The NM_003494.4: c.5836_5839del p.(Gln1946TrpfsTer19) variant in DYSF, which is also known as NM_001130987.2: c.5953_5956del p.(Gln1985TrpfsTer19)), is a frameshift variant predicted to cause a premature stop codon in biologically relevant exon 52/55, leading to nonsense mediated decay in a gene in which loss of function is an established disease mechanism (PVS1). This variant has been detected in at least 3 unrelated individuals with limb girdle muscular dystrophy (PMID: 30564623, 19528035), including in unknown phase with a pathogenic variant (c.1852G>C p.(Gly618Arg), 0.5 pt, PMID: 30564623) (PM3_Supporting). At least one patient with this variant displayed progressive limb girdle muscle weakness and absent dysferlin protein expression, which is highly specific for DYSF-associated LGMD (PP4_Strong, PMID: 19528035, 30564623). The variant was also reported to co-segregate with the disease in one affected family member (PMID: 19528035) (PP1). The filtering allele frequency of the variant is 0.000114 for European (non-Finnish) genome alleles in gnomAD v3.1.2 (the upper threshold of the 95% CI of 3/68008), which is greater than the LGMD VCEP threshold (<0.0001) for PM2_Supporting (criterion not met). In summary, this variant meets the criteria to be classified as Pathogenic for autosomal recessive limb girdle muscular dystrophy based on the ACMG/AMP criteria applied, as specified by the ClinGen LGMD VCEP (LGMD VCEP specifications version 1.0.0; 01/08/2025): PVS1, PM3_Supporting, PP4_Strong, PP1.