Reasoning Based AI in Rare Disease Diagnosis

A recent study in Nature marks a conceptual advance in medical genetics by reframing rare disease diagnosis as a coordinated reasoning task rather than a static prediction problem. The proposed agentic system orchestrates phenotype, genotype, and knowledge retrieval modules under a large language model host, generating ranked hypotheses with transparent, evidence linked logic. It is […]

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Toward calibrated variant effect estimates

Recent articles in JMG exemplify a broader shift from cataloguing gene-disease associations to estimating clinically calibrated variant effects. Large sequencing cohorts are coupled with deep clinical characterisation to (1) delineate how inherited variants contribute to fetal structural anomalies and adult disease risk, (2) expand and refine genotype-phenotype relationships for rare neurodevelopmental and syndromic conditions, and […]

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Reclassification of variants of uncertain significance in type 1 collagen genes: a national reference laboratory experience.

Osteogenesis Imperfecta  (OI) is an important condition to diagnose early to ensure children are monitored and treated in a timely manner. Increased access to genetic testing has enabled more diagnosis but this can be complicated by ‘Variants of uncertain significance (VUS)’ which results in uncertainty. Using England’s national OI database, we undertook an iterative analysis […]

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Expanding the phenotypic spectrum of MECOM-associated syndrome: rare variants are associated with syndromic pulmonary arterial hypertension

Pulmonary arterial hypertension (PAH) is a rare blood vessel disorder that can be fatal. The development of PAH in early childhood, often accompanied by other medical issues, is likely caused by genetic factors but few of the underlying genes have been identified. By connecting doctors and researchers around the world, we identified MECOM, a master regulator […]

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Biallelic TTBK1 variant causes a severe syndromic neurodevelopmental disorder: clinical and genetic insights from two siblings

Rare genetic conditions affecting brain development are often difficult to diagnose, especially when the responsible gene has previously been studied only in adult brain diseases. In this study, we describe two siblings with a severe neurodevelopmental disorder caused by a loss-of-function change in the TTBK1 gene. TTBK1 is best known for its role in Alzheimer’s disease and other neurodegenerative […]

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Novel in-frame variant in DES (p.Glu353dup) causes myofibrillar myopathy: clinical, in silico and functional studies

Desmin (DES) is a key protein that helps muscle cells maintain their structure and function. In this study, we identified and characterized a previously unknown mutation in DES in an Argentine family affected by a muscle disease. Unlike most known DES mutations, this alteration is a small insertion whose disease-causing role was unclear. By combining […]

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Refining the phenotypic spectrum of PNKP-related microcephaly: a study of 27 new patients

Primary microcephaly are genetic conditions that are characterized by small head circumference at birth and always associated with intellectual disability. However, early-onset seizures are prevalent in PNKP-related microcephaly. In this study, we present the clinical and molecular genetics findings of 27 patients carrying biallelic PNKP variants. Our findings showed that hypoplastic frontal lobe when associated […]

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Obstetric history of women with m.3243A>G: an observational cohort study

Mitochondrial disease is a common type of inherited metabolic disease, typically caused by pathogenic variants in the maternally inherited mitochondrial DNA (mtDNA). In this study, we investigated a cohort of Finnish women harbouring the mtDNA variant m.3243A>G, the most common cause of adult mitochondrial disease. We found that these individuals may have an elevated risk […]

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Haplotype studies and the use of a nearby tagging variant confirm a founder origin for an intragenic CYP11B1 inversion

Genomic inversions occur when a stretch of DNA flips over, reversing its orientation. The absence of copy-number change can make these variants hard to spot. In this commentary, Pagnamenta and colleagues examine an inversion recently reported by Janot et al. in a gene linked to disorders of sexual development. They show it can be detected […]

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