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Updated: Jan 1, 2026

Determining the Likelihood of Variant Pathogenicity Using Amino Acid-level Signal-to-Noise Analysis of Genetic Variation
Published on: January 16, 2019
Life-threatening presentations of propionic acidemia due to the Amish PCCB founder variant
William B Hannah1,2,3, Katherine J Dempsey1,2, Lori-Anne P Schillaci1,2
1Center for Human Genetics, University Hospitals Cleveland Medical Center, Cleveland, OH, United States of America.
Abstract:
Although individuals of Amish descent with propionic acidemia (PA) are generally thought to have a milder disease phenotype, we now have a better understanding of the natural history of PA in this population. Here we describe two Amish patients with emergent presentations of PA, one with metabolic decompensation and another with cardiogenic shock. PA can present with life-threatening metabolic decompensation or an adult-onset severe cardiomyopathy. We discuss critical clinical implications of this observation.
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