This variant, c.2512C>T (p.Gln838Ter), is a nonsense variant that is predicted to result in nonsense mediated decay and lack of gene product, meeting PVS1. The highest population minor allele frequency in gnomAD v2.1.1 is 0.00006 in the African population, meeting PM2. It has been reported in two siblings with infantile onset Pompe disease who meet the ClinGen LSD VCEP’s specifications for PP4, and who are compound heterozygous for the variant and c.2105G>T (p.Arg702Leu) (PMID 26167453). However, this in trans data will be used in the assessment of p.Arg702Leu and is not included here in order to avoid a circular argument. Another patient, with limb girdle muscular dystrophy, has been reported to be compound heterozygous for the variant and c.-32-13T>G. However, residual GAA activity was not provided, and therefore this data was not included (PMID 30564623). There is a ClinVar entry for this variant (Variation ID: 92479, 1 star review status) with one submitter classifying the variant as pathogenic. In summary, this variant meets the criteria to be classified as pathogenic for Pompe disease. GAA-specific ACMG/AMP criteria applied, as specified by the ClinGen LSD VCEP: PVS1, PM2, PP4.