PatientID: N/A

KindredID: 1

Case: F, 42Y0M, Ethnicity Unknown

DiseaseAssertion: VHL

FamilyInfo: Her mother and children have VHL.

CasePresentingHPOs: HP:0009713, HP:0010797, HP:0002666, HP:0030405, HP:0100684 (spinal hemangioblastoma, hemangioblastoma, pheochromocytoma, pancreatic endocrine tumour, salivary gland neoplasm)

CaseHPOFreeText: Patient presented with right sided neck mass that had been causing discomfort for two months. MRI showed a 9-mm rim-enhancing lesion in the right parotid that prompted consideration of malignancy. A parotidectomy revealed a well-demarcated 0.7-cm cyst filled with thick, white to translucent, mucoid material. Histologic examination demonstrated that the cystic tumor with an invasive but well-circumscribed border. The majority of the neoplasm was cystic, and there was no necrosis, appreciable mitotic activity, or cellular pleomorphism or anaplasia, indicative of a low-grade mucoepidermoid carcinoma. She previously had surgical excision of hemangioblastomas of the brain and spinal cord as well as resection of a pheochromocytoma of the left adrenal gland. Additionally, she also had been followed for 2 small pancreatic nodules that were subsequently found to be neuroendocrine tumors. The patient ended up requiring a partial pancreatectomy for a pancreatic neuroendocrine tumour related to her VHL disease.

CaseNotHPOs: N/A

CaseNotHPOFreeText: N/A

CasePreviousTesting: N/A

PreviouslyPublished: N/A

SupplementalData: N/A

Variant: p.T105M(c.314C>T)

LegacyVariant: N/A

CaseProblemVariantFreeText: Only the protein change was provided in the paper.

ClinVarID: 1057750 https://www.ncbi.nlm.nih.gov/clinvar/variation/1057750/?new_evidence=false

CAID: N/A

gnomAD: 0.000004545 https://gnomad.broadinstitute.org/variant/3-10183845-C-T

VariantEvidence: N/A

MutationType:missense_variant;transition

CivicName:T105M(c.314C>T)

MultipleGeneVariants: Germline, VHL, c.500G>A (p.Arg167Gln)

Case 3: 32 y.o. female, study ID UZ002 in supplemental table

DiseaseAssertion: type 2B VWD presequencing, type 2B Malmo/New York VWD postsequencing

FamilyInfo:

ParentalGenotype(s):

CasePresentingHPOs:

CaseHPOFreeRext: vWF:Ag (%) = 51; vWF:GPIbR (%) = 30; Act/Ag ratio = 0.59; FVIII:C (%) = 48; Platelets (x10^9/L) = 264

CaseNOTHPOs:

CaseNOTHPOFreeText:

CasePreviousTesting: The Thrombosis-Hemostasis gene panel test used whole exome sequencing and included 99 diagnostic-grade genes (table 1 in PMID:36696193)

GenotypingMethod:WES using the coagulation subpanel of the UZ Leuven Thrombosis-Haemostasis gene panel test. WES was performed on the sequencing platform NovaSeq 6000 (Illumina), and Alissa Interpret software v5.2-5.4 (Agilent) was used for variant interpretation. Assessment of copy number variation was validated within the bioinformatics pipeline. The American College of Medical Genetics and Genomics and the Association of Molecular Pathology guidelines were used to classify variants as pathogenic (P), likely pathogenic (LP), a variant of uncertain significance (VUS), or (likely) benign (LB, B) variants

PreviouslyPublished:

Gene: VWF

Variant: c.3797C>T p.Pro1266Leu

HGVS:

ClinVarID: 314

CAID:

gnomAD: 0.0006678 (1077/1612852) 2 homozygotes https://gnomad.broadinstitute.org/variant/12-6019621-G-A?dataset=gnomad_r4

Case: IP #1 in type U VWD sub-cohort

DiseaseAssertion: unclassified VWD

FamilyInfo:

ParentalGenotype(s):

CasePresentingHPOs:

CaseHPOFreeRext: VWF:Ag [IU/dL] = 17; VWF:Ac [IU/dL] = 13; FVIII:C [IU/dL] = 49

CaseNOTHPOs:

CaseNOTHPOFreeText:

CasePreviousTesting:

GenotypingMethod: Sequence variations in the VWF were identified through direct sequencing, while the detection of large rearrangements utilized the multiplex ligation-dependent probe amplification (MLPA) technique or assessed copy number variations (CNVs). Sanger sequencing methodology was applied for VWF analysis in patients investigated prior to 2016 (approximately 14% of IPs), whereas next-generation sequencing (NGS) was employed for the analysis of VWF in patients inspected from 2017 onwards (about 86% of IPs). In both strategies, the entire VWF, encompassing all 52 exons, intron/exon boundaries, and promoter regions, was analyzed.

PreviouslyPublished:

Gene: VWF

Variant: c.2435del p.Pro812Argfs*31

HGVS:

ClinVarID: 303

CAID:

gnomAD: 0.00007187 (116 in 1613916) no homozygotes https://gnomad.broadinstitute.org/variant/12-6044297-CG-C?dataset=gnomad_r4

MultipleGeneVariants:

Gene: VWF

Variant: c.3797C>T p.Pro1266Leu

ClinVarID: 314

gnomAD: 0.0006678 (1077 in 1612852) 2 homozyogotes https://gnomad.broadinstitute.org/variant/12-6019621-G-A?dataset=gnomad_r4

Case: Patient 3 (Family B), male, 55yo

DiseaseAssertion: VWD2B

FamilyInfo: NA

ParentalGenotype(s): NA

CasePresentingHPOs: HP:0030129, HP:0030130, HP:0011871, HP:0012147

(impaired ristocetin cofactor assay activity, Impaired von Willebrand factor collagen binding activity, Impaired RIPA, Reduced quantity of VWF)

CaseHPOFreeText: blood group O, Platelet count x103/μl = 204, PFA 100 sec = >300, SPA % = 0, MADR mg/mL = 0.45, VWF:Ag U/dL = 23.4, VWF:CB U/dL = 21.1, VWF:CB ratio = 0.9, VWF:RCo U/dL = 17.2, VWF:RCo ratio = 0.74, Platelet VWF U/dL = 42.6, FVIII U/dL = 60.5, BAT F/M = 20

CaseNOTHPOs:

CaseNOTHPOFreeText:

CasePreviousTesting: NA

GenotypingMethod: Sequencing of exon 28 of VWF

PreviouslyPublished: NA

Gene: VWF

Variant 1: c.3797C>T (p.Pro1266Leu)

HGVS: NM_000552.4(VWF):c.3797C>T (p.Pro1266Leu)

ClinVarID: 314; https://www.ncbi.nlm.nih.gov/clinvar/variation/314/

CAID: NA

gnomAD: MAF = 0.003667 (92/25086 alleles; 1 homozygote) in the European (Finnish) population; https://gnomad.broadinstitute.org/variant/12-6128787-G-A?dataset=gnomad_r2_1

Variant 2: c.7085G>T (p.Cys2362Phe)

HGVS: NM_000552.4(VWF):c.7085G>T (p.Cys2362Phe)

ClinVarID: 315; https://www.ncbi.nlm.nih.gov/clinvar/variation/315/

CAID: NA

gnomAD: absent

Case: 2B-8

DiseaseAssertion: VWD2B

FamilyInfo:

ParentalGenotype(s):

CasePresentingHPOs: AcuStar RCo/Ag = 0.99; AcuStar CB/Ag = 1.35; ELISA CB/Ag = 1.02

CaseHPOFreeText:

CaseNOTHPOs:

CaseNOTHPOFreeText:

CasePreviousTesting:

GenotypingMethod: not described

PreviouslyPublished: 16985174

Gene: VWF

Variant: c.3797C>T (p.Pro1266Leu)

HGVS: NM_000552.5(VWF):c.3797C>T (p.Pro1266Leu)

ClinVarID: 314; https://www.ncbi.nlm.nih.gov/clinvar/variation/314/?new_evidence=false

CAID:

gnomAD: MAF (European, Finnish) = 0.003667; 1 homozygote; https://gnomad.broadinstitute.org/variant/12-6128787-G-A