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Early onset or syndromic epilepsy v8.28 PIGG Arina Puzriakova Phenotypes for gene: PIGG were changed from Mental retardation, autosomal recessive 53 616917 to Neurodevelopmental disorder with or without hypotonia, seizures, and cerebellar atrophy, OMIM:616917
Early onset or syndromic epilepsy v1.191 PIGG Rebecca Foulger Source Wessex and West Midlands GLH was added to PIGG.
Early onset or syndromic epilepsy v1.190 PIGG Rebecca Foulger Source NHS GMS was added to PIGG.
Early onset or syndromic epilepsy v1.189 PIGG Rebecca Foulger reviewed gene: PIGG: Rating: AMBER; Mode of pathogenicity: ; Publications: ; Phenotypes: ; Mode of inheritance:
Early onset or syndromic epilepsy v1.188 PIGG Tracy Lester reviewed gene: PIGG: Rating: GREEN; Mode of pathogenicity: ; Publications: 26996948; Phenotypes: Mental retardation, 616917; Mode of inheritance: BIALLELIC, autosomal or pseudoautosomal
Early onset or syndromic epilepsy v0.547 PIGG Sarah Leigh Marked gene: PIGG as ready
Early onset or syndromic epilepsy v0.547 PIGG Sarah Leigh Added comment: Comment when marking as ready: Associated with relevant phenotype in OMIM and as probable Gen2Phen gene. At least 3 variants, plus one 2.4mb deletion encompassing the PIGG gene reported in three unrelated cases.
Early onset or syndromic epilepsy v0.547 PIGG Sarah Leigh Gene: pigg has been classified as Green List (High Evidence).
Early onset or syndromic epilepsy v0.547 PIGG Sarah Leigh Classified gene: PIGG as Green List (high evidence)
Early onset or syndromic epilepsy v0.547 PIGG Sarah Leigh Gene: pigg has been classified as Green List (High Evidence).
Early onset or syndromic epilepsy v0.546 PIGG Sarah Leigh Phenotypes for gene: PIGG were changed from # 616917. MENTAL RETARDATION, AUTOSOMAL RECESSIVE 53; MRT53 to Mental retardation, autosomal recessive 53 616917
Early onset or syndromic epilepsy v0.503 PIGG Konstantinos Varvagiannis gene: PIGG was added
gene: PIGG was added to Genetic Epilepsy Syndromes. Sources: Literature,Expert Review
Mode of inheritance for gene: PIGG was set to BIALLELIC, autosomal or pseudoautosomal
Publications for gene: PIGG were set to 26996948; 28581210
Phenotypes for gene: PIGG were set to # 616917. MENTAL RETARDATION, AUTOSOMAL RECESSIVE 53; MRT53
Penetrance for gene: PIGG were set to Complete
Review for gene: PIGG was set to GREEN
Added comment: PMID: 26996948 reports on 5 individuals from 3 families, with biallelic pathogenic variants in PIGG.

Individuals from first family, were born to consanguineous parents from Egypt and were homozygous for a stopgain variant [p.(Gln310*)]. The patient from the second family had a rare missense SNV [p.(Arg669Cys)] and a de novo microdeletion affecting PIGG on her other allele. In the third family (consanguineous parents from Pakistan), two affected sibs were found to be homozygous for a splice variant.

The phenotype consisted of hypotonia, early-onset seizures and intellectual disability. Ataxia was an additional feature in one of the families.

Seizures, were observed in most of patients but do not appear to be a universal feature as they were absent in one of the sibs from the third family (10 years of age), while the other had a single episode by the age of 12 years.

In vitro testing of lymphoblastoid cell lines (generated from individuals from the 1st and 3rd family) indicated that the variants abolished completely the function of PIGG, whereas the surface level of GPI anchored proteins was normal. //

PMID: 28581210 describes the phenotype of 2 sibs from Palestine, homozygous for a stopgain variant [p.(Trp547*)]. Hypotonia, feeding difficulties, severe non-progressive ataxia (with cerebellar hypoplasia), intellectual disability and seizures were common features. Differences in severity and/or additional features might be explained by other homozygous variants (the girl had a concurrent diagnosis of MCAD deficiency).

The authors demonstrated that the PIGG transcript levels were significantly lower (approximately half) in the two siblings compared to their parents, while the transcripts with the mutation in the heterozygous parents were very low due to nonsense-mediated decay.

Patient fibroblasts showed decreased surface level of GPI-anchored proteins, in contrast with what was noted in lymphoblastoid cells in the previous study. //

As a result this gene can be considered for inclusion in this panel as green (or amber).
Sources: Literature, Expert Review