotHPOs HP:0001083

      (Lens dislocation)

      NotHPOsFreeText no malar flush, lens displacement, or skeletal deformity on exam at 13mo.

      CasePreviousTesting Plasma homocysteine was 45μM pretreatment. Pyroxidine treatment reduced those levels to trace amounts. In patient fibroblasts, no CBS protein was detect on Western blot and CBS assay detected no activity. (PMID: 20329304): "Full hemogram, routine urine analysis, liver function tests, serum ion and iron-binding capacity, plasma magnesium, serum calcium, inorganic phosphate, fasting blood sugars, blood urea nitrogen, and bone marrow examination were all normal". Strong positive on cyanide nitroprusside, heavy homocysteine spot on chromatogram of urinary amino acids.

      CaseMethod1 PCR

      CaseMethod2 Sanger

      CaseGenotypingMethod Created a bacteria expression system in E.coli by substituting one of three fragments of (PCR amplified)patient cDNA into WT CBS sequence already subcloned in expression plasmids. Bacteria were screened based on which ones did not have CBS activity. Those that did not have activity were thought to have LOF variants in CBS. Plasmids containing the inactivating fragments, one cut with NcoI/XmaI and another cut with Bpu1102/BstX, were sequenced.

      Variant 1. NM_000071.2:c.715G>A (p.Glu239Lys),

      1. NM_000071.2:c.233C>G (p.Pro78Arg);3. NM_000071.2:c.306G>C (p.Lys102Asn) - 2&3 in cis, compound heterozygous

      ClinVar 1. n/a, 2. 188988;3. 188989

      CAID 1. CA410600501

      gnomAD 1. not in gnomAD, 2. MAF=0.0001631(Other), no homozygotes, 3. MAF=0.0001630(Other), no homozygotes

      CaseAddInfo n/a

      CasePMIDs 20329304

    1. The patient

      Case1 (Level 1)

      Case1: male, 5y (at time of study, born 1998), Greece, Gypsy (Roma)

      CasePresentingHPOs: HP:0002587, HP:0008872, HP:0001662, HP:0003235 (projectile vomiting (at birth), feeding difficulties in infancy, bradycardia (infancy), hypermethioninemia)

      HPOsFreeText: 3350 g birthweight, elevated serum aminmotransferases, mildly elevated ALT and AST at 2y, mild ferritin elevation 173 ng/ml, serum triglycerides 155 mg/dl, total cholesterol 248 mg/dl, aspartate transaminase 31 to 154 U/L, alanine transaminase 34-180 U/L, urine methionine 508-627 umol/L, methionine excretion 60 umol/mmol, plasma methionine 1005-1049 umol/L, plasma AdoMet 1643-2222 nmol/L, plasma cystathionine 740-900 nmol/L, plasma phosphatidylcholine 2622-2641 umol/L, plasma betaine 218-382 umol/L, plasma dimethylglycine 11.7-12.1 umol/L

      CaseNotHPOs: HP:0002240 (hepatomegaly)

      NotHPOsFreeText: normal apgar score, normal blood ammonia, normal lactate, normal tyrosine, , normal plasma N-methylglycine 1.4-1.6 umol/L, normal plasma AdoHcy 32-43 nmol/L, normal plasma tHcy 11.1-12.1 umol/L, normal plasma tCys 206-217 umol/L, normal plasma choline 10.2-14.0 umol/L

      CaseAddInfo: Adopted at 9 mo, no family info,

      CasePMIDs: n/a

      Case1 (Level 2)


      CasePreviousTesting: metabolite assays: tHcy- fluorescent polarization method; urinary organic acids- gas chromatography mass spectrometry; plasma methionine, tHcy, cystathionine, tCys, dimethylglycine, sarcosine- capillary gas chromatography

      CaseMethod1: PCR

      CaseGenotypingMethod: genomic DNA isolated from blood samples (affected patient and 10 healthy American controls). 1.9 kb 5'-fragment of GNMT gene prepared using PCR primers and 1.8 kb 3' fragment prepared using other primers. PCR fragments were purified. Sequencing done by dideoxy sequencing method. Plasmid pGE3 containing wild-type GNMT cDNA was used to prepare mutated human GNMT cDNA. Fragments of all exons and most introns and 300 nucelotides at 5' and 3' flanking ends were sequence using the GNMT sequence specified by GI 8671581 which found a single nucleotide substitution in AAC codon of exon 3:3415A>G.


      Variant: NM_018960.5(GNMT):c.422A>G (p.Asn141Ser)

      ClinVar: 218931

      CAID: CA347847

      gnomAD: not in gnomAD


      CaseAddInfo: No additional point mutation was found in the coding regions of patients GNMT gene, so the paper concludes that either he is homozygous or he has a deletion on the other allele that overlaps 3415A>G change and prevented PCR amplification in region of question.

    1. Biallelic

      Case#: Hazelwood case, 43 yrs (report), male

      CaseHPOs: HP:0003235, HP:0012185 (hypermethioninemia, carpal tunnel)

      CaseHPOsFreeText: Elevated urine methionine; Halitosis due to elevated breath dimethylsulphide; mild aortic insufficiency “attributable to rheumatic fever”, Gilbert disease (based on transient hyperbilirubinemia)

      CaseNotHPOsFreeText: Normal brain MRI with no evidence of demyelination (age 43 years). Developmentally, physically, and mentally normal. Liver histology was normal (age 31 years). Normal neurologic exam. Normal electrolytes and blood chemistry, normal cholesterol, normal AST, ALT, and LDH, normal testosterone.

      CasePreviousTesting: 25–30-fold elevation of plasma methionine (716-941 uM; controls 15-40, mean 26). Normal plasma tyrosine, normal homocysteine. Urine methionine 352-578 umol/day (controls 39-225, mean 99). Urine transamination metabolites 174-254 mmol/mol creatinine (controls ~1.8); breath dimethylsulfide 2.52-5.86 nmol/L (controls 0.13-0.65, mean 0.34); 7% normal activity of hepatic methionine adenosyltransferase in liver; hepatic activities of cystathionine-beta-synthase, gamma-cystathionase, and betaine homocysteine methyltransferase were normal.

      CaseMethod1: SSCP

      CaseMethod2: Sequencing

      CaseGenotypingMethod: All 9 exons and intron-exon junctions of MAT1A were amplified by PCR from genomic DNA. This was followed by SSCP analysis and sequence analysis of PCR products with abnormal mobility.

      Variant: c.539insTG (homozygous)

      ClinVar: NA

      CAID: CA210326818

      gnomAD: The highest population minor allele frequency = 0.00001759 (non-Finnish); no homozygotes in any population.

      CaseAddInfo: Both parents are heterozygous for the variant. Possible consanguinity - the patient’s father’s maternal grandfather and his mother’s paternal grandmother shared the same name and had lived their entire lives in an isolated West Virginia community.

      CasePMIDs: 3812486, 3339126

      Points: 1.5 points. This individual is homozygous for a frameshift variant in MAT1A. The highest population minor allele frequency = 0.00001759 (non-Finnish); no homozygotes in any population. The score is reduced because only some, but not all, causes of hypermethioninemia have been ruled out.

    1. Patient 1

      Case1: Newborn, male, Hmong (China)

      CasePresentingHPOs:

      HPOFreeText: Delivered at 33 weeks of gestation as a result of preterm labor. Postnatally required care for respiratory distress and pneumonia. NBS revealed elevated C5 acylcarnitine. Treated with L-carnitine supplementation and discharged at 4 weeks. Normal development at 12 months.

      CaseNotHPOs:

      CasePreviousTesting: Plasma C5-acylcarnitine 0.7, 3.4 umol/L (ref <0.6); urine 2-MBG 1.8, 10.2, 13.4, 28.7 ug/mg creatinine (ref 0.3-7.5); urine IVG 0.1, 0.3, 0.4, 1.1 ug/mg creatinine (ref 0.3-14.3).

      CaseGenotypingMethod: PCR and sequencing of entire gene.

      Variant: NM_001609.3:c.1165A>G (p.Met389Val) (homozygous)

      CAID: CA5730948

      gnomAD: East Asian 0.0005513

      VariantEvidence: PCR of cDNA using primers in exon 9 and exon 11 showed that exon 10 was missing. Analysis of intron exon junctions flanking exon 10 did not reveal any changes.

      CaseAddInfo: Diagnosis confirmed by Western blot of fibroblasts which showed no SBCAD protein. Treatment discontinued without consequence.

      CasePMIDs:

    2. Patient 2

      Case2: Newborn, Hmong (China)

      CasePresentingHPOs:

      HPOFreeText: Born after normal pregnancy, postnatal course normal except for moderately elevated C5-acylcarnitine found during NBS. Treatment with L-carnitine supplementation. Treatment was discontinued without consequence.

      CaseNotHPOs:

      CasePreviousTesting: Plasma C5-acylcarnitine 3.0, 3.2 umol/L (ref <0.6); urine 2-MBG 2.9, 15.5 ug/mg creatinine (ref 0.3-7.5); urine IVG 0.1, 0.6 ug/mg creatinine (ref 0.3-14.3).

      CaseGenotypingMethod: PCR and sequencing of entire gene.

      Variant: NM_001609.3:c.1165A>G (p.Met389Val) (homozygous)

      CAID: CA5730948

      gnomAD: East Asian 0.0005513

      VariantEvidence: PCR of cDNA using primers in exon 9 and exon 11 showed that exon 10 was missing. Analysis of intron exon junctions flanking exon 10 did not reveal any changes.

      CaseAddInfo: Diagnosis confirmed by Western blot of fibroblasts which showed no SBCAD protein.

      CasePMIDs:

    1. HCU-102-3

      Case# HCU-102-3, 8yo report, Iran, Sistani

      CasePresentingHPOs HP:0001083, HP:0003235, HP:0000924

      (Ectopia lentis, Increased methionine in blood, Skeletal abnormality)

      HPOsFreeText skeletal abnormality/elongated long bone, increased urinary cysteine, elevated plasma methionine

      CaseNotHPOs HP:0001249, HP:0002970, HP:0001010, HP:0000501

      (Intellectual disability, Genu varum, Hypopigmentation, Glaucoma)

      NotHPOsFreeText n/a

      CasePreviousTesting plasma methionine 108μm/l(normal range 6-40μm/l)

      CaseMethod1 Sanger

      CaseMethod2 n/a

      CaseGenotypingMethod Sanger sequenced exon 3 of the CBS gene

      Variant NM_000071.2(CBS):c.346G>A (p.Gly116Arg), homozygous

      ClinVar 188787

      gnomAD MAF=0.00002892(Latino), no homozygotes

      CaseAddInfo from the province of Sistan and Baluchestan. no known consanguinity although the patient is homozygous for a founder variant

      CasePMIDs n/a

    1. 19

      Case19: 1 mo (at biopsy), White

      Case 19 (Level 2)


      CasePreviousTesting: same as group. found 1.2 nmol/mg protein/18 h propionate incorporation, 1.0 nmol/mg/protein/18 h propionate incorporation with hydroxocobalamin supplementation

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.655A>T (p.Asn219Tyr)

      ClinVar: 1886

      CAID: CA249731

      gnomAD: 0.0001318 (European non-Finnish)


      Variant2: NM_000255.3:c.1332+1delG

      ClinVar: 554656

      CAID: CA3846920

      gnomAD: 0.000008828 (European non-Finnish)


      CaseAddInfo: mut0 type, heterozygous mutations, unknown cis or trans

    2. 18

      Case18: 2 mo (at biopsy), French Canadian

      Case 18 (Level 2)


      CasePreviousTesting: same as group. found 0.7 nmol/mg protein/18 h propionate incorporation, 0.7 nmol/mg/protein/18 h propionate incorporation with hydroxocobalamin supplementation

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.655A>T (p.Asn219Tyr)

      ClinVar: 1886

      CAID: CA249731

      gnomAD: 0.0001318 (European non-Finnish)

      __

      Variant2: NM_000255.3:c.1240delG (p.Glu414LysfsTer17)

      ClinVar: n/a

      CAID: CA3846936

      gnomAD: 0.000008796 (European Non-Finnish)


      CaseAddInfo: mut0 type. Variant 2 is novel. heterozygous mutations, unknown cis or trans.

    3. 17

      Case17: 6 y (at biopsy), Black

      Case 17 (Level 2)


      CasePreviousTesting: same as group. found 0.6 nmol/mg protein/18 h propionate incorporation, 0.6 nmol/mg/protein/18 h propionate incorporation with hydroxocobalamin supplementation

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.631_633delGAG (p.Glu211del)

      ClinVar: n/a

      CAID: CA913187321

      gnomAD: n/a


      Variant2: NM_000255.3:c.682C>T (p.Arg228Ter)

      ClinVar: 203855

      CAID: CA312778

      gnomAD: 0.0002615 (Latino)


      CaseAddInfo: mut0 type, heterozygous mutations. Variant 1 is novel. MUT mutations are in trans- demonstrated by RT-PCR of mRNA. Additional variant found in MCEE gene (NM_032601.3:c.428G>A, ClinVar: 336936, CAID: CA1702575, gnomAD: 0.08102 (Latino)) MCEE variant is unlikely to be associated with patient's MMA.

    4. 16

      Case16: 5 days (at biopsy), Lao/Thai/Mexican/Portugese

      Case 16 (Level 2)


      CasePreviousTesting: same as group. found 0.6 nmol/mg protein/18 h propionate incorporation, 0.5 nmol/mg/protein/18 h propionate incorporation with hydroxocobalamin supplementation

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.581C>T (p.Pro194Leu)

      ClinVar: n/a

      CAID: CA364404418

      gnomAD: n/a


      Variant2: NM_000255.3:c.682C>T (p.Arg228Ter)

      ClinVar: 203855

      CAID: CA312778

      gnomAD: 0.0002615 (Latino)


      CaseAddInfo: mut0 type, heterozygous mutation, unknown cis or trans

    5. 15

      Case15: 3 wks (at biopsy), white

      Case (Level 2)


      CasePreviousTesting: same as group. found 0.5 nmol/mg protein/18 h propionate incorporation, 0.7 nmol/mg/protein/18 h propionate incorporation with hydroxocobalamin supplementation

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.572C>A (p.Ala191Glu)

      ClinVar: 203854

      CAID: CA312777

      gnomAD: 0.00006976 (European non-FInnish)


      Variant2: NM_000255.3:c.754-2A>G

      ClinVar: 552691

      CAID: CA364402853

      gnomAD: n/a


      CaseAddInfo: variant 2 is a novel, splice site mutation. Heterozygous mutations, unknown cis or trans.

    6. 13

      Case13: 21 y (at biopsy), English/Irish

      Case (Level 2)


      CasePreviousTesting: same as group. found 1.5 nmol/mg protein/18 h propionate incorporation, 1.5 nmol/mg/protein/18 h propionate incorporation with hydroxocobalamin supplementation

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.572C>A (p.Ala191Glu)

      ClinVar: 203854

      CAID: CA312777

      gnomAD: 0.00006976 (European non-FInnish)


      Variant2: NM_000255.3:c.682C>T (p.Arg228Ter)

      ClinVar: 203855

      CAID: CA312778

      gnomAD: 0.0002615 (Latino)


      CaseAddInfo: mut0 type, heterozygous mutation, unknown cis or trans

    7. 12

      Case12: 6y (at biopsy), no ethnicity recorded

      Case (Level 2)


      CasePreviousTesting: same as group. found 0.5 nmol/mg protein/18 h propionate incorporation, 1.3 nmol/mg/protein/18 h propionate incorporation with hydroxocobalamin supplementation

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.556A>G (p.Met186Val)

      ClinVar: 551460

      CAID: CA3847093

      gnomAD: 0.00001760 (European Non-Finnish)


      Variant2: NM_000255.3:c.1106G>A (p.Arg369His)

      ClinVar: 203846

      CAID: CA312764

      gnomAD: 0.0001504 (East Asian)


      CaseAddInfo: mut- type, heterozygous mutations, unknown cis or trans

    8. 11

      Case11: 6y (at biopsy), White/Hispanic

      Case (Level 2)


      CasePreviousTesting: same as group. found 2.6 nmol/mg protein/18 h propionate incorporation, 7.0 nmol/mg/protein/18 h propionate incorporation with hydroxocobalamin supplementation

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.566A>T (p.Asn189Ille)

      ClinVar: 222915

      CAID: CA3847091

      gnomAD: 0.000008804 (European Non-Finnish)


      Variant2: NM_000255.3:c.655A>T (p.Asn219Tyr)

      ClinVar: 1886

      CAID: CA249731

      gnomAD: 0.0001318 (European non-Finnish)


      CaseAddInfo: Variant 1 is novel, unknown cis or trans. mut- type.

    9. 14

      Case14: 3 mo (at biopsy), White/Australian

      Case (Level 2)


      CasePreviousTesting: same as group. found 0.5 nmol/mg protein/18 h propionate incorporation, 0.5 nmol/mg/protein/18 h propionate incorporation with hydroxocobalamin supplementation

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.572C>A (p.Ala191Glu)

      ClinVar: 203854

      CAID: CA312777

      gnomAD: 0.00006976 (European non-FInnish)


      Variant2: NM_000255.3:c.682C>T (p.Arg228Ter)

      ClinVar: 203855

      CAID: CA312778

      gnomAD: 0.0002615 (Latino)


      CaseAddInfo: mut0 type, heterozygous mutation, unknown cis or trans

    1. Individual 2

      Case2: Female

      CasePresentingHPOs: HP:0000252, HP:0001270, HP:0000750, HP:0001252 (Microcephaly, Motor delay, Delayed speech and language development, Muscular hypotonia)

      HPOsFreeText: N/A

      CaseNotHPOs: HP:0000407 (Sensorineural hearing impairment)

      NotHPOsFreeText: N/A

      CaseAddInfo: Parents are non-consanguineous, Compound heterozyosity was confirmed in trans via parental testing

      CasePreviousTesting: At 2 yrs levels were at 2-oxoadipate, 520–970 mmol/mol creatinine; 2-hydroxyadipate, 100–150 mmol/mol creatinine; 2-aminoadipate, elevated; Moderate protein restriction did not influence disease course; IQ of 87

      CaseGenotypingMethod: After confirmation of the DHTKD1 mutations in Individual 1, Sanger sequencing confirmed compound heterozygous mutations in the same gene here.

      Variant1: NM_018706.7(DHTKD1):c.1228C>T (p.Arg410Ter)

      ClinVar: 39565 https://www.ncbi.nlm.nih.gov/clinvar/variation/39565/

      gnomAD: 0.00005437, https://gnomad.broadinstitute.org/variant/10-12136140-C-T

      Variant2: NM_018706.5(DHTKD1):c.2185G>A (p.Gly729Arg)

      ClinVar: 39564 https://www.ncbi.nlm.nih.gov/clinvar/variation/39564/

      gnomAD: 0.002748, https://gnomad.broadinstitute.org/variant/10-12154929-G-A

    1. Case presentation

      Case#: 64 year old (report), female

      CaseHPOsFreeText: At age 52 years, sudden difficulty with swallowing and speech, ophthalmoparesis with a vertical and horizontal eye movement disorder, dysesthesia of the hands with a quality of “pins and needles” and a glove-like distribution, as well as generalized areflexia. Diagnosed with Miller Fisher syndrome. Treatment with intravenous immunoglobulins led to remission of symptoms. Abdominal pain since childhood. At 63 years of age, she had generalized epileptic seizures with prolonged postictal confusion, persisting diarrhea, abdominal pain, renal failure, repeat episodes of lactic acidosis. Ventilated for >8 weeks due to massive metabolic acidosis and respiratory failure during seizure; tracheotomy, PEG. VitB6 supplement. Rehabilitation, and recovered after several months.

      CaseNotHPOsFreeText: Muscle strength was normal. Abdominal computer tomography (CT), magnetic resonance imaging (MRI) and gastroscopy were normal. No signs of infection in CSF. CT and MRI of the brain as well as abdominal- and thorax-CT were normal initially then fat embolies in brain, pulmonary embolism, vertebral fractures. EMG was normal. No signs of malnutrition or liver disease (which can cause hyperprolinemia).

      CasePreviousTesting: No evidence of porphyria on “laboratory tests”, or diseases of copper metabolism, lead poisoning, or adrenoleukodystrophy. Muscle biopsy showed nonspecific atrophy, but no evidence of mitochondrial disease. Serum proline 3085 μmol/l (reference 90-342 μmol/l), urine proline 46,531 μmol/g Crea (reference < 100 μmol/g Crea), CSF proline 104 mg/dl (reference < 6 mg/dl), urine Hydroxyproline 1395 μmol/g Crea (reference <100). Vitamin-B6 was decreased at 3.3 μg/l (reference > 4.9 μg/l). “targeted genetic analyses by Sanger sequencing revealed no pathogenic variant within the PRODH-gene (hyperprolinemia type I)”

      CaseMethod1: PCR

      CaseMethod2: Sequencing

      CaseGenotypingMethod: “targeted genetic analyses by Sanger sequencing” for ALDH4A1 (no further details).

      Variant: Compound heterozygous, confirmed in trans (the patient’s son only has one of the variants) 1) NM_003748.3:c.62+1G>A, 2) NM_003748.3:c.349G>C (p.Asp117His)

      ClinVar: 1) N/A; 2) N/A

      CAID: 1) CA338769667; 2) CA338760898

      gnomAD: 1) Not in gnomAD; 2) Not in gnomAD

      VariantEvidence: No functional evidence for the missense change. Score: This patient is an adult with hyperprolinemia who is compound heterozygous for two variants in ALDH4A1, c.62+1G>A and c.349G>C (p.Asp117His). Neither variant is in gnomAD. Variants in PRODH have been ruled out.

    1. Case 3

      Case# Case 3, M, Chinese, 3day onset

      CasePresentingHPOs HP:0008344, HP:0001954, HP:0005972, HP:0011968, HP:0008947

      CasePreviousTesting Tested blood aa levels with liquid chromatography-mass spectrum spectrometry, several branched chain amino acids were overly abundant. Whole exome targeted capture sequencing was applied for the mutation screening of the suspicious patients. A total of 712 genes associated with inherited metabolic diseases were selected and their coding regions were captured.

      CaseMethod1 Whole Exome

      CaseMethod2 Sanger

      CaseGenotypingMethod validated whole exome findings with sanger and qPCR.

      Variant NM_000056.3:c.659del(p.D229fs)

      CAID CA658820635

      CaseAddInfo Mother was not tested but WES was used in the patient and father

    1. P39

      Case39: Female, Chinese, 3.4y (end of study)

      HPOsFreeText: 1y onset, poor neurological outcome

      NotHPOsFreeText: not responsive to vitamin B12

      Case39 (Level 2)


      CasePreviousTesting: same as group

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.1741C>T (p.Arg581Ter)

      ClinVar: 554675

      CAID: CA364395893

      gnomAD: n/a


      CaseAddInfo: one variant, not homozygous.

    2. P40

      Case40: Female, Chinese, 2.1y (end of study)

      HPOsFreeText: 8 mo onset, poor neurological outcome

      NotHPOsFreeText: not responsive to vitamin B12

      Case40 (Level 2)


      CasePreviousTesting: same as group

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.1777G>T (p.Glu593Ter)

      ClinVar: 558328

      CAID: CA364395728

      gnomAD: n/a


      Variant2: NM_000255.3:c.2179C>T (p.Arg727Ter)

      ClinVar: 218998

      CAID: CA347913

      gnomAD: 0.0001504 (East Asian)


      CaseAddInfo: variant 1 is novel. heterozygous mutations in trans

    3. P38

      Case38: Male, Chinese, 1.5y (end of study)

      HPOsFreeText: neonatal onset, poor neurological outcome

      NotHPOsFreeText: not responsive to vitamin B12

      Case38 (Level 2)


      CasePreviousTesting: same as group

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.1741C>T (p.Arg581Ter)

      ClinVar: 554675

      CAID: CA364395893

      gnomAD: n/a


      CaseAddInfo: one variant, not homozygous.

    4. P37

      Case37: Female, Chinese, 5.8y (end of study)

      HPOsFreeText: 3y onset

      NotHPOsFreeText: normal cognitive and motor development without further episodes of metabolic decompensation, not responsive to vitamin B12

      Case37 (Level 2)


      CasePreviousTesting: same as group

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.1677-1G>A (p.=)

      ClinVar: 550012

      CAID: CA3846767

      gnomAD: 0.0003511 (East Asian)


      CaseAddInfo: one variant, not homozygous

    5. P36

      Case36: Female, Chinese, 9.3(end of study)

      NotHPOsFreeText: asymptomatic, no onset

      Case36 (Level 2)


      CasePreviousTesting: NBS

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.1630_1631delGGinsTA (p.Gly544Ter)

      ClinVar: 203860

      CAID: CA312786

      gnomAD: 0.0001088 (East Asian)


      Variant2: NM_000255.3:c.1943G>A (p.Gly648Asp)

      ClinVar: n/a

      CAID: CA3846709

      gnomAD: 0.0001087 (East Asian)

      CaseAddInfo: heterozygous mutations in trans, but no symptoms. identical twin to Case35/P35.

    6. P35

      Case35: Female, Chinese, 9.3y (end of study)

      NotHPOsFreeText: asymptomatic, no onset

      Case35 (Level 2)


      CasePreviousTesting: NBS

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.1630_1631delGGinsTA (p.Gly544Ter)

      ClinVar: 203860

      CAID: CA312786

      gnomAD: 0.0001088 (East Asian)


      Variant2: NM_000255.3:c.1943G>A (p.Gly648Asp)

      ClinVar: n/a

      CAID: CA3846709

      gnomAD: 0.0001087 (East Asian)

      CaseAddInfo: heterozygous mutations in trans, but no symptoms. identical twin to Case36/P36.

    7. P34

      Case34: Male, Chinese, 5.5y (end of study)

      HPOsFreeText: 2 mo onset, poor neurologic outcome

      NotHPOsFreeText: not responsive to vitamin B12

      Case34 (Level 2)


      CasePreviousTesting: same as group

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.1630_1631delGGinsTA (p.Gly544Ter)

      ClinVar: 203860

      CAID: CA312786

      gnomAD: 0.0001088 (East Asian)


      Variant2: NM_000255.3:c.1880A>G (p.His627Arg)

      ClinVar: 551830

      CAID: CA3846719

      gnomAD: 0.00002639 (European non-Finnish)

      CaseAddInfo: heterozygous mutations in trans

    8. P33

      Case33: Male, Chinese, 1.8y (end of study)

      HPOsFreeText: Neonatal development

      NotHPOsFreeText: normal cognitive and motor development without further episodes of metabolic decompensation, not responsive to vitamin B12

      Case33 (Level 2)


      CasePreviousTesting: same as group

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.1280G>A (p.

      ClinVar: 218990

      CAID: CA347873

      gnomAD: 0.0004011 (East Asian)


      CaseAddInfo: one variant, not homozygous

    9. P31

      Case31: Male, Chinese, 3.7y (end of study)

      HPOsFreeText: neonatal onset, poor neurological outcome

      NotHPOsFreeText: not responsive to vitamin B12

      Case31 (Level 2)


      CasePreviousTesting: same as group

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.1106G>A (p.Arg369His)

      ClinVar: 203846

      CAID: CA312764

      gnomAD: 0.0001504 (East Asian)

      CaseAddInfo: one variant, not homozygous.

    10. P30

      Case30: Male, Chinese, 1 mo (age at death)

      HPOsFreeText: neonatal onset

      NotHPOsFreeText: not responsive to vitamin B12

      Case30 (Level 2)


      CasePreviousTesting: same as group

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.925T>G (p.Trp309Gly)

      ClinVar: n/a

      CAID: CA364401026

      gnomAD: n/a


      Variant2: NM_000255.3:c.1630_1631delGGinsTA (p.Gly544Ter)

      ClinVar: 203860

      CAID: CA312786

      gnomAD: 0.0001088 (East Asian)


      CaseAddInfo: heterozygous mutations in trans, died at 1 mo

    11. P32

      Case32: Male, Chinese, 1.8y (end of study)

      HPOsFreeText: neonatal onset, poor neurological outcome

      NotHPOsFreeText: not responsive to vitamin B12

      Case32 (Level 2)


      CasePreviousTesting: same as group

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.1280G>A (p.

      ClinVar: 218990

      CAID: CA347873

      gnomAD: 0.0004011 (East Asian)


      Variant2: NM_000255.3:c.1677-1G>A (p.=)

      ClinVar: 550012

      CAID: CA3846767

      gnomAD: 0.0003511 (East Asian)


      CaseAddInfo: heterozygous mutations in trans

    12. P29

      Case29: Male, Chinese, 3.2 y (end of study)

      HPOsFreeText: neonatal onset, poor neurological outcome

      NotHPOsFreeText: not responsive to vitamin B12

      Case29 (Level 2)


      CasePreviousTesting: NBS

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.755dupA (p.His252GlinfsTer6)

      ClinVar: n/a

      CAID: CA3847037

      gnomAD: 0.0001090 (East Asian)


      Variant2: NM_000255.3:c.1741C>T (p.Arg581Ter)

      ClinVar: 554675

      CAID: CA364395893

      gnomAD: n/a


      CaseAddInfo: heterozygous mutations in trans

    13. P28

      Case28: Male, Chinese, 6.8y (end of study)

      HPOsFreeText: neonatal onset, poor neurological outcome

      NotHPOsFreeText: not responsive to vitamin B12

      Case28 (Level 2)


      CasePreviousTesting: same as group

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.754-1G>A (p.=)

      ClinVar: n/a

      CAID: CA364402849

      gnomAD: n/a


      Variant2: NM_000255.3:c.1061C>T (p.Ser354Phe)

      ClinVar: n/a

      CAID: CA364400211

      gnomAD: n/a


      CaseAddInfo: heterozygous mutations in trans.

    14. P27

      Case27: Male, Chinese, 1.8y (end of study)

      HPOsFreeText: neonatal onset, poor neurological outcome

      NotHPOsFreeText: not responsive to vitamin B12

      Case27 (Level 2)


      CasePreviousTesting: same as group

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.729_730insTT (p.Asp244LeufsTer?)

      ClinVar: 552079

      CAID: CA3847064

      gnomAD: 0.0002008 (East Asian)


      CaseAddInfo: one variant, not homozygous.

    15. P26

      Case26: Female, Chinese, 6.6y (end of study)

      HPOsFreeText: responsive to vitamin B12

      NotHPOSFreeText: asymptomatic, no onset

      Case26 (Level 2)


      CasePreviousTesting: NBS

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_000255.3:c.729_730insTT (p.Asp244LeufsTer?)

      ClinVar: 552079

      CAID: CA3847064

      gnomAD: 0.0002008 (East Asian)


      CaseAddInfo: one variant, not homozygous. asymptomatic.

    1. II. 1

      CaseBII-1: N/A

      CasePresentingHPOs: N/A

      HPOsFreeText: Pretreatment phenylalanine level at 890 umol/L

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: Proband for Family B

      Variant1: NM_000277.3(PAH):c.1222C>T (p.Arg408Trp)

      ClinVar: 577 https://www.ncbi.nlm.nih.gov/clinvar/variation/577/

      gnomAD: 0.001766, https://gnomad.broadinstitute.org/variant/12-102840493-G-A?dataset=gnomad_r3

      Variant2: NM_000277.3(PAH):c.1241A>G (p.Tyr414Cys)

      ClinVar: 593 https://www.ncbi.nlm.nih.gov/clinvar/variation/593/

      gnomAD: 0.0005264, https://gnomad.broadinstitute.org/variant/12-102840474-T-C?dataset=gnomad_r3

    2. II.2

      CaseEII-2: N/A

      CasePresentingHPOs: N/A

      HPOsFreeText: Pretreatment phenylalanine level at 320 umol/L

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: N/A

      Variant1: NM_000277.3(PAH):c.1222C>T (p.Arg408Trp)

      ClinVar: 577 https://www.ncbi.nlm.nih.gov/clinvar/variation/577/

      gnomAD: 0.001766, https://gnomad.broadinstitute.org/variant/12-102840493-G-A?dataset=gnomad_r3

      Variant2: NM_000277.3(PAH):c.533A>G (p.Glu178Gly)

      ClinVar: 92746 https://www.ncbi.nlm.nih.gov/clinvar/variation/92746/

      gnomAD: 0.0001473, https://gnomad.broadinstitute.org/variant/12-103249087-T-C

    1. 12258M19866 years726<0.5Intermediate?S97fs

      Case# Patient 12, Male, Turkish, 6yo diagnosis

      CasePresentingHPOs HP:0004923

      CasePreviousTesting screened for BH4 deficiency using dried blood and urine spots, Final di-agnosis was made by measurements of neurotransmitter and pterinmetabolites in cerebrospinal fluid (CSF) and urine, in addition toDHPR enzyme activity, which was assessed in whole red bloodcells

      CaseMethod1 PCR

      CaseMethod2 DGGE

      Variant NM_000320.2:c.371delC(p.S97fs)

      CAID CA658795310

      VariantEvidence frameshift

    1. Family 8

      CaseFZ8: Male, United States, 3 yrs report

      CasePresentingHPOs: HP:0001511, HP:0008897, HP:0001999, HP:0000973, HP:0100678, HP:0000963, HP:0010648, HP:0001388, HP:0001374, HP:0001181, HP:0000938, HP:0000270, HP:0025356, HP:0001252, HP:0000518, HP:0000325, HP:0011220, HP:0000337, HP:0000411, HP:0000369, HP:0100790, HP:0005116, HP:0000717, HP:0008872, HP:0000486, HP:0500163, HP:0003572, HP:0500139 (Intrauterine growth retardation, Postnatal growth retardation, Abnormal facial shape, Cutis laxa, Premature skin wrinkling, Thin skin, Dermal translucency, Joint laxity, Congenital hip dislocation, Adducted thumb, Osteopenia, Delayed cranial suture closure, Psychomotor retardation, Muscular hypotonia, Cataract, Triangular face, Prominent forehead, Broad forehead, Protruding ear, Low-set ears, Hernias, Arterial tortuosity, Autism, Feeding difficulties in infancy, Strabismus, Hypoornithinemia, Low plasma citrulline, Hypoprolinemia)

      HPOsFreeText: Typical facial gestalt

      CaseNotHPOs: HP:0002645, HP:0012443, HP:0001762, HP:0002650, HP:0000252, HP:0001348 (Wormian bones, Abnormality of brain morphology, Talipes equinovarus, Scoliosis, Microcephaly, Brisk reflexes)

      NotHPOsFreeText: N/A

      CaseAddInfo: Variant is confirmed de novo in this case with one other confirmed and one non-confirmed case with the same variant and similar presentation, No family history

      CasePreviousTesting: N/A

      CaseGenotypingMethod: ALDH18A1 and PYRC1 were investigated by Sanger sequencing, with the latter revealing no abnormalities and the former showing a heterozygous change at the Arg138 residue.Investigation revealed no further variants in the coding regions. Familial sequencing revealed the inheritance was de novo with no variants in the parents.

      Variant: NM_002860.4(ALDH18A1):c.413G>A (p.Arg138Gln)

      ClinVar: 217260 https://www.ncbi.nlm.nih.gov/clinvar/variation/217260/

      gnomAD: Not in gnomAD

    1. Patient K.A. (BIODEF 264)

      Case: K.A./ BIODEF 264, male, Caucasian, 1 day

      CasePresentingHPOs:  HP:0008297, HP:0040206, HP:0040210, HP:0001252

      HPOText: Plasma Phe level of 290umol/L at 3 days old, 853 umol/L at 6 days old, and 1997 umol/L at 13 days old. Urinary pterins indicated high neopterin/biopterin ratio and increased levels of primapterin. At 1 month old, neopterin and biopterin levels in normal range. At one month old showed mild hypotonia (extermities and trunk), but at 2.5 years Phe diet stopped and patient developed normally.

      CasePreviousTesting: n/a

      CaseGenotypingMethod: Direct nucleotide-sequence determination of PCR products from blood samples was performed for the coding exons (2-4) of PCBD1.

      Variant: NM_000281.3(PCBD1):c.292C>T (p.Gln98Ter)

      ClinVar ID: 16799

      No-stars, 1 submission from OMIM.

      Homozygous, non-LOF.

      gnomAD: MAF (Euro-NF)= 2.2291E-4 (29/126606) hets only. No homozygotes recorded

      http://gnomad.broadinstitute.org/variant/10-72643730-G-A

      AddCaseInfo: The only individual in the family diagnosed with HyperPhe.

      VariantEvidence: The mutant Q97X protein was expressed in E.Coli to determine the solubility of the mutant enzyme and the activity. The mQ97X fragment was mostly found in the insoluble fraction of the supernatant. The remaining fraction obtained in the soluble fraction did retain some activity in vitro. Interestingly, when more Q97X was obtained in the soluble fraction (by growing the E.coli at 20 degrees C), the Km (Michaelis constant) was 2-3 times higher than wildtype (text only, no figures to compare).

      Patient part of the BIODEF database: PMID:8830181

    2. Patient I.B. (BIODEF 273)

      Case: I.B./ BIODEF 273, male, Ashkenazi Jewish, 3 days

      CasePresentingHPOs: HP:0040210, HP:0008297,

      HPOText: Plasma Phe levels were 240 umol/L at 3 days old, and 1845 umol/L at 14 days old. A low-Phe diet caused a rapid decline of Phe level to normal within 36 hours. An oral BH4–loading test (10 mg/kg body weight) resulted in a decrease of plasma Phe from 540 μmol/liter to 234 μmol/liter and then to 196 μmol/liter within 4 and 8 h, respectively. At 1 month, pterin and neurotransmitter in the CSF were normal. Starting a 2 month of age the patient was administered a low Phe diet and BH4 for 4 months. After the 4 months, the BH4 was discontinued, and Phe levels are between 120-300 umol/L at 5 years. Patient is developing normally.

      CaseNOTHPOs: n/a

      CasePreviousTesting: n/a

      CaseGenotypingMethod: Direct nucleotide-sequence determination of PCR products from blood samples was performed for the coding exons (2-4) of PCBD1.

      Variant: NM_000281.3(PCBD1):c.259G>T (p.Glu87Ter) 

      ClinVar ID: 16795

      No star, one submission for OMIM

      Homozygous

      gnomAD: MAF (Ashkenazi Jewish)= 1.183E-3 (12/10146) in heterozygous only. No homozygous reported.

      http://gnomad.broadinstitute.org/variant/10-72643763-C-A

      AddCaseInfo: The proband's older sister (J.B., 18 . months older) has the same genotype (homozygous for the T79I mutation), but was never noted as having HyperPhe, and was never treated. She has developed "normally." This family is recorded as Family B in the paper.

      VariantEvidence: The mutant E86X/E87X protein was expressed in E.Coli to determine the solubility of the mutant enzyme and the activity. The mutant E86X/E87X fragment was mostly found in the insoluble fraction of the supernatant. The remaining fraction obtained in the soluble fraction did retain some enzyme activity in vitro. Interestingly, when more E86X/E87X was obtained in the soluble fraction (by growing the E.coli at 20 degrees C), the Km (Michaelis constant) was similar to wildtype levels (text only, no figures to compare).

      Patient part of the BIODEF database: PMID:8830181

    1. Biallelic

      Case#: Patient 10, male, 5.9 years (report)

      CaseHPOs: HP:0003235 (hypermethioninemia)

      CaseHPOsFreeText: Identified by newborn screening

      CaseNotHPOsTest: Normal neurologic and/or muscular status, IQ 111

      CasePreviousTesting: Plasma methionine 484-742; transamination products in plasma 5.01-6.21 uM (normal 0.2-0.54) and in urine 45.2-75.6 mmol/mol creatinine (normal 1.2-4.6), urine dimethylsuphide 10 nM (normal – trace-2 nM).

      Variant: p.Arg199Cys (homozygous)

      ClinVar: N/A

      CAID: CA5576749

      gnomAD: The highest population minor allele frequency in gnomAD is 0.0001735 (Latino); no homozygotes in any population.

      VariantEvidence: When the variant was expressed in bacteria, the amount of MAT1A protein was reduced on Western blot, and MAT1A activity was 11% of normal.

      CasePMIDs: 7573050

      Points: 1 point. This individual is homozygous for a missense change, p.Arg199Cys, in MAT1A. When the variant was expressed in bacteria, the amount of MAT1A protein was reduced on Western blot, and MAT1A activity was 11% of normal. The highest population minor allele frequency in gnomAD is 0.0001735 (Latino); no homozygotes in any population.

    1. c.1A > T

      Case# PB1, Saudi Arabia

      CasePresentingHPOs HP:0000707, HP:0003011, HP:0025031, HP:0001939, HP:0002715

      CasePreviousTesting Blood spot newborn screen/presented symptoms in Hospital

      CaseMethod1 PCR

      CaseGenotypingMethod PCR of coding exons of BCKDHA (9 exons), BCKDHB (11 exons) DBT (11 exons) and DLD (14 exons).

      Variant NM_000056.3:c.1A>T

      CAID CA364657845

      gnomAD 0.00003656 (European (Non-Finnish)), 0.00001346 (Overall)

      VariantEvidence none

      CaseAddInfo consanguineous family

    1. Clinical data

      Case#: Guo 2015 Proband, M, 18 months (onset), Chinese

      CasePresentingHPOs: HP:0002329, HP:0011968, HP:0002317, HP:0012088, HP:0001946

      Onset of symptoms upon episode of fever. Slightly reduced muscle tension. Second episode 2 months later and plasma amino acid analysis was performed: 431.67 umol/L leucine (normal 4.2-367), 167.13 umol/L isoleucine (normal 26.9-146), 47.81 umol/L valine (normal 117.6-495.7), 44.88 umol/L alloisoleucine (normal 0-7.7).

      CaseNotHPOs: HP:0002373, HP:0002013, HP:0002361

      CaseGenotyping Method: BCKDHA, BCKDHB, DBT, and DLD were screened for mutations using second generation sequencing. Direct sequencing was performed on the parents to confirm variants.

      Variant: 1. NM_000056.3:c.767A>G (p.Y256C); 2. NM_000056.3:c.768C>G (p.Y256X)

      CAID: 1. CA364659935; 2. CA142287564

      gnomAD: 1. 4.069e-6 overall

    1. 2DBT

      Case#: Patient 2, Lebanon, Arab

      CasePresentingHPOs: Intermediate form of MSUD

      CasePreviousTesting: Previously diagnosed with MSUD by GC/MS/MS.

      CaseMethod1: PCR

      CaseMethod2: Sequencing

      CaseGenotypingMethod: Genomic DNA extracted, sequencing of BCKDHA, BCKDHB and DBT.

      Variant: NM_001918.3:c.224G>A (homozygous)

      CAID: CA341345382

      gnomAD: Not in gnomAD

      VariantEvidence: Mutation is present in lipoyl-binding domain, likely preventing binding of the lipoyl co-factor. Possibly results in a defect in the lipoyl-binding function (Alamut software analysis).

      CaseAddInfo: Same variant reported in patient 1 from the same geographical location, but unrelated according to the authors.

    1. 54

      Case54 Male, 7.3yo report, Ethnicity: Turkish

      CasePresentingHPOs HP:0003571, HP:0008872, HP:0002013, HP:0008947, HP:0002789, HP:0002045

      (propionicacidemia, feeding difficulties in infancy, vomiting, infantile hypotonia, tachypnea, hypothermia)

      HPOsFreeText feeding difficulties, vomiting, hypotonia, tachypnea, hypothermia(3do). 55 IQ on Culture Free Test

      CaseNotHPOs n/a

      CasePreviousTesting Diagnosis by selective metabolic screen. Patient fibroblasts had 1.5% PCC activity of control

      Variant NM_000532.4(PCCB):c.990dupT (p.Glu331Terfs), homozygous

      ClinVar 167423

      gnomAD MAF= 0.001001(African), no homozygotes

      CaseAddInfo parental consanguinity

      CasePMIDs n/a

    1. Table 1:

      Case6: Female, 16 days at initiation of follow up, European ancestry

      HPOsFreeText: NBS C4-acylcarnitine 2.0 umol/L, Plasma C4-acylcarnitine 1.36 umol/L, in vitro probe isoC4-acylcarnitine 0.160 umol/g protein, in vitro probe C4-acylcarnitine 0.150 umol/g protein, urine c4 acylcarnitine 19.13 mmol/mol creatinine, urine C4/C3 ratio 101

      CaseNotHPOs: normal urine isobutyryglycine

      CaseAddInfo: no data for clinical condition or SCAD gene variants

      Case6 (Level 2)


      CasePreviousTesting: same as group

      CaseMethod1: same as group

      CaseMethod2: same as group

      CaseGenotypingMethod: same as group


      Variant1: NM_014384.2(ACAD8):c.958G>A (p.Ala320Thr)

      ClinVar: 372297

      CAID: CA6373180

      gnomAD: 0.001725 (European Finnish)


      Variant2: NM_014384.2(ACAD8):c.1129G>A (p.Gly377Ser)

      ClinVar: 5356

      CAID: CA117435

      gnomAD: 0.0001551 (European non-Finnish)


      CaseAddInfo: compound heterozygote, specified allele 1 and 2 but not maternal and paternal. no potential splice site alteration

    1. 4

      Case4 Female, 9yo report, USA, Lumbee

      CasePresentingHPOs HP:0003150, HP:0011471, HP:0002540, HP:0001344, HP:0100309, HP:0012751, HP:0200147, HP:0100952

      (Glutaricaciduria, Gastronomy tube feeding in infancy, Non-ambulatory, Nonverbal, Subdural haematoma, Abnormal basal ganglia MRI signal intensity, Neuronal loss in basal ganglia, Enlarged sylvian fissure)

      HPOsFreeText Urine glutaric acid was highly elevated and 3-hydroxyglutaric acid was elevated. Patient presented with acute metabolic decompensation at 6mo. After decompensation, brain MRI found subdural hematomas, atrophied temporal lobes with widened Sylvian fissures, and elevated signal intensity in basal ganglia. Follow-up report studies noted volume loss in basal ganglia. Patient was diet restricted in lysine and tryptophan with per individual adjustments to maintain normal plasma amino acid levels. Treatment also included supplemental carnitine and riboflavin.

      CaseNotHPOs n/a

      NotHPOsFreeText n/a

      CasePreviousTesting n/a

      CaseMethod1 PCR

      CaseMethod2 Sanger

      CaseGenotypingMethod PCR and sanger sequencing was performed on exon 10 of the GCDH gene.

      Variant NM_000159.3(GCDH):c.1240G>A (p.Glu414Lys), homozygous

      ClinVar 167133

      gnomAD MAF=0.0002017(African), no homozygotes

      CaseAddInfo nonconsanguineous

      CasePMIDs n/a

    1. AHN3.4

      CaseAHN3.4: Australia, White

      CasePresentingHPOs: HP:0008353 (Neutral hyperaminoaciduria)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: Variants segregate with the disease

      CasePMIDs: 15286788

      CasePreviousTesting: Hartnup aminoaciduria profile was confirmed by ion exchange high performance liquid chromatography

      CaseGenotypingMethod: All SLC6A19 exons and flanking introns were directly amplified and sequenced from genomic DNA.

      Variant1: NM_001003841.3:c.719G>A (p.Arg240Gln)

      CAID: CA3182844, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA3182844

      gnomAD: 0.0001307, https://gnomad.broadinstitute.org/variant/5-1213633-G-A

      Variant2: NM_001003841.3(SLC6A19):c.1701+1G>A

      ClinVar: 623442, https://www.ncbi.nlm.nih.gov/clinvar/variation/623442/

      gnomAD: 0.00005286, https://gnomad.broadinstitute.org/variant/5-1221429-G-A

    1. Proband

      CaseF3P: 4 yrs report, India

      CasePresentingHPOs: HP:0001010, HP:0000750, HP:0001249, HP:0006801, HP:0004923 (Hypopigmentation of the skin, Delayed speech and language development, Intellectual disability, Brisk deep tendon reflexes, Hyperphenylalaninemia)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: Family is consanguinous, Parents were confirmed heterozygous, Variant may not undergo NMD however would be missing essential domains (but PAH level supports some residual function)

      CasePreviousTesting: Blood phenylalanine before treatment was 439 μmol/l, Blood tyrosine before treatment was 121 μmol/l, PKU diagnosis was based on ferric chloride test on patient urine samples and detection of elevated Phenylalanine levels in blood samples by using HPLC, in addition to analysis of clinical features.

      CaseGenotypingMethod: Genomic DNA was isolated from blood samples of proband and family members. PCR amplification and sequencing was used to screen for mutations. Each mutation was confirmed by bi-directional DNA sequencing.

      Variant: NM_000277.3:c.976del (p.Trp326Glyfs*15)

      CAID: CA16020912 http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA16020912

      gnomAD: Not in gnomAD

    1. AM7162

      CaseAM7162: Female, 6 yrs report

      CasePresentingHPOs: HP:0001992, HP:0002179, HP:0010864, HP:0008936, HP:0002509, HP:0000750, HP:0011968, HP:0008872, HP:0100247, HP:0002373, HP:0001347, HP:0011449 (Organic aciduria, Opisthotonus, Severe Intellectual disability, Muscular hypotonia of the trunk, Limb hypertonia, Delayed speech and language development, Feeding difficulties, Feeding difficulties in infancy, Recurrent singultus, Febrile seizure, Hyperreflexia, Knee clonus)

      HPOsFreeText: Birth weight 2.86 kg, Cranial circumference is 49 cm (3rd percentile), weight 18.6 kg (25th percentile) and height 115 cm (50th percentile) at 6 yrs of age

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: Parents are first cousin consanguineous; Proband is confirmed homozygous for this variant via a QFM‐PCR assay for the dosage of ACY1 exons 12 and 13; Variant leads to skipping of Exon 13 and a resulting frameshift with a premature termination

      CasePreviousTesting: Urinary organic acid analysis confirmed by enzyme assay showed elevated levels of N ‐acetylated derivatives of glutamic acid, leucine, valine and isoleucine; Several genetic investigations, such as karyotyping, ring 15 chromosome analysis and mutational analysis of MECP5 and STXBP1 genes, were performed and were found to be normal; MRI showed dilatation of the left temporal horn at the age of 13 months;

      CaseGenotypingMethod: Genomic DNA was isolated and the ACY1 gene was PCR-amplified and sequenced. PCR analysis of retrotranscribed RNA was performed to analyze the effect of this variant on splicing.

      Variant: NM_000666.3(ACY1):c.1001_1001+5del

      ClinVar: 162019, https://www.ncbi.nlm.nih.gov/clinvar/variation/162019/

      gnomAD: 0.00001758, https://gnomad.broadinstitute.org/variant/3-52022618-ATGTGAG-A

    1. one male

      CaseWA: Male, 2 yrs onset, Germany

      CasePresentingHPOs: HP:0002013, HP:0012470, HP:0004372, HP:0002069, HP:0010819, HP:0007359, HP:0010845, HP:0002133, HP:0007979, HP:0000572, HP:0000577, HP:0000543, HP:0001263, HP:0001310, HP:0002075, HP:0002317, HP:0002188 (Vomiting, Setting-sun eye phenomenon, Lowered consciousness, Bilateral tonic-clonic seizure, Atonic seizure, Focal-onset seizure, EEG with generalised slow activity, Status epilepticus, Gaze-evoked horizontal nystagmus, Visual loss, Exotropia, Optic disc pallor, Global developmental delay, Dysmetria, Dysdiadochokinesis, Unsteady gait, Delayed CNS myelination)

      HPOsFreeText: Tonic flexion of the right limbs, The right hemisphere showed continuous spike and slow-spike waves with a temporo-occipital maximum

      CaseNotHPOs: HP:0010841 (Multifocal epileptiform discharges)

      NotHPOsFreeText: N/A

      CaseAddInfo: Parents are nonconsanguineous, Proband is confirmed homozygous via parental testing

      CasePreviousTesting: EEG showed severe cerebral dysfunction of the right hemisphere (continuous subdelta and delta activity); Antiepileptic treatment with phenobarbital was initiated after the first seizure but was replaced by levetiracetam after the second seizure

      CaseGenotypingMethod: Exome sequencing was performed and potential variants prioritized. Identified variants were selected for Sanger sequencing in both the proband and parents.

      Variant: NM_004171.4:c.1421+1G>C

      CAID: CA380121375, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA380121375

      gnomAD: Not in gnomAD

    1. Biallelic

      Case#: Patient 1, female, 25 years (report), German

      CaseHPOs: HP:0003235 (hypermethioninemia)

      CaseHPOsFreeText: Identified by newborn screening.

      CaseNotHPOsFreeText: Hepatic, vascular or neurological symptoms have never been noted, and cranial MRI was normal at the age of 20 years

      CasePreviousTesting: Over a period of 25 years, methionine concentrations ranged from 850 to 1100 µmol/L (normal 20–40), and fasting total plasma homocysteine was 30–45 µmol/L (normal 5–15).

      CaseMethod1: PCR

      CaseMethod2: Sequencing

      CaseGenotypingMethod: All 9 exons and intron-exon junctions of MAT1A were amplified by PCR from genomic DNA. This was followed by SSCP analysis and sequence analysis of PCR products with abnormal mobility.

      Variant: c.65C>T (p.Ser22Leu) (homozygous)

      ClinVar: N/A

      CAID: CA377364910

      gnomAD: The highest population minor allele frequency in gnomAD is 0.00002891 (Latino)

      VariantEvidence: When expressed in E. Coli, the variant resulted in reduction of methionine adenosyltransferase (MAT) and tripolyphosphatase (PPPase) activities to <50% of wild type (Fernandez-Irigoyn et al, 2010, PMID 20675163; Fig 2).

      CaseAddInfo: Parents are reported to be unrelated

      Points: 0.5

    1. Theproband

      CaseC: Male, Childhood onset, Asian, China

      CasePresentingHPOs: HP:0004923 (Hyperphenylalaninemia)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: Parents are confirmed heterozyogus and proband is homozygous for this mutation

      CasePreviousTesting: "Classical Severe PKU" presence confirmed by Guthrie test and clinical criteria described in PMID:7006308, Plasma phenylalanine level in excess of 20 mg/dl, Homozygous for RFLP haplotype 4

      CaseGenotypingMethod: PCR amplification of PAH exon three plus the flanking intronic regions was performed. The genomic DNA was cloned and sequenced to confirm the presence of the mutation. Haplotype analysis confirmed linkage disequillibrium with RFLP haplotype 4.

      Variant: NM_000277.3(PAH):c.331C>T (p.Arg111Ter)

      ClinVar: 581 https://www.ncbi.nlm.nih.gov/clinvar/variation/581/

      gnomAD: 0.0001230, https://gnomad.broadinstitute.org/variant/12-103288534-G-A

    1. t

      CaseSE4: Male, Australia

      CasePresentingHPOs: HP:0008353 (Neutral hyperaminoaciduria)

      HPOsFreeText: N/A

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseGenotypingMethod: Five loci were investigated for evidence of linkage to Hartnup due to their established role in amino acid transport including SLC3A2, SLC7A8, SLC1A5, SLC6A18, and SLC6A19. These 5 regions were studied with microsattelite markers and produced linkage only between D5S392 and D5S417, the region with SLC6A18 and 19. SLC6A18 did not increase neutral amino acid uptake in X. laevis oocytes so SLC6A19 was investigated and directly sequenced in the families each of which displayed a causal variant.

      CasePreviousTesting: SLC1A5 had no causative variants detected.

      CaseAddInfo: Asymptomatic except for hyperaminoaciduria

      Variant: NM_001003841.3(SLC6A19):c.517G>A (p.Asp173Asn)

      ClinVar: 2019 https://www.ncbi.nlm.nih.gov/clinvar/variation/2019/

      gnomAD: 0.003016, https://gnomad.broadinstitute.org/variant/5-1212453-G-A?dataset=gnomad_r2_1

    1. 2927 (F)

      Case2927: Female, 2 years diagnosis, Czech

      CasePresentingHPOs: HP:0001270, HP:0001263, HP:0003153, HP:0012443, HP:0000486, HP:0012795, HP:0000639, HP:0000545, HP:0000646, HP:0002280, HP:0030890, HP:0000488, HP:0001744 (Motor delay, Global developmental delay, Cystathioninuria, Abnormality of brain morphology, Strabismus, Abnormality of the optic disc, Nystagmus, Myopia, Amblyopia, Enlarged cisterna magna, White matter hyperintensity, Retinopathy, Splenomegaly)

      HPOsFreeText: Normal total homocysteine (7.1 μM/l; reference 5.1–13.9), Elevated cystathionine (6 μM/l; reference 0.04–0.34), Normal total cysteine (306 μmol/l; reference 203–369), Birth weight was 2400 g, Responsive to B6 treatment

      CaseNotHPOs: HP:0002240, HP:0001977 (Hepatomegaly, Abnormal thrombosis)

      NotHPOsFreeText: N/A

      CaseAddInfo: Patient is homozygous for this mutation

      CasePreviousTesting: Cystathionine (Cysta), total cysteine (tCys), and total homocysteine (tHcy) panels

      CaseGenotypingMethod: PCR amplification of CTH coding regions and exon-intron boundaries was performed. These fragments were sequenced and aligned with a reference to find mutations. Those found were confirmed by restriction digest of 100 controls.

      Variant: NM_001902.5:c.200C>T (p.Thr67Ile)

      ClinVar: 2939 https://www.ncbi.nlm.nih.gov/clinvar/variation/2939/

      gnomAD: Ashkenazi Jewish 9.934e-3, Overall 6.308e-3 https://gnomad.broadinstitute.org/variant/1-70881670-C-T

    1. AC013 II-1

      CaseAC013_II-1: Female, 7 yrs report, Turkey

      CasePresentingHPOs: HP:0001992, HP:0001249, HP:0004322, HP:0001513, HP:0030838 (Organic aciduria, Intellectual disability, Short stature, Obesity, Hip pain)

      HPOsFreeText: BMI 93rd percentile

      CaseNotHPOs: N/A

      NotHPOsFreeText: N/A

      CaseAddInfo: Parents are consanguineous, Proband is asserted homozygous for this variant

      CasePreviousTesting: Identified by the assessment of urinary organic acids by gas chromatography–mass spectrometry; Accumulation of N-acetylated amino acids was much less pronounced than in previously reported patients; Metabolic studies were initiated after the patient complained of pain in her left hip

      CaseGenotypingMethod: Genomic DNA was extracted either from peripheral blood or EBV-transformed lymphocytes. PCR-amplification and bidirectional sequencing of all exons and exon-intron boundaries of ACY1 was performed.

      Variant: NM_000666.3(ACY1):c.1133G>A (p.Arg378Gln)

      ClinVar: 809490, https://www.ncbi.nlm.nih.gov/clinvar/variation/809490/

      gnomAD: 0.003104, https://gnomad.broadinstitute.org/variant/3-52022997-G-A

    1. 6

      Patient6: Male, 8yo

      CasePresentingHPOs: HP:0002572 (episodic vomiting)

      HPOsFreeText: chronic intermittent IVA, 3 monthly attacks of cyclic vomiting, treated with IVA special formula, elevated isovalerylglycine, C5-carnitine = 9.06 µmol/l

      CaseNotHPOs:

      NotHPOsFreeText:

      CaseAddInfo: symptom onset at 6mo, diagnosis at 72mo via clinical presentation, consanguineous family

      CasePMIDs:

      CasePreviousTesting: same as group

      CaseGenotypingMethod: same as group

      Variant1: NM_002225.3(IVD):c.465+2T>C

      ClinVar: 94055, https://www.ncbi.nlm.nih.gov/clinvar/variation/94055/

      gnomAD: 0.00001991, https://gnomad.broadinstitute.org/variant/15-40702998-T-C

      Variant2: NC_000015.9:g.40699940T>C (NM_002225.4(IVD):c.234+14C=)

      CAID: CA147572, http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/allele?hgvs=NC_000015.9%3Ag.40699940T%3EC

      ClinVar: 94053, https://www.ncbi.nlm.nih.gov/clinvar/variation/94053/

      gnomAD: 0.6830, https://gnomad.broadinstitute.org/variant/15-40699940-T-C