Congenital Disorders of Glycosylation

Gene: PIGM

Green List (high evidence)

PIGM (phosphatidylinositol glycan anchor biosynthesis class M)
EnsemblGeneIds (GRCh38): ENSG00000143315
EnsemblGeneIds (GRCh37): ENSG00000143315
OMIM: 610273, ClinGen, DECIPHER
PIGM is in 3 panels

3 reviews

Sarah Milton (Victorian Clinical Genetics Services)

I don't know

PIGM encodes an enzyme involved in glycosylphosphatidylinositol (GPI)-anchor biosynthesis pathway.

PMID: 31445883, 16767100 describe 7 patients with the same biallelic variant in PIGM promoter: c.−270C>G presenting with portal vein thrombosis, macrocephaly and seizures.
Some supportive functional studies demonstrated loss of GPI anchored cell surface markers with presumed reduced expression of PIGM. All families of a similar ethnicity.

Subsequently PMID: 39425582, 39912323, 41782195 have published a total of 7 individuals from 5 families with biallelic missense or LOF variants in PIGM with variable phenotypes. Features included: refractory seizures, mild to moderate intellectual disability in one family. Another 2 individuals showed with progressive microcephaly, DEE and tetrapesis and finally a prominent skin phenotype (scaly plaques, abnormal skin folds) and refractory seizures seen in a separate 2 individuals.
Minimal additional supportive functional studies.

Variants were appropriately rare in gnomad with many other enzymes in the GPI family having been associated with seizures/ID.
Created: 1 Apr 2026, 3:28 p.m. | Last Modified: 1 Apr 2026, 3:28 p.m.
Panel Version: 1.4689

Mode of inheritance
BIALLELIC, autosomal or pseudoautosomal

Phenotypes
hypercoagulability syndrome due to glycosylphosphatidylinositol deficiency, MONDO:0012465

Publications

Zornitza Stark (Victorian Clinical Genetics Services)

Green List (high evidence)

Sufficient evidence now for Green rating.
Created: 29 Apr 2026, 7:06 p.m. | Last Modified: 29 Apr 2026, 7:06 p.m.
Panel Version: 1.86

Mode of inheritance
BIALLELIC, autosomal or pseudoautosomal

Phenotypes
Glycosylphosphatidylinositol deficiency, MIM# 610293

Dean Phelan (Victorian Clinical Genetics Services)

I don't know

OMIM - Glycosylphosphatidylinositol deficiency, AR

Function - Glycosylphosphatidylinositol is a glycolipid that anchors more than 150 proteins to the cell surface, and these proteins, termed GPI-anchored proteins (GPI-APs), perform a variety of functions as enzymes, adhesion molecules, complement regulators, and coreceptors in signal transduction pathways

OMIM - Four unrelated consanguineous Arab families with (in total) seven affected members with the same homozygous promoter variant (two publications below).

Clingen - not curated

PMID: 31445883 - (2019) Defects of the glycosylphosphatidylinositol (GPI) biosynthesis pathway constitute an emerging subgroup of congenital disorders of glycosylation with heterogeneous phenotypes. A mutation in the promoter of PIGM, resulting in a syndrome with portal vein thrombosis and persistent absence seizures, was previously described. We now report four additional patients in two unrelated families (segregates perfectly). The patients described expand the phenotypic spectrum of PIGM deficiency to include macrocephaly and infantile-onset cerebrovascular thrombotic events. Finally, we offer insights regarding targeted treatment of this rare disorder with sodium phenylbutyrate.

PMID: 16767100 - (2006) We have identified a novel disease characterized by a propensity to venous thrombosis and seizures in which deficiency of GPI is inherited in an autosomal recessive manner. In two unrelated kindreds, a point mutation (c --> g) at position -270 from the start codon of PIGM, a mannosyltransferase-encoding gene, disrupts binding of the transcription factor Sp1 to its cognate promoter motif. This mutation substantially reduces transcription of PIGM and blocks mannosylation of GPI, leading to partial but severe deficiency of GPI.

Summary - associated with disease in multiple (four) unrelated families but all are Middle Eastern consanguineous families with the same promoter mutation. Functional studies have confirmed the mutation disrupts normal protein function.
Created: 15 Jul 2020, 10:03 a.m. | Last Modified: 15 Jul 2020, 10:03 a.m.
Panel Version: 0.57

Mode of inheritance
BIALLELIC, autosomal or pseudoautosomal

Phenotypes
portal vein thrombosis; persistent absence seizures; macrocephaly; infantile-onset cerebrovascular thrombotic events

Publications

Details

Mode of Inheritance
BIALLELIC, autosomal or pseudoautosomal
Sources
  • Expert Review Green
  • Victorian Clinical Genetics Services
Phenotypes
  • Glycosylphosphatidylinositol deficiency, MIM# 610293
  • portal vein thrombosis
  • persistent absence seizures
  • macrocephaly
  • infantile-onset cerebrovascular thrombotic events
  • portal vein thrombosis
  • persistent absence seizures
  • macrocephaly
  • infantile-onset cerebrovascular thrombotic events
Tags
founder
OMIM
610273
ClinGen
PIGM
DECIPHER
PIGM
Clinvar variants
Variants in PIGM
Penetrance
None
Publications
Panels with this gene

History Filter Activity

29 Apr 2026, Gel status: 3

Set publications

Zornitza Stark (Victorian Clinical Genetics Services)

Publications for gene: PIGM were set to 31445883; 16767100

29 Apr 2026, Gel status: 3

Entity classified by Genomics England curator

Zornitza Stark (Victorian Clinical Genetics Services)

Gene: pigm has been classified as Green List (High Evidence).

18 Jan 2021, Gel status: 2

Set Phenotypes

Zornitza Stark (Victorian Clinical Genetics Services)

Phenotypes for gene: PIGM were changed from portal vein thrombosis; persistent absence seizures; macrocephaly; infantile-onset cerebrovascular thrombotic events; portal vein thrombosis; persistent absence seizures; macrocephaly; infantile-onset cerebrovascular thrombotic events to Glycosylphosphatidylinositol deficiency, MIM# 610293; portal vein thrombosis; persistent absence seizures; macrocephaly; infantile-onset cerebrovascular thrombotic events; portal vein thrombosis; persistent absence seizures; macrocephaly; infantile-onset cerebrovascular thrombotic events

15 Jul 2020, Gel status: 2

Set Phenotypes

Zornitza Stark (Victorian Clinical Genetics Services)

Phenotypes for gene: PIGM were changed from portal vein thrombosis; persistent absence seizures; macrocephaly; infantile-onset cerebrovascular thrombotic events; portal vein thrombosis; persistent absence seizures; macrocephaly; infantile-onset cerebrovascular thrombotic events to portal vein thrombosis; persistent absence seizures; macrocephaly; infantile-onset cerebrovascular thrombotic events; portal vein thrombosis; persistent absence seizures; macrocephaly; infantile-onset cerebrovascular thrombotic events

15 Jul 2020, Gel status: 2

Set Phenotypes

Zornitza Stark (Victorian Clinical Genetics Services)

Phenotypes for gene: PIGM were changed from portal vein thrombosis; persistent absence seizures; macrocephaly; infantile-onset cerebrovascular thrombotic events to portal vein thrombosis; persistent absence seizures; macrocephaly; infantile-onset cerebrovascular thrombotic events; portal vein thrombosis; persistent absence seizures; macrocephaly; infantile-onset cerebrovascular thrombotic events

15 Jul 2020, Gel status: 2

Entity classified by Genomics England curator

Zornitza Stark (Victorian Clinical Genetics Services)

Gene: pigm has been classified as Amber List (Moderate Evidence).

15 Jul 2020, Gel status: 2

Added Tag

Zornitza Stark (Victorian Clinical Genetics Services)

Tag founder tag was added to gene: PIGM.

15 Jul 2020, Gel status: 2

Set Phenotypes

Zornitza Stark (Victorian Clinical Genetics Services)

Phenotypes for gene: PIGM were changed from to portal vein thrombosis; persistent absence seizures; macrocephaly; infantile-onset cerebrovascular thrombotic events

15 Jul 2020, Gel status: 2

Set publications

Zornitza Stark (Victorian Clinical Genetics Services)

Publications for gene: PIGM were set to

15 Jul 2020, Gel status: 2

Set mode of inheritance

Zornitza Stark (Victorian Clinical Genetics Services)

Mode of inheritance for gene: PIGM was changed from Unknown to BIALLELIC, autosomal or pseudoautosomal

15 Jul 2020, Gel status: 2

Entity classified by Genomics England curator

Zornitza Stark (Victorian Clinical Genetics Services)

Gene: pigm has been classified as Amber List (Moderate Evidence).

17 Nov 2019, Gel status: 3

Created, Added New Source, Set mode of inheritance

Zornitza Stark (Victorian Clinical Genetics Services)

gene: PIGM was added gene: PIGM was added to Congenital Disorders of Glycosylation_VCGS. Sources: Expert Review Green,Victorian Clinical Genetics Services Mode of inheritance for gene: PIGM was set to Unknown