The NM_000152.5:c.1385T>C variant in GAA is a missense variant predicted to cause substitution of leucine by proline at amino acid 462 (p.Leu462Pro). The highest population minor allele frequency in gnomAD v4.1.0. is 8.5e-7 (1/1179884 alleles) in the Non-Finnish European population, which is lower than the ClinGen Lysosomal Diseases VCEP’s threshold for PM2_Supporting (<0.001), meeting this criterion (PM2_Supporting). The variant has been reported in an 8 month old male with clinical features consistent with infantile onset Pompe disease and documentation of deficient GAA activity (PMID: 25612604) (PP4_Moderate). This patient is compound heterozygous for the variant and another missense variant that has been classified as likely pathogenic by the ClinGen LD VCEP (PMID: 25612604). Expression of the variant in HEK293 cells (methodology: PMID 36246652) resulted in no GAA activity relative to wild type. Western blot revealed only a precursor (110 kDa) band, evidence of abnormal GAA synthesis and processing (data unpublished) (PS3_moderate). The computational predictor REVEL gives a score of 0.951 which is above the threshold of 0.7, evidence that correlates with impact to GAA function (PP3). There is a ClinVar entry for this variant (Variation ID: 1693548, 3 star review status) with 2 submitters as VUS (1 submitter) or pathogenic (1 submitter). In summary, this variant meets the criteria to be classified as likely pathogenic for Pompe disease based on the ACMG/AMP criteria applied, as specified by the ClinGen Lysosomal Diseases Variant Curation Expert Panel (Specifications Version 2.0.0): PM2_supporting, PP4_moderate, PP3, PS3_moderate (Classification approved by the ClinGen Lysosomal Diseases Variant Curation Expert Panel on June 17, 2025)