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Diagnostic Exome Sequencing yields a single genetic diagnosis in approximately 30% of cases, and according to recent studies the prevalence of identifying two genetic conditions in a single individual ranges between 4.6 and 7%. We present a patient diagnosed with three different rare conditions, each explained by a pathogenic mutation in a different gene. A 17 year old female was evaluated for history of motor and speech delay, scoliosis, distinctive craniofacial features and dry skin in the Department of Clinical Genomics at Mayo Clinic. Previous diagnostic testing was unrevealing including biochemical testing, echocardiogram, abdominal ultrasound and electroencephalogram. For more information click here.