<?xml version="1.0" encoding="UTF-8"?><xml><records><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Khayat, Michael M</style></author><author><style face="normal" font="default" size="100%">Li, He</style></author><author><style face="normal" font="default" size="100%">Chander, Varuna</style></author><author><style face="normal" font="default" size="100%">Hu, Jianhong</style></author><author><style face="normal" font="default" size="100%">Hansen, Adam W</style></author><author><style face="normal" font="default" size="100%">Li, Shoudong</style></author><author><style face="normal" font="default" size="100%">Traynelis, Josh</style></author><author><style face="normal" font="default" size="100%">Shen, Hua</style></author><author><style face="normal" font="default" size="100%">Weissenberger, George</style></author><author><style face="normal" font="default" size="100%">Stossi, Fabio</style></author><author><style face="normal" font="default" size="100%">Johnson, Hannah L</style></author><author><style face="normal" font="default" size="100%">Lupski, James R</style></author><author><style face="normal" font="default" size="100%">Posey, Jennifer E</style></author><author><style face="normal" font="default" size="100%">Sabo, Aniko</style></author><author><style face="normal" font="default" size="100%">Meng, Qingchang</style></author><author><style face="normal" font="default" size="100%">Murdock, David R</style></author><author><style face="normal" font="default" size="100%">Wangler, Michael</style></author><author><style face="normal" font="default" size="100%">Gibbs, Richard A</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Phenotypic and protein localization heterogeneity associated with AHDC1 pathogenic protein-truncating alleles in Xia-Gibbs syndrome.</style></title><secondary-title><style face="normal" font="default" size="100%">Hum Mutat</style></secondary-title><alt-title><style face="normal" font="default" size="100%">Hum Mutat</style></alt-title></titles><dates><year><style  face="normal" font="default" size="100%">2021</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2021 May</style></date></pub-dates></dates><volume><style face="normal" font="default" size="100%">42</style></volume><pages><style face="normal" font="default" size="100%">577-591</style></pages><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;Xia-Gibbs syndrome (XGS) is a rare Mendelian disease typically caused by de novo stop-gain or frameshift mutations in the AT-hook DNA binding motif containing 1 (AHDC1) gene. Patients usually present in early infancy with hypotonia and developmental delay and later exhibit intellectual disability (ID). The overall presentation is variable, however, and the emerging clinical picture is still evolving. A detailed phenotypic analysis of 34 XGS individuals revealed five core phenotypes (delayed motor milestones, speech delay, low muscle tone, ID, and hypotonia) in more than 80% of individuals and an additional 12 features that occurred more variably. Seizures and scoliosis were more frequently associated with truncations that arise before the midpoint of the protein although the occurrence of most features could not be predicted by the mutation position. Transient expression of wild type and different patient truncated AHDC1 protein forms in human cell lines revealed abnormal patterns of nuclear localization including a diffuse distribution of a short truncated form and nucleolar aggregation in mid-protein truncated forms. Overall, both the occurrence of variable phenotypes and the different distribution of the expressed protein reflect the heterogeneity of this syndrome.&lt;/p&gt;</style></abstract><issue><style face="normal" font="default" size="100%">5</style></issue><custom1><style face="normal" font="default" size="100%">https://www.ncbi.nlm.nih.gov/pubmed/33644933?dopt=Abstract</style></custom1></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Montenegro-Garreaud, Ximena</style></author><author><style face="normal" font="default" size="100%">Hansen, Adam W</style></author><author><style face="normal" font="default" size="100%">Khayat, Michael M</style></author><author><style face="normal" font="default" size="100%">Chander, Varuna</style></author><author><style face="normal" font="default" size="100%">Grochowski, Christopher M</style></author><author><style face="normal" font="default" size="100%">Jiang, Yunyun</style></author><author><style face="normal" font="default" size="100%">Li, He</style></author><author><style face="normal" font="default" size="100%">Mitani, Tadahiro</style></author><author><style face="normal" font="default" size="100%">Kessler, Elena</style></author><author><style face="normal" font="default" size="100%">Jayaseelan, Joy</style></author><author><style face="normal" font="default" size="100%">Shen, Hua</style></author><author><style face="normal" font="default" size="100%">Gezdirici, Alper</style></author><author><style face="normal" font="default" size="100%">Pehlivan, Davut</style></author><author><style face="normal" font="default" size="100%">Meng, Qingchang</style></author><author><style face="normal" font="default" size="100%">Rosenfeld, Jill A</style></author><author><style face="normal" font="default" size="100%">Jhangiani, Shalini N</style></author><author><style face="normal" font="default" size="100%">Madan-Khetarpal, Suneeta</style></author><author><style face="normal" font="default" size="100%">Scott, Daryl A</style></author><author><style face="normal" font="default" size="100%">Abarca-Barriga, Hugo</style></author><author><style face="normal" font="default" size="100%">Trubnykova, Milana</style></author><author><style face="normal" font="default" size="100%">Gingras, Marie-Claude</style></author><author><style face="normal" font="default" size="100%">Muzny, Donna M</style></author><author><style face="normal" font="default" size="100%">Posey, Jennifer E</style></author><author><style face="normal" font="default" size="100%">Liu, Pengfei</style></author><author><style face="normal" font="default" size="100%">Lupski, James R</style></author><author><style face="normal" font="default" size="100%">Gibbs, Richard A</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Phenotypic expansion in KIF1A-related dominant disorders: A description of novel variants and review of published cases.</style></title><secondary-title><style face="normal" font="default" size="100%">Hum Mutat</style></secondary-title><alt-title><style face="normal" font="default" size="100%">Hum Mutat</style></alt-title></titles><dates><year><style  face="normal" font="default" size="100%">2020</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2020 12</style></date></pub-dates></dates><volume><style face="normal" font="default" size="100%">41</style></volume><pages><style face="normal" font="default" size="100%">2094-2104</style></pages><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;KIF1A is a molecular motor for membrane-bound cargo important to the development and survival of sensory neurons. KIF1A dysfunction has been associated with several Mendelian disorders with a spectrum of overlapping phenotypes, ranging from spastic paraplegia to intellectual disability. We present a novel pathogenic in-frame deletion in the KIF1A molecular motor domain inherited by two affected siblings from an unaffected mother with apparent germline mosaicism. We identified eight additional cases with heterozygous, pathogenic KIF1A variants ascertained from a local data lake. Our data provide evidence for the expansion of KIF1A-associated phenotypes to include hip subluxation and dystonia as well as phenotypes observed in only a single case: gelastic cataplexy, coxa valga, and double collecting system. We review the literature and suggest that KIF1A dysfunction is better understood as a single neuromuscular disorder with variable involvement of other organ systems than a set of discrete disorders converging at a single locus.&lt;/p&gt;</style></abstract><issue><style face="normal" font="default" size="100%">12</style></issue><custom1><style face="normal" font="default" size="100%">https://www.ncbi.nlm.nih.gov/pubmed/32935419?dopt=Abstract</style></custom1></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Karaca, Ender</style></author><author><style face="normal" font="default" size="100%">Posey, Jennifer E</style></author><author><style face="normal" font="default" size="100%">Bostwick, Bret</style></author><author><style face="normal" font="default" size="100%">Liu, Pengfei</style></author><author><style face="normal" font="default" size="100%">Gezdirici, Alper</style></author><author><style face="normal" font="default" size="100%">Yesil, Gozde</style></author><author><style face="normal" font="default" size="100%">Coban Akdemir, Zeynep</style></author><author><style face="normal" font="default" size="100%">Bayram, Yavuz</style></author><author><style face="normal" font="default" size="100%">Harms, Frederike L</style></author><author><style face="normal" font="default" size="100%">Meinecke, Peter</style></author><author><style face="normal" font="default" size="100%">Alawi, Malik</style></author><author><style face="normal" font="default" size="100%">Bacino, Carlos A</style></author><author><style face="normal" font="default" size="100%">Sutton, V Reid</style></author><author><style face="normal" font="default" size="100%">Kortüm, Fanny</style></author><author><style face="normal" font="default" size="100%">Lupski, James R</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Biallelic and De Novo Variants in DONSON Reveal a Clinical Spectrum of Cell Cycle-opathies with Microcephaly, Dwarfism and Skeletal Abnormalities.</style></title><secondary-title><style face="normal" font="default" size="100%">Am J Med Genet A</style></secondary-title><alt-title><style face="normal" font="default" size="100%">Am. J. Med. Genet. A</style></alt-title></titles><dates><year><style  face="normal" font="default" size="100%">2019</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2019 Oct</style></date></pub-dates></dates><volume><style face="normal" font="default" size="100%">179</style></volume><pages><style face="normal" font="default" size="100%">2056-2066</style></pages><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;Co-occurrence of primordial dwarfism and microcephaly together with particular skeletal findings are seen in a wide range of Mendelian syndromes including microcephaly micromelia syndrome (MMS, OMIM 251230), microcephaly, short stature, and limb abnormalities (MISSLA, OMIM 617604), and microcephalic primordial dwarfisms (MPDs). Genes associated with these syndromes encode proteins that have crucial roles in DNA replication or in other critical steps of the cell cycle that link DNA replication to cell division. We identified four unrelated families with five affected individuals having biallelic or de novo variants in DONSON presenting with a core phenotype of severe short stature (z score &lt; -3 SD), additional skeletal abnormalities, and microcephaly. Two apparently unrelated families with identical homozygous c.631C &gt; T p.(Arg211Cys) variant had clinical features typical of Meier-Gorlin syndrome (MGS), while two siblings with compound heterozygous c.346delG p.(Asp116Ile*62) and c.1349A &gt; G p.(Lys450Arg) variants presented with Seckel-like phenotype. We also identified a de novo c.683G &gt; T p.(Trp228Leu) variant in DONSON in a patient with prominent micrognathia, short stature and hypoplastic femur and tibia, clinically diagnosed with Femoral-Facial syndrome (FFS, OMIM 134780). Biallelic variants in DONSON have been recently described in individuals with microcephalic dwarfism. These studies also demonstrated that DONSON has an essential conserved role in the cell cycle. Here we describe novel biallelic and de novo variants that are associated with MGS, Seckel-like phenotype and FFS, the last of which has not been associated with any disease gene to date.&lt;/p&gt;</style></abstract><issue><style face="normal" font="default" size="100%">10</style></issue><custom1><style face="normal" font="default" size="100%">https://www.ncbi.nlm.nih.gov/pubmed/31407851?dopt=Abstract</style></custom1></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Punetha, Jaya</style></author><author><style face="normal" font="default" size="100%">Karaca, Ender</style></author><author><style face="normal" font="default" size="100%">Gezdirici, Alper</style></author><author><style face="normal" font="default" size="100%">Lamont, Ryan E</style></author><author><style face="normal" font="default" size="100%">Pehlivan, Davut</style></author><author><style face="normal" font="default" size="100%">Marafi, Dana</style></author><author><style face="normal" font="default" size="100%">Appendino, Juan P</style></author><author><style face="normal" font="default" size="100%">Hunter, Jill V</style></author><author><style face="normal" font="default" size="100%">Akdemir, Zeynep C</style></author><author><style face="normal" font="default" size="100%">Fatih, Jawid M</style></author><author><style face="normal" font="default" size="100%">Jhangiani, Shalini N</style></author><author><style face="normal" font="default" size="100%">Gibbs, Richard A</style></author><author><style face="normal" font="default" size="100%">Innes, A Micheil</style></author><author><style face="normal" font="default" size="100%">Posey, Jennifer E</style></author><author><style face="normal" font="default" size="100%">Lupski, James R</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Biallelic CACNA2D2 variants in epileptic encephalopathy and cerebellar atrophy.</style></title><secondary-title><style face="normal" font="default" size="100%">Ann Clin Transl Neurol</style></secondary-title><alt-title><style face="normal" font="default" size="100%">Ann Clin Transl Neurol</style></alt-title></titles><dates><year><style  face="normal" font="default" size="100%">2019</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2019 Aug</style></date></pub-dates></dates><volume><style face="normal" font="default" size="100%">6</style></volume><pages><style face="normal" font="default" size="100%">1395-1406</style></pages><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;&lt;b&gt;OBJECTIVE: &lt;/b&gt;To characterize the molecular and clinical phenotypic basis of developmental and epileptic encephalopathies caused by rare biallelic variants in CACNA2D2.&lt;/p&gt;&lt;p&gt;&lt;b&gt;METHODS: &lt;/b&gt;Two affected individuals from a family with clinical features of early onset epileptic encephalopathy were recruited for exome sequencing at the Centers for Mendelian Genomics to identify their molecular diagnosis. GeneMatcher facilitated identification of a second family with a shared candidate disease gene identified through clinical gene panel-based testing.&lt;/p&gt;&lt;p&gt;&lt;b&gt;RESULTS: &lt;/b&gt;Rare biallelic CACNA2D2 variants have been previously reported in three families with developmental and epileptic encephalopathy, and one family with congenital ataxia. We identified three individuals in two unrelated families with novel homozygous rare variants in CACNA2D2 with clinical features of developmental and epileptic encephalopathy and cerebellar atrophy. Family 1 includes two affected siblings with a likely damaging homozygous rare missense variant c.1778G&gt;C; p.(Arg593Pro) in CACNA2D2. Family 2 includes a proband with a homozygous rare nonsense variant c.485_486del; p.(Tyr162Ter) in CACNA2D2. We compared clinical and molecular findings from all nine individuals reported to date and note that cerebellar atrophy is shared among all.&lt;/p&gt;&lt;p&gt;&lt;b&gt;INTERPRETATION: &lt;/b&gt;Our study supports the candidacy of CACNA2D2 as a disease gene associated with a phenotypic spectrum of neurological disease that include features of developmental and epileptic encephalopathy, ataxia, and cerebellar atrophy. Age at presentation may affect apparent penetrance of neurogenetic trait manifestations and of a particular clinical neurological endophenotype, for example, seizures or ataxia.&lt;/p&gt;</style></abstract><issue><style face="normal" font="default" size="100%">8</style></issue><custom1><style face="normal" font="default" size="100%">https://www.ncbi.nlm.nih.gov/pubmed/31402629?dopt=Abstract</style></custom1></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Posey, Jennifer E</style></author><author><style face="normal" font="default" size="100%">O'Donnell-Luria, Anne H</style></author><author><style face="normal" font="default" size="100%">Chong, Jessica X</style></author><author><style face="normal" font="default" size="100%">Harel, Tamar</style></author><author><style face="normal" font="default" size="100%">Jhangiani, Shalini N</style></author><author><style face="normal" font="default" size="100%">Coban Akdemir, Zeynep H</style></author><author><style face="normal" font="default" size="100%">Buyske, Steven</style></author><author><style face="normal" font="default" size="100%">Pehlivan, Davut</style></author><author><style face="normal" font="default" size="100%">Carvalho, Claudia M B</style></author><author><style face="normal" font="default" size="100%">Baxter, Samantha</style></author><author><style face="normal" font="default" size="100%">Sobreira, Nara</style></author><author><style face="normal" font="default" size="100%">Liu, Pengfei</style></author><author><style face="normal" font="default" size="100%">Wu, Nan</style></author><author><style face="normal" font="default" size="100%">Rosenfeld, Jill A</style></author><author><style face="normal" font="default" size="100%">Kumar, Sushant</style></author><author><style face="normal" font="default" size="100%">Avramopoulos, Dimitri</style></author><author><style face="normal" font="default" size="100%">White, Janson J</style></author><author><style face="normal" font="default" size="100%">Doheny, Kimberly F</style></author><author><style face="normal" font="default" size="100%">Witmer, P Dane</style></author><author><style face="normal" font="default" size="100%">Boehm, Corinne</style></author><author><style face="normal" font="default" size="100%">Sutton, V Reid</style></author><author><style face="normal" font="default" size="100%">Muzny, Donna M</style></author><author><style face="normal" font="default" size="100%">Boerwinkle, Eric</style></author><author><style face="normal" font="default" size="100%">Günel, Murat</style></author><author><style face="normal" font="default" size="100%">Nickerson, Deborah A</style></author><author><style face="normal" font="default" size="100%">Mane, Shrikant</style></author><author><style face="normal" font="default" size="100%">MacArthur, Daniel G</style></author><author><style face="normal" font="default" size="100%">Gibbs, Richard A</style></author><author><style face="normal" font="default" size="100%">Hamosh, Ada</style></author><author><style face="normal" font="default" size="100%">Lifton, Richard P</style></author><author><style face="normal" font="default" size="100%">Matise, Tara C</style></author><author><style face="normal" font="default" size="100%">Rehm, Heidi L</style></author><author><style face="normal" font="default" size="100%">Gerstein, Mark</style></author><author><style face="normal" font="default" size="100%">Bamshad, Michael J</style></author><author><style face="normal" font="default" size="100%">Valle, David</style></author><author><style face="normal" font="default" size="100%">Lupski, James R</style></author></authors><translated-authors><author><style face="normal" font="default" size="100%">Centers for Mendelian Genomics</style></author></translated-authors></contributors><titles><title><style face="normal" font="default" size="100%">Insights into genetics, human biology and disease gleaned from family based genomic studies.</style></title><secondary-title><style face="normal" font="default" size="100%">Genet Med</style></secondary-title><alt-title><style face="normal" font="default" size="100%">Genet. Med.</style></alt-title></titles><dates><year><style  face="normal" font="default" size="100%">2019</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2019 04</style></date></pub-dates></dates><volume><style face="normal" font="default" size="100%">21</style></volume><pages><style face="normal" font="default" size="100%">798-812</style></pages><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;Identifying genes and variants contributing to rare disease phenotypes and Mendelian conditions informs biology and medicine, yet potential phenotypic consequences for variation of &gt;75% of the ~20,000 annotated genes in the human genome are lacking. Technical advances to assess rare variation genome-wide, particularly exome sequencing (ES), enabled establishment in the United States of the National Institutes of Health (NIH)-supported Centers for Mendelian Genomics (CMGs) and have facilitated collaborative studies resulting in novel &quot;disease gene&quot; discoveries. Pedigree-based genomic studies and rare variant analyses in families with suspected Mendelian conditions have led to the elucidation of hundreds of novel disease genes and highlighted the impact of de novo mutational events, somatic variation underlying nononcologic traits, incompletely penetrant alleles, phenotypes with high locus heterogeneity, and multilocus pathogenic variation. Herein, we highlight CMG collaborative discoveries that have contributed to understanding both rare and common diseases and discuss opportunities for future discovery in single-locus Mendelian disorder genomics. Phenotypic annotation of all human genes; development of bioinformatic tools and analytic methods; exploration of non-Mendelian modes of inheritance including reduced penetrance, multilocus variation, and oligogenic inheritance; construction of allelic series at a locus; enhanced data sharing worldwide; and integration with clinical genomics are explored. Realizing the full contribution of rare disease research to functional annotation of the human genome, and further illuminating human biology and health, will lay the foundation for the Precision Medicine Initiative.&lt;/p&gt;</style></abstract><issue><style face="normal" font="default" size="100%">4</style></issue><custom1><style face="normal" font="default" size="100%">https://www.ncbi.nlm.nih.gov/pubmed/30655598?dopt=Abstract</style></custom1></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Jiang, Yunyun</style></author><author><style face="normal" font="default" size="100%">Wangler, Michael F</style></author><author><style face="normal" font="default" size="100%">McGuire, Amy L</style></author><author><style face="normal" font="default" size="100%">Lupski, James R</style></author><author><style face="normal" font="default" size="100%">Posey, Jennifer E</style></author><author><style face="normal" font="default" size="100%">Khayat, Michael M</style></author><author><style face="normal" font="default" size="100%">Murdock, David R</style></author><author><style face="normal" font="default" size="100%">Sanchez-Pulido, Luis</style></author><author><style face="normal" font="default" size="100%">Ponting, Chris P</style></author><author><style face="normal" font="default" size="100%">Xia, Fan</style></author><author><style face="normal" font="default" size="100%">Hunter, Jill V</style></author><author><style face="normal" font="default" size="100%">Meng, Qingchang</style></author><author><style face="normal" font="default" size="100%">Murugan, Mullai</style></author><author><style face="normal" font="default" size="100%">Gibbs, Richard A</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">The phenotypic spectrum of Xia-Gibbs syndrome.</style></title><secondary-title><style face="normal" font="default" size="100%">Am J Med Genet A</style></secondary-title><alt-title><style face="normal" font="default" size="100%">Am. J. Med. Genet. A</style></alt-title></titles><dates><year><style  face="normal" font="default" size="100%">2018</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2018 06</style></date></pub-dates></dates><volume><style face="normal" font="default" size="100%">176</style></volume><pages><style face="normal" font="default" size="100%">1315-1326</style></pages><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;Xia-Gibbs syndrome (XGS: OMIM # 615829) results from de novo truncating mutations within the AT-Hook DNA Binding Motif Containing 1 gene (AHDC1). To further define the phenotypic and molecular spectrum of this disorder, we established an XGS Registry and recruited patients from a worldwide pool of approximately 60 probands. Additional de novo truncating mutations were observed among 25 individuals, extending both the known number of mutation sites and the range of positions within the coding region that were sensitive to alteration. Detailed phenotypic examination of 20 of these patients via clinical records review and data collection from additional surveys showed a wider age range than previously described. Data from developmental milestones showed evidence for delayed speech and that males were more severely affected. Neuroimaging from six available patients showed an associated thinning of the corpus callosum and posterior fossa cysts. An increased risk of both scoliosis and seizures relative to the population burden was also observed. Data from a modified autism screening tool revealed that XGS shares significant overlap with autism spectrum disorders. These details of the phenotypic heterogeneity of XGS implicate specific genotype/phenotype correlations and suggest potential clinical management guidelines.&lt;/p&gt;</style></abstract><issue><style face="normal" font="default" size="100%">6</style></issue><custom1><style face="normal" font="default" size="100%">http://www.ncbi.nlm.nih.gov/pubmed/29696776?dopt=Abstract</style></custom1></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Posey, Jennifer E</style></author><author><style face="normal" font="default" size="100%">Harel, Tamar</style></author><author><style face="normal" font="default" size="100%">Liu, Pengfei</style></author><author><style face="normal" font="default" size="100%">Rosenfeld, Jill A</style></author><author><style face="normal" font="default" size="100%">James, Regis A</style></author><author><style face="normal" font="default" size="100%">Coban Akdemir, Zeynep H</style></author><author><style face="normal" font="default" size="100%">Walkiewicz, Magdalena</style></author><author><style face="normal" font="default" size="100%">Bi, Weimin</style></author><author><style face="normal" font="default" size="100%">Xiao, Rui</style></author><author><style face="normal" font="default" size="100%">Ding, Yan</style></author><author><style face="normal" font="default" size="100%">Xia, Fan</style></author><author><style face="normal" font="default" size="100%">Beaudet, Arthur L</style></author><author><style face="normal" font="default" size="100%">Muzny, Donna M</style></author><author><style face="normal" font="default" size="100%">Gibbs, Richard A</style></author><author><style face="normal" font="default" size="100%">Boerwinkle, Eric</style></author><author><style face="normal" font="default" size="100%">Eng, Christine M</style></author><author><style face="normal" font="default" size="100%">Sutton, V Reid</style></author><author><style face="normal" font="default" size="100%">Shaw, Chad A</style></author><author><style face="normal" font="default" size="100%">Plon, Sharon E</style></author><author><style face="normal" font="default" size="100%">Yang, Yaping</style></author><author><style face="normal" font="default" size="100%">Lupski, James R</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Resolution of Disease Phenotypes Resulting from Multilocus Genomic Variation.</style></title><secondary-title><style face="normal" font="default" size="100%">N Engl J Med</style></secondary-title><alt-title><style face="normal" font="default" size="100%">N Engl J Med</style></alt-title></titles><keywords><keyword><style  face="normal" font="default" size="100%">Exome</style></keyword><keyword><style  face="normal" font="default" size="100%">Genetic Diseases, Inborn</style></keyword><keyword><style  face="normal" font="default" size="100%">Genetic Variation</style></keyword><keyword><style  face="normal" font="default" size="100%">Genotyping Techniques</style></keyword><keyword><style  face="normal" font="default" size="100%">High-Throughput Nucleotide Sequencing</style></keyword><keyword><style  face="normal" font="default" size="100%">Humans</style></keyword><keyword><style  face="normal" font="default" size="100%">Phenotype</style></keyword><keyword><style  face="normal" font="default" size="100%">Retrospective Studies</style></keyword><keyword><style  face="normal" font="default" size="100%">Sequence Analysis, DNA</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2017</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2017 Jan 05</style></date></pub-dates></dates><volume><style face="normal" font="default" size="100%">376</style></volume><pages><style face="normal" font="default" size="100%">21-31</style></pages><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;&lt;b&gt;BACKGROUND: &lt;/b&gt;Whole-exome sequencing can provide insight into the relationship between observed clinical phenotypes and underlying genotypes.&lt;/p&gt;&lt;p&gt;&lt;b&gt;METHODS: &lt;/b&gt;We conducted a retrospective analysis of data from a series of 7374 consecutive unrelated patients who had been referred to a clinical diagnostic laboratory for whole-exome sequencing; our goal was to determine the frequency and clinical characteristics of patients for whom more than one molecular diagnosis was reported. The phenotypic similarity between molecularly diagnosed pairs of diseases was calculated with the use of terms from the Human Phenotype Ontology.&lt;/p&gt;&lt;p&gt;&lt;b&gt;RESULTS: &lt;/b&gt;A molecular diagnosis was rendered for 2076 of 7374 patients (28.2%); among these patients, 101 (4.9%) had diagnoses that involved two or more disease loci. We also analyzed parental samples, when available, and found that de novo variants accounted for 67.8% (61 of 90) of pathogenic variants in autosomal dominant disease genes and 51.7% (15 of 29) of pathogenic variants in X-linked disease genes; both variants were de novo in 44.7% (17 of 38) of patients with two monoallelic variants. Causal copy-number variants were found in 12 patients (11.9%) with multiple diagnoses. Phenotypic similarity scores were significantly lower among patients in whom the phenotype resulted from two distinct mendelian disorders that affected different organ systems (50 patients) than among patients with disorders that had overlapping phenotypic features (30 patients) (median score, 0.21 vs. 0.36; P=1.77×10).&lt;/p&gt;&lt;p&gt;&lt;b&gt;CONCLUSIONS: &lt;/b&gt;In our study, we found multiple molecular diagnoses in 4.9% of cases in which whole-exome sequencing was informative. Our results show that structured clinical ontologies can be used to determine the degree of overlap between two mendelian diseases in the same patient; the diseases can be distinct or overlapping. Distinct disease phenotypes affect different organ systems, whereas overlapping disease phenotypes are more likely to be caused by two genes encoding proteins that interact within the same pathway. (Funded by the National Institutes of Health and the Ting Tsung and Wei Fong Chao Foundation.).&lt;/p&gt;</style></abstract><issue><style face="normal" font="default" size="100%">1</style></issue><custom1><style face="normal" font="default" size="100%">https://www.ncbi.nlm.nih.gov/pubmed/27959697?dopt=Abstract</style></custom1></record></records></xml>