---
- diseases:
  - ageOfOnset:
      ontologyClass:
        id: HP:0011463
        label: Childhood onset
    diseaseCode:
      id: MONDO:0100308
      label: atactic disorder
    excluded: 0
  id: 16-year-old boy
  info:
    phenopacket:
      interpretations:
      - diagnosis:
          disease:
            id: MONDO:0100340
            label: Friedreich ataxia 1
          genomicInterpretations:
          - gene:
              symbol: FXN
              valueId: HGNC:3951
            interpretationStatus: REJECTED
            subjectOrBiosampleId: 16-year-old boy
        id: interpretation.1
        progressStatus: COMPLETED
        summary: Genetic analysis of the frataxin gene confirmed two alleles in the
          normal size range and no evidence of an expansion.
      - diagnosis:
          disease:
            id: MONDO:0010188
            label: familial isolated deficiency of vitamin E
          genomicInterpretations:
          - interpretationStatus: CAUSATIVE
            subjectOrBiosampleId: 16-year-old boy
            variantInterpretation:
              acmgPathogenicityClassification: PATHOGENIC
              therapeuticActionability: ACTIONABLE
              variationDescriptor:
                allelicState:
                  id: GENO:0000136
                  label: homozygous
                expressions:
                - syntax: hgvs.c
                  value: NM_000370.3(TTPA):c.706del
                - syntax: transcript_reference
                  value: NM_000370.3
                geneContext:
                  symbol: TTPA
                  valueId: HGNC:12404
                id: variant.1
                label: NP_000361.1:p.(His236IlefsTer28)
                moleculeContext: genomic
                variation:
                  allele:
                    literalSequenceExpression: {}
                    sequenceLocation:
                      sequenceId: refseq:NC_000008.11
                      sequenceInterval:
                        endNumber:
                          value: 63061383
                        startNumber:
                          value: 63061382
                vcfRecord:
                  alt: T
                  chrom: NC_000008.11
                  genomeAssembly: GRCh38
                  pos: 63061382
                  ref: TG
        id: interpretation.2
        progressStatus: SOLVED
      metaData:
        created: 2022-04-21T10:35:00Z
        createdBy: anonymous biocurator
        externalReferences:
        - description: 'Ataxia due to vitamin E deficiency: A case report and updated
            review'
          id: doi:10.1002/ccr3.6303
        phenopacketSchemaVersion: 2.0.0
        resources:
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          iriPrefix: http://purl.obolibrary.org/obo/NCIT_
          name: NCI Thesaurus
          namespacePrefix: NCIT
          url: http://purl.obolibrary.org/obo/ncit.owl
          version: 21.05d
        - id: hp
          iriPrefix: http://purl.obolibrary.org/obo/HP_
          name: human phenotype ontology
          namespacePrefix: HP
          url: http://purl.obolibrary.org/obo/hp.owl
          version: 2022-06-11
        - id: mondo
          iriPrefix: http://purl.obolibrary.org/obo/MONDO_
          name: Mondo Disease Ontology
          namespacePrefix: MONDO
          url: http://purl.obolibrary.org/obo/mondo.obo
          version: 2022-04-04
        - id: uberon
          iriPrefix: http://purl.obolibrary.org/obo/UBERON_
          name: Uber-anatomy ontology
          namespacePrefix: UBERON
          url: http://purl.obolibrary.org/obo/uberon.owl
          version: 2021-07-27
        - id: loinc
          iriPrefix: https://loinc.org/
          name: Logical Observation Identifiers Names and Codes
          namespacePrefix: LOINC
          url: https://loinc.org
          version: 2.73
        - id: ucum
          iriPrefix: https://units-of-measurement.org/
          name: Unified Code for Units of Measure
          namespacePrefix: UCUM
          url: https://ucum.org
          version: 2.1
        - id: geno
          iriPrefix: http://purl.obolibrary.org/obo/GENO_
          name: Genotype Ontology
          namespacePrefix: GENO
          url: http://purl.obolibrary.org/obo/geno.owl
          version: 2022-03-05
        - id: drugcentral
          iriPrefix: https://drugcentral.org/drugcard/
          name: Drug Central
          namespacePrefix: DrugCentral
          url: https://drugcentral.org/
          version: 2022-08-22
  karyotypicSex: UNKNOWN_KARYOTYPE
  measures:
  - assayCode:
      id: LOINC:2923-1
      label: Retinol [Mass/volume] in Serum or Plasma
    measurementValue:
      quantity:
        referenceRange:
          high: 60
          low: 20
          unit:
            id: UCUM:ug.dL-1
            label: microgram per deciliter
        unit:
          id: UCUM:ug.dL-1
          label: microgram per deciliter
        value: 45
    observationMoment: &1
      age:
        iso8601duration: P16Y
    timeObserved: *1
  - assayCode:
      id: LOINC:1823-4
      label: Alpha tocopherol [Mass/volume] in Serum or Plasma
    measurementValue:
      quantity:
        referenceRange:
          high: 10
          low: 6
          unit:
            id: UCUM:mg.dL-1
            label: milligram per deciliter
        unit:
          id: UCUM:mg.dL-1
          label: milligram per deciliter
        value: 3.9
    observationMoment: &2
      age:
        iso8601duration: P16Y
    timeObserved: *2
  - assayCode:
      id: LOINC:2157-6
      label: Creatine kinase [Enzymatic activity/volume] in Serum or Plasma
    measurementValue:
      quantity:
        referenceRange:
          high: 198
          low: 22
          unit:
            id: UCUM:U.L-1
            label: enzyme unit per liter
        unit:
          id: UCUM:U.L-1
          label: enzyme unit per liter
        value: 80
    observationMoment: &3
      age:
        iso8601duration: P16Y
    timeObserved: *3
  - assayCode:
      id: LOINC:1823-4
      label: Alpha tocopherol [Mass/volume] in Serum or Plasma
    measurementValue:
      quantity:
        referenceRange:
          high: 10
          low: 6
          unit:
            id: UCUM:mg.dL-1
            label: milligram per deciliter
        unit:
          id: UCUM:mg.dL-1
          label: milligram per deciliter
        value: 17.34
    observationMoment: &4
      age:
        iso8601duration: P16Y6M
    timeObserved: *4
  phenotypicFeatures:
  - excluded: 0
    featureType:
      id: HP:0001288
      label: Gait disturbance
    onset:
      age:
        iso8601duration: P10Y
  - excluded: 0
    featureType:
      id: HP:0001324
      label: Muscle weakness
    modifiers:
    - id: HP:0012837
      label: Generalized
    onset:
      age:
        iso8601duration: P10Y
  - excluded: 0
    featureType:
      id: HP:0002066
      label: Gait ataxia
    onset:
      age:
        iso8601duration: P16Y
  - excluded: 0
    featureType:
      id: HP:0001308
      label: Tongue fasciculations
    onset:
      age:
        iso8601duration: P16Y
  - excluded: 0
    featureType:
      id: HP:0002080
      label: Intention tremor
    onset:
      age:
        iso8601duration: P16Y
  - excluded: 0
    featureType:
      id: HP:0002075
      label: Dysdiadochokinesis
    onset:
      age:
        iso8601duration: P16Y
  - excluded: 0
    featureType:
      id: HP:0001251
      label: Ataxia
    onset:
      age:
        iso8601duration: P16Y
  - excluded: 0
    featureType:
      id: HP:0001284
      label: Areflexia
    onset:
      age:
        iso8601duration: P16Y
  - excluded: 0
    featureType:
      id: HP:0011448
      label: Ankle clonus
    onset:
      age:
        iso8601duration: P16Y
  - excluded: 0
    featureType:
      id: HP:0003690
      label: Limb muscle weakness
    onset:
      age:
        iso8601duration: P16Y
  - excluded: 1
    featureType:
      id: HP:0003474
      label: Somatic sensory dysfunction
    onset:
      age:
        iso8601duration: P16Y
  - excluded: 1
    featureType:
      id: HP:0002599
      label: Head titubation
    onset:
      age:
        iso8601duration: P16Y
  - excluded: 1
    featureType:
      id: HP:0031910
      label: Abnormal cranial nerve physiology
    onset:
      age:
        iso8601duration: P16Y
  sex:
    id: NCIT:C16576
    label: Female
  treatments:
  - drugType: UNKNOWN_DRUG_TYPE
    routeOfAdministration:
      id: NCIT:C38288
      label: Oral Route of Administration
    treatmentCode:
      id: DrugCentral:257
      label: atorvastatin
- id: proband A
  info:
    phenopacket:
      interpretations:
      - diagnosis:
          disease:
            id: OMIM:158810
            label: Bethlem myopathy 1
          genomicInterpretations:
          - interpretationStatus: CAUSATIVE
            subjectOrBiosampleId: arbitrary interpretation id
            variantInterpretation:
              acmgPathogenicityClassification: PATHOGENIC
              therapeuticActionability: UNKNOWN_ACTIONABILITY
              variationDescriptor:
                allelicState:
                  id: GENO:0000135
                  label: heterozygous
                expressions:
                - syntax: hgvs
                  value: NM_001848.2:c.877G>A
                geneContext:
                  symbol: COL6A1
                  valueId: HGNC:2211
                id: variant id
                moleculeContext: unspecified_molecule_context
                vcfRecord:
                  alt: A
                  chrom: chr21
                  genomeAssembly: GRCh38
                  pos: 45989626
                  ref: G
        id: arbitrary interpretation id
        progressStatus: COMPLETED
      metaData:
        created: 2021-05-14T10:35:00Z
        createdBy: anonymous biocurator
        externalReferences:
        - description: 'COL6A1 mutation leading to Bethlem myopathy with recurrent
            hematuria: a case report'
          id: PMID:30808312
        phenopacketSchemaVersion: 2.0.0
        resources:
        - id: hp
          iriPrefix: http://purl.obolibrary.org/obo/HP_
          name: human phenotype ontology
          namespacePrefix: HP
          url: http://purl.obolibrary.org/obo/hp.owl
          version: 2021-08-02
        - id: geno
          iriPrefix: http://purl.obolibrary.org/obo/GENO_
          name: Genotype Ontology
          namespacePrefix: GENO
          url: http://purl.obolibrary.org/obo/geno.owl
          version: 2020-03-08
        - id: eco
          iriPrefix: http://purl.obolibrary.org/obo/ECO_
          name: Evidence & Conclusion Ontology (ECO)
          namespacePrefix: ECO
          url: http://purl.obolibrary.org/obo/eco.owl
          version: 2022-08-05
        - id: omim
          iriPrefix: https://www.omim.org/entry/
          name: An Online Catalog of Human Genes and Genetic Disorders
          namespacePrefix: OMIM
          url: https://www.omim.org
          version: 2022-11-23
  karyotypicSex: UNKNOWN_KARYOTYPE
  phenotypicFeatures:
  - evidence:
    - evidenceCode:
        id: ECO:0000033
        label: author statement supported by traceable reference
      reference:
        description: 'COL6A1 mutation leading to Bethlem myopathy with recurrent hematuria:
          a case report'
        id: PMID:30808312
    excluded: 0
    featureType:
      id: HP:0001629
      label: Ventricular septal defect
    onset:
      ontologyClass:
        id: HP:0003577
        label: Congenital onset
  - evidence:
    - evidenceCode:
        id: ECO:0000033
        label: author statement supported by traceable reference
      reference:
        description: 'COL6A1 mutation leading to Bethlem myopathy with recurrent hematuria:
          a case report'
        id: PMID:30808312
    excluded: 0
    featureType:
      id: HP:0000280
      label: Coarse facial features
  - evidence:
    - evidenceCode:
        id: ECO:0000033
        label: author statement supported by traceable reference
      reference:
        description: 'COL6A1 mutation leading to Bethlem myopathy with recurrent hematuria:
          a case report'
        id: PMID:30808312
    excluded: 0
    featureType:
      id: HP:0008689
      label: Bilateral cryptorchidism
    onset:
      ontologyClass:
        id: HP:0003577
        label: Congenital onset
  - evidence:
    - evidenceCode:
        id: ECO:0000033
        label: author statement supported by traceable reference
      reference:
        description: 'COL6A1 mutation leading to Bethlem myopathy with recurrent hematuria:
          a case report'
        id: PMID:30808312
    excluded: 0
    featureType:
      id: HP:0001561
      label: Polyhydramnios
    onset:
      ontologyClass:
        id: HP:0011461
        label: Fetal onset
  - evidence:
    - evidenceCode:
        id: ECO:0000033
        label: author statement supported by traceable reference
      reference:
        description: 'COL6A1 mutation leading to Bethlem myopathy with recurrent hematuria:
          a case report'
        id: PMID:30808312
    excluded: 0
    featureType:
      id: HP:0000054
      label: Micropenis
    onset:
      ontologyClass:
        id: HP:0003577
        label: Congenital onset
  - evidence:
    - evidenceCode:
        id: ECO:0000033
        label: author statement supported by traceable reference
      reference:
        description: 'COL6A1 mutation leading to Bethlem myopathy with recurrent hematuria:
          a case report'
        id: PMID:30808312
    excluded: 0
    featureType:
      id: HP:0001798
      label: Anonychia
    onset:
      ontologyClass:
        id: HP:0003577
        label: Congenital onset
  - evidence:
    - evidenceCode:
        id: ECO:0000033
        label: author statement supported by traceable reference
      reference:
        description: 'COL6A1 mutation leading to Bethlem myopathy with recurrent hematuria:
          a case report'
        id: PMID:30808312
    excluded: 0
    featureType:
      id: HP:0001320
      label: Cerebellar vermis hypoplasia
  - evidence:
    - evidenceCode:
        id: ECO:0000033
        label: author statement supported by traceable reference
      reference:
        description: 'COL6A1 mutation leading to Bethlem myopathy with recurrent hematuria:
          a case report'
        id: PMID:30808312
    excluded: 0
    featureType:
      id: HP:0000518
      label: Cataract
    onset:
      ontologyClass:
        id: HP:0003593
        label: Infantile onset
  - evidence:
    - evidenceCode:
        id: ECO:0000033
        label: author statement supported by traceable reference
      reference:
        description: 'COL6A1 mutation leading to Bethlem myopathy with recurrent hematuria:
          a case report'
        id: PMID:30808312
    excluded: 0
    featureType:
      id: HP:0002198
      label: Dilated fourth ventricle
  - evidence:
    - evidenceCode:
        id: ECO:0000033
        label: author statement supported by traceable reference
      reference:
        description: 'COL6A1 mutation leading to Bethlem myopathy with recurrent hematuria:
          a case report'
        id: PMID:30808312
    excluded: 0
    featureType:
      id: HP:0100333
      label: Unilateral cleft lip
    onset:
      ontologyClass:
        id: HP:0003577
        label: Congenital onset
  sex:
    id: NCIT:C20197
    label: Male
- diseases:
  - diseaseCode:
      id: MONDO:0005015
      label: diabetes mellitus
    excluded: 1
  - diseaseCode:
      id: MONDO:0004994
      label: cardiomyopathy
    excluded: 0
  - ageOfOnset:
      timestamp: 2020-03-17T00:00:00Z
    diseaseCode:
      id: MONDO:0100096
      label: COVID-19
    excluded: 0
  id: P123542
  info:
    phenopacket:
      metaData:
        created: 2021-08-17T00:00:00Z
        createdBy: anonymous biocurator
        externalReferences:
        - description: 'The Imperfect Cytokine Storm: Severe COVID-19 With ARDS in
            a Patient on Durable LVAD Support'
          id: DOI:10.1016/j.jaccas.2020.04.001
          reference: PMID:32292915
        phenopacketSchemaVersion: 2.0.0
        resources:
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          iriPrefix: http://purl.obolibrary.org/obo/HP_
          name: human phenotype ontology
          namespacePrefix: HP
          url: http://purl.obolibrary.org/obo/hp.owl
          version: 2021-08-02
        - id: ncit
          iriPrefix: http://purl.obolibrary.org/obo/NCIT_
          name: NCI Thesaurus
          namespacePrefix: NCIT
          url: http://purl.obolibrary.org/obo/ncit.owl
          version: 21.05d
        - id: mondo
          iriPrefix: http://purl.obolibrary.org/obo/MONDO_
          name: Mondo Disease Ontology
          namespacePrefix: MONDO
          url: http://purl.obolibrary.org/obo/mondo.obo
          version: 2022-04-04
        - id: loinc
          iriPrefix: https://loinc.org/
          name: Logical Observation Identifiers Names and Codes
          namespacePrefix: LOINC
          url: https://loinc.org
          version: 2.73
        - id: pato
          iriPrefix: http://purl.obolibrary.org/obo/PATO_
          name: PhenotypicFeature And Trait Ontology
          namespacePrefix: PATO
          url: http://purl.obolibrary.org/obo/pato.owl
          version: 2022-08-31
        - id: chebi
          iriPrefix: https://purl.obolibrary.org/obo/CHEBI_
          name: Chemical Entities of Biological Interest
          namespacePrefix: CHEBI
          url: https://www.ebi.ac.uk/chebi
          version: 2022-11-23
        - id: ucum
          iriPrefix: https://units-of-measurement.org/
          name: Unified Code for Units of Measure
          namespacePrefix: UCUM
          url: https://ucum.org
          version: 2.1
  interventionsOrProcedures:
  - ageOfProcedure:
      timestamp: 2016-01-01T00:00:00Z
    procedureCode:
      id: NCIT:C80473
      label: Left Ventricular Assist Device
  - ageOfProcedure:
      timestamp: 2020-03-22T00:00:00Z
    procedureCode:
      id: NCIT:C116648
      label: Tracheal Intubation
  karyotypicSex: UNKNOWN_KARYOTYPE
  measures:
  - assayCode:
      id: LOINC:26474-7
      label: Lymphocytes [#/volume] in Blood
    measurementValue:
      quantity:
        unit:
          id: NCIT:C67245
          label: Thousand Cells
        value: 1.4
    observationMoment: &5
      interval:
        end: 2020-03-01T00:00:00Z
        start: 2019-09-01T00:00:00Z
    timeObserved: *5
  - assayCode:
      id: LOINC:26474-7
      label: Lymphocytes [#/volume] in Blood
    measurementValue:
      quantity:
        unit:
          id: NCIT:C67245
          label: Thousand Cells
        value: 0.7
    observationMoment: &6
      timestamp: 2020-03-20T00:00:00Z
    timeObserved: *6
  phenotypicFeatures:
  - excluded: 0
    featureType:
      id: HP:0001945
      label: 'Fever '
    onset:
      timestamp: 2021-02-01T05:00:00Z
  - excluded: 0
    featureType:
      id: HP:0030157
      label: Flank pain
    onset:
      timestamp: 2021-02-01T05:00:00Z
  - excluded: 0
    featureType:
      id: HP:0000790
      label: Hematuria
    onset:
      timestamp: 2021-02-01T05:00:00Z
  - excluded: 0
    featureType:
      id: HP:0012625
      label: Stage 3 chronic kidney disease
    onset:
      timestamp: 2021-02-01T05:00:00Z
  - excluded: 0
    featureType:
      id: HP:0003326
      label: Myalgia
    onset:
      interval:
        end: 2020-03-20T00:00:00Z
        start: 2020-03-18T00:00:00Z
  - excluded: 0
    featureType:
      id: HP:0002014
      label: Diarrhea
    onset:
      interval:
        end: 2020-03-20T00:00:00Z
        start: 2020-03-18T00:00:00Z
  - excluded: 0
    featureType:
      id: HP:0002094
      label: Dyspnea
    onset:
      interval:
        end: 2020-03-20T00:00:00Z
        start: 2020-03-18T00:00:00Z
  - excluded: 0
    featureType:
      id: HP:0033677
      label: Acute respiratory distress syndrome
    onset:
      timestamp: 2020-03-20T00:00:00Z
  sex: &7
    id: NCIT:C20197
    label: Male
  treatments:
  - doseIntervals:
    - interval:
        end: 2021-02-02T08:22:42Z
        start: 2021-02-01T18:58:43Z
      quantity:
        unit:
          id: NCIT:C67388
          label: Liter per Minute
        value: 2
      scheduleFrequency:
        id: PATO:0000689
        label: continuous
    - interval:
        end: 2021-02-02T12:22:42Z
        start: 2021-02-02T08:22:42Z
      quantity:
        unit:
          id: NCIT:C67388
          label: Liter per Minute
        value: 50
      scheduleFrequency:
        id: PATO:0000689
        label: continuous
    drugType: UNKNOWN_DRUG_TYPE
    routeOfAdministration:
      id: NCIT:C38284
      label: Nasal Route of Administration
    treatmentCode:
      id: NCIT:C722
      label: Oxygen
  - doseIntervals:
    - interval:
        end: 2020-03-30T00:00:00Z
        start: 2020-03-20T00:00:00Z
      quantity:
        unit:
          id: UCUM:mg
          label: milligram
        value: 6
      scheduleFrequency:
        id: NCIT:C125004
        label: Once Daily
    drugType: UNKNOWN_DRUG_TYPE
    treatmentCode:
      id: CHEBI:41879
      label: dexamethasone
  - doseIntervals:
    - interval:
        end: 2020-03-28T00:00:00Z
        start: 2020-03-22T00:00:00Z
      quantity:
        unit:
          id: NCIT:C91060
          label: Centimeters of Water
        value: 14
      scheduleFrequency:
        id: PATO:0000689
        label: continuous
    drugType: UNKNOWN_DRUG_TYPE
    routeOfAdministration:
      id: NCIT:C50254
      label: Positive end Expiratory Pressure Valve Device
    treatmentCode:
      id: NCIT:C722
      label: Oxygen
  - doseIntervals:
    - interval:
        end: 2020-03-28T00:00:00Z
        start: 2020-03-24T00:00:00Z
      quantity:
        unit:
          id: NCIT:C124458
          label: Milligram per Kilogram per Dose
        value: 4
      scheduleFrequency:
        id: NCIT:C64529
        label: Every Four Weeks
    drugType: UNKNOWN_DRUG_TYPE
    treatmentCode:
      id: NCIT:C84217
      label: Tocilizumab
- id: 10-year old boy
  info:
    phenopacket:
      interpretations:
      - diagnosis:
          disease:
            id: MONDO:0010679
            label: Duchenne muscular dystrophy
          genomicInterpretations:
          - interpretationStatus: CAUSATIVE
            subjectOrBiosampleId: 10-year old boy
            variantInterpretation:
              acmgPathogenicityClassification: PATHOGENIC
              therapeuticActionability: UNKNOWN_ACTIONABILITY
              variationDescriptor:
                allelicState:
                  id: GENO:0000134
                  label: hemizygous
                expressions:
                - syntax: hgvs.c
                  value: NM_004006.3:c.7310-11543_7359del
                - syntax: transcript_reference
                  value: NM_004006.3
                geneContext:
                  symbol: DMD
                  valueId: HGNC:2928
                id: variant-id
                moleculeContext: genomic
                variation:
                  copyNumber:
                    derivedSequenceExpression:
                      location:
                        sequenceId: refseq:NC_000023.11
                        sequenceInterval:
                          endNumber:
                            value: 31785736
                          startNumber:
                            value: 31774144
                      reverseComplement: 0
                    number:
                      value: 1
        id: interpretation.id
        progressStatus: SOLVED
      metaData:
        created: 2021-05-14T10:35:00Z
        createdBy: anonymous biocurator
        phenopacketSchemaVersion: 2.0.0
        resources:
        - id: hp
          iriPrefix: http://purl.obolibrary.org/obo/HP_
          name: human phenotype ontology
          namespacePrefix: HP
          url: http://purl.obolibrary.org/obo/hp.owl
          version: 2022-06-11
        - id: mondo
          iriPrefix: http://purl.obolibrary.org/obo/MONDO_
          name: Mondo Disease Ontology
          namespacePrefix: MONDO
          url: http://purl.obolibrary.org/obo/mondo.obo
          version: 2022-04-04
        - id: geno
          iriPrefix: http://purl.obolibrary.org/obo/GENO_
          name: Genotype Ontology
          namespacePrefix: GENO
          url: http://purl.obolibrary.org/obo/geno.owl
          version: 2022-03-05
  karyotypicSex: UNKNOWN_KARYOTYPE
  phenotypicFeatures:
  - excluded: 0
    featureType:
      id: HP:0031936
      label: Delayed ability to walk
    onset:
      age:
        iso8601duration: P1Y6M
  - excluded: 0
    featureType:
      id: HP:0003707
      label: Calf muscle pseudohypertrophy
    onset:
      ontologyClass:
        id: HP:0011463
        label: Childhood onset
  - excluded: 0
    featureType:
      id: HP:0009046
      label: Difficulty running
    onset:
      ontologyClass:
        id: HP:0011463
        label: Childhood onset
  - excluded: 0
    featureType:
      id: HP:0003458
      label: 'EMG: myopathic abnormalities'
    onset:
      age:
        iso8601duration: P10Y
  - excluded: 0
    featureType:
      id: HP:0003236
      label: Elevated circulating creatine kinase concentration
    onset:
      age:
        iso8601duration: P10Y
  sex: *7
- id: nine-month old infant
  info:
    phenopacket:
      interpretations:
      - diagnosis:
          disease:
            id: OMIM:609637
            label: Holoprosencephaly 5
          genomicInterpretations:
          - interpretationStatus: CAUSATIVE
            subjectOrBiosampleId: genomic interpretation id
            variantInterpretation:
              acmgPathogenicityClassification: PATHOGENIC
              therapeuticActionability: UNKNOWN_ACTIONABILITY
              variationDescriptor:
                allelicState:
                  id: GENO:0000135
                  label: heterozygous
                expressions:
                - syntax: hgvs
                  value: NM_007129.3:c.1069C>G
                geneContext:
                  symbol: ZIC2
                  valueId: 'HGNC:12873 '
                id: variant id
                moleculeContext: unspecified_molecule_context
                vcfRecord:
                  alt: G
                  chrom: NC_000013.11
                  genomeAssembly: GRCh38
                  pos: 99983133
                  ref: C
        id: arbitrary interpretation id
        progressStatus: COMPLETED
      metaData:
        created: 2021-05-14T10:35:00Z
        createdBy: anonymous biocurator
        externalReferences:
        - description: Xiong J, et al., 2019
          id: PMID:30855487
        phenopacketSchemaVersion: 2.0.0
        resources:
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          name: human phenotype ontology
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          version: 2021-08-02
        - id: geno
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          name: Genotype Ontology
          namespacePrefix: GENO
          url: http://purl.obolibrary.org/obo/geno.owl
          version: 2020-03-08
        - id: eco
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          name: Evidence & Conclusion Ontology (ECO)
          namespacePrefix: ECO
          url: http://purl.obolibrary.org/obo/eco.owl
          version: 2022-08-05
        - id: omim
          iriPrefix: https://www.omim.org/entry/
          name: An Online Catalog of Human Genes and Genetic Disorders
          namespacePrefix: OMIM
          url: https://www.omim.org
          version: 2022-11-23
  karyotypicSex: UNKNOWN_KARYOTYPE
  phenotypicFeatures:
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    - evidenceCode:
        id: ECO:0000033
        label: author statement supported by traceable reference
      reference:
        description: Xiong J, et al., 2019
        id: PMID:30855487
    excluded: 0
    featureType:
      id: HP:0000238
      label: Hydrocephalus
    onset:
      gestationalAge:
        weeks: 40
  - evidence:
    - evidenceCode:
        id: ECO:0000033
        label: author statement supported by traceable reference
      reference:
        description: Xiong J, et al., 2019
        id: PMID:30855487
    excluded: 0
    featureType:
      id: HP:0002507
      label: Semilobar holoprosencephaly
    onset:
      ontologyClass:
        id: HP:0003577
        label: Congenital onset
  - evidence:
    - evidenceCode:
        id: ECO:0000033
        label: author statement supported by traceable reference
      reference:
        description: Xiong J, et al., 2019
        id: PMID:30855487
    excluded: 0
    featureType:
      id: HP:0001750
      label: Single ventricle
    onset:
      gestationalAge:
        weeks: 40
  - evidence:
    - evidenceCode:
        id: ECO:0000033
        label: author statement supported by traceable reference
      reference:
        description: Xiong J, et al., 2019
        id: PMID:30855487
    excluded: 0
    featureType:
      id: HP:0001272
      label: Cerebellar atrophy
    onset:
      age:
        iso8601duration: P9M
  - evidence:
    - evidenceCode:
        id: ECO:0000033
        label: author statement supported by traceable reference
      reference:
        description: Xiong J, et al., 2019
        id: PMID:30855487
    excluded: 0
    featureType:
      id: HP:0100702
      label: Arachnoid cyst
    onset:
      age:
        iso8601duration: P9M
  - evidence:
    - evidenceCode:
        id: ECO:0000033
        label: author statement supported by traceable reference
      reference:
        description: Xiong J, et al., 2019
        id: PMID:30855487
    excluded: 0
    featureType:
      id: HP:0001272
      label: Cerebellar atrophy
    onset:
      age:
        iso8601duration: P9M
  - evidence:
    - evidenceCode:
        id: ECO:0000033
        label: author statement supported by traceable reference
      reference:
        description: Xiong J, et al., 2019
        id: PMID:30855487
    excluded: 0
    featureType:
      id: HP:0001263
      label: Global developmental delay
    onset:
      ontologyClass:
        id: HP:0003593
        label: Infantile onset
  - evidence:
    - evidenceCode:
        id: ECO:0000033
        label: author statement supported by traceable reference
      reference:
        description: Xiong J, et al., 2019
        id: PMID:30855487
    excluded: 0
    featureType:
      id: HP:0001347
      label: Hyperreflexia
    onset:
      gestationalAge:
        weeks: 40
  sex: &8
    id: NCIT:C16576
    label: Female
- diseases:
  - diseaseCode:
      id: OMIM:154700
      label: Marfan syndrome
    excluded: 0
  id: proband C
  info:
    phenopacket:
      metaData:
        created: 2021-05-14T10:35:00Z
        createdBy: anonymous biocurator
        phenopacketSchemaVersion: 2.0.0
        resources:
        - id: hp
          iriPrefix: http://purl.obolibrary.org/obo/HP_
          name: human phenotype ontology
          namespacePrefix: HP
          url: http://purl.obolibrary.org/obo/hp.owl
          version: 2021-08-02
        - id: omim
          iriPrefix: https://www.omim.org/entry/
          name: An Online Catalog of Human Genes and Genetic Disorders
          namespacePrefix: OMIM
          url: https://www.omim.org
          version: 2022-11-23
        - id: drugcentral
          iriPrefix: https://drugcentral.org/drugcard/
          name: Drug Central
          namespacePrefix: DrugCentral
          url: https://drugcentral.org/
          version: 2022-08-22
        - id: ncit
          iriPrefix: http://purl.obolibrary.org/obo/NCIT_
          name: NCI Thesaurus
          namespacePrefix: NCIT
          url: http://purl.obolibrary.org/obo/ncit.owl
          version: 21.05d
        - id: ucum
          iriPrefix: https://units-of-measurement.org/
          name: Unified Code for Units of Measure
          namespacePrefix: UCUM
          url: https://ucum.org
          version: 2.1
  karyotypicSex: UNKNOWN_KARYOTYPE
  phenotypicFeatures:
  - excluded: 0
    featureType:
      id: HP:0002616
      label: Aortic root aneurysm
  sex: *8
  treatments:
  - doseIntervals:
    - interval:
        end: 2021-03-20T00:00:00Z
        start: 2019-03-20T00:00:00Z
      quantity:
        unit:
          id: UCUM:mg
          label: milligram
        value: 30
      scheduleFrequency:
        id: NCIT:C64496
        label: Twice Daily
    drugType: UNKNOWN_DRUG_TYPE
    routeOfAdministration:
      id: NCIT:C38288
      label: Oral Route of Administration
    treatmentCode:
      id: DrugCentral:1610
      label: losartan
- id: proband A
  info:
    phenopacket:
      biosamples:
      - id: biosample.1
        phenotypicFeatures:
        - excluded: 0
          type:
            id: HP:0003798
            label: Nemaline bodies
        procedure:
          bodySite:
            id: UBERON:0002378
            label: muscle of abdomen
          code:
            id: NCIT:C51895
            label: Muscle Biopsy
          performed:
            age:
              iso8601duration: P1D
        sampledTissue:
          id: UBERON:0002378
          label: muscle of abdomen
      interpretations:
      - diagnosis:
          disease:
            id: MONDO:0014138
            label: nemaline myopathy 8
          genomicInterpretations:
          - interpretationStatus: CAUSATIVE
            subjectOrBiosampleId: interpretation.1
            variantInterpretation:
              acmgPathogenicityClassification: PATHOGENIC
              therapeuticActionability: UNKNOWN_ACTIONABILITY
              variationDescriptor:
                allelicState:
                  id: GENO:0000135
                  label: heterozygous
                expressions:
                - syntax: hgvs.c
                  value: NM_152393.4(KLHL40):c.602G>A
                - syntax: transcript_reference
                  value: NM_152393.4
                geneContext:
                  symbol: KLHL40
                  valueId: HGNC:30372
                id: rs397509420
                label: NM_152393.4(KLHL40):c.602G>A (p.Trp201Ter)
                moleculeContext: transcript
                variation:
                  allele:
                    literalSequenceExpression:
                      sequence: A
                    sequenceLocation:
                      sequenceId: NC_000003.12
                      sequenceInterval:
                        endNumber:
                          value: 42686220
                        startNumber:
                          value: 42686219
          - interpretationStatus: CAUSATIVE
            subjectOrBiosampleId: interpretation.2
            variantInterpretation:
              acmgPathogenicityClassification: PATHOGENIC
              therapeuticActionability: UNKNOWN_ACTIONABILITY
              variationDescriptor:
                allelicState:
                  id: GENO:0000135
                  label: heterozygous
                expressions:
                - syntax: hgvs.c
                  value: NM_152393.4(KLHL40):c.1516A>C
                - syntax: transcript_reference
                  value: NM_152393.4
                geneContext:
                  symbol: KLHL40
                  valueId: HGNC:30372
                id: rs778022582
                label: NM_152393.4(KLHL40):c.1516A>C (p.Thr506Pro)
                moleculeContext: transcript
                variation:
                  allele:
                    literalSequenceExpression:
                      sequence: C
                    sequenceLocation:
                      sequenceId: NC_000003.12
                      sequenceInterval:
                        endNumber:
                          value: 42688963
                        startNumber:
                          value: 42688962
        id: interpretation.id
        progressStatus: SOLVED
      metaData:
        created: 2021-05-14T10:35:00Z
        createdBy: anonymous biocurator
        phenopacketSchemaVersion: 2.0.0
        resources:
        - id: ncit
          iriPrefix: http://purl.obolibrary.org/obo/NCIT_
          name: NCI Thesaurus
          namespacePrefix: NCIT
          url: http://purl.obolibrary.org/obo/ncit.owl
          version: 21.05d
        - id: hp
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          name: human phenotype ontology
          namespacePrefix: HP
          url: http://purl.obolibrary.org/obo/hp.owl
          version: 2022-02
        - id: mondo
          iriPrefix: http://purl.obolibrary.org/obo/MONDO_
          name: Mondo Disease Ontology
          namespacePrefix: MONDO
          url: http://purl.obolibrary.org/obo/mondo.obo
          version: 2022-04-04
        - id: uberon
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          name: Uber-anatomy ontology
          namespacePrefix: UBERON
          url: http://purl.obolibrary.org/obo/uberon.owl
          version: 2021-07-27
        - id: geno
          iriPrefix: http://purl.obolibrary.org/obo/GENO_
          name: Genotype Ontology
          namespacePrefix: GENO
          url: http://purl.obolibrary.org/obo/geno.owl
          version: 2022-03-05
  karyotypicSex: UNKNOWN_KARYOTYPE
  phenotypicFeatures:
  - excluded: 0
    featureType:
      id: HP:0001558
      label: Decreased fetal movement
    onset:
      gestationalAge:
        weeks: 23
  - excluded: 0
    featureType:
      id: HP:0025672
      label: Fetal skin edema
    onset:
      gestationalAge:
        days: 4
        weeks: 32
  - excluded: 0
    featureType:
      id: HP:0010557
      label: Overlapping fingers
    onset:
      gestationalAge:
        days: 4
        weeks: 32
  - excluded: 0
    featureType:
      id: HP:0001561
      label: Polyhydramnios
    modifiers:
    - id: HP:0012827
      label: Borderline
    onset:
      gestationalAge:
        days: 4
        weeks: 32
  - excluded: 0
    featureType:
      id: HP:0030931
      label: 1-minute APGAR score of 4
    onset:
      ontologyClass:
        id: HP:0003577
        label: Congenital onset
  - excluded: 0
    featureType:
      id: HP:0030922
      label: 5-minute APGAR score of 2
    onset:
      ontologyClass:
        id: HP:0003577
        label: Congenital onset
  - excluded: 0
    featureType:
      id: HP:0033469
      label: 10-minute APGAR score of 1
    onset:
      ontologyClass:
        id: HP:0003577
        label: Congenital onset
  - excluded: 0
    featureType:
      id: HP:0012027
      label: Laryngeal edema
    onset:
      ontologyClass:
        id: HP:0003577
        label: Congenital onset
  - excluded: 0
    featureType:
      id: HP:0001290
      label: Generalized hypotonia
    onset:
      ontologyClass:
        id: HP:0003577
        label: Congenital onset
  sex: *7
- diseases:
  - ageOfOnset:
      ontologyClass:
        id: HP:0003581
        label: Adult onset
    diseaseCode:
      id: MONDO:0008327
      label: exfoliation syndrome
    excluded: 0
    primarySite:
      id: UBERON:0004549
      label: right eye
  id: proband A
  info:
    phenopacket:
      metaData:
        created: 2021-05-14T10:35:00Z
        createdBy: anonymous biocurator
        phenopacketSchemaVersion: 2.0.0
        resources:
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          iriPrefix: http://purl.obolibrary.org/obo/UBERON_
          name: Uber-anatomy ontology
          namespacePrefix: UBERON
          url: http://purl.obolibrary.org/obo/uberon.owl
          version: 2022-08-19
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          url: http://purl.obolibrary.org/obo/ncit.owl
          version: 22.07d
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          version: 2022-06-11
        - id: ucum
          iriPrefix: https://units-of-measurement.org/
          name: Unified Code for Units of Measure
          namespacePrefix: UCUM
          url: https://ucum.org
          version: 2.1
        - id: loinc
          iriPrefix: https://loinc.org/
          name: Logical Observation Identifiers Names and Codes
          namespacePrefix: LOINC
          url: https://loinc.org
          version: 2.73
        - id: mondo
          iriPrefix: http://purl.obolibrary.org/obo/MONDO_
          name: Mondo Disease Ontology
          namespacePrefix: MONDO
          url: http://purl.obolibrary.org/obo/mondo.obo
          version: 2022-04-04
        - id: drugcentral
          iriPrefix: https://drugcentral.org/drugcard/
          name: Drug Central
          namespacePrefix: DrugCentral
          url: https://drugcentral.org/
          version: 2022-08-22
        - id: snomedct
          iriPrefix: https://browser.ihtsdotools.org/?perspective=full&edition=MAIN/2023-03-31&release=&languages=en&conceptId1=
          name: SNOMED CT
          namespacePrefix: SNOMEDCT
          url: https://www.snomed.org/
          version: 2023-03-31
  interventionsOrProcedures:
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      age:
        iso8601duration: P70Y
    bodySite:
      id: UBERON:0004549
      label: right eye
    procedureCode:
      id: NCIT:C157809
      label: Cataract Surgery
  - ageOfProcedure:
      age:
        iso8601duration: P70Y6W
    bodySite:
      id: UBERON:0004548
      label: left eye
    procedureCode:
      id: NCIT:C157809
      label: Cataract Surgery
  - ageOfProcedure:
      age:
        iso8601duration: P71Y1M
    bodySite:
      id: UBERON:0004549
      label: right eye
    procedureCode:
      id: LOINC:29031-2
      label: Right eye YAG mode
  karyotypicSex: XY
  measures:
  - assayCode:
      id: LOINC:79892-6
      label: Right eye Intraocular pressure
    measurementValue:
      quantity:
        referenceRange:
          high: 21
          low: 10
          unit:
            id: LOINC:56844-4
            label: Intraocular pressure of Eye
        unit:
          id: UCUM:mm[Hg]
          label: millimetres of mercury
        value: 14
    observationMoment: &9
      age:
        iso8601duration: P71Y1M1D
    timeObserved: *9
  - assayCode:
      id: NCIT:C156778
      label: Vision Assessment
    measurementValue:
      typedQuantities:
      - quantity:
          unit:
            id: NCIT:C48570
            label: Percent Unit
          value: 100
        quantityType:
          id: NCIT:C87149
          label: Visual Acuity
  - assayCode:
      id: SNOMEDCT:397312009
      label: Intraocular lens anterior chamber depth
    measurementValue:
      quantity:
        referenceRange:
          high: 21
          low: 10
          unit:
            id: LOINC:56844-4
            label: Intraocular pressure of Eye
        unit:
          id: UCUM:mm
          label: millimeter
        value: 3.93
    observationMoment: &10
      age:
        iso8601duration: P71Y1M1D
    timeObserved: *10
  - assayCode:
      id: SNOMEDCT:397312009
      label: Intraocular lens anterior chamber depth
    measurementValue:
      quantity:
        referenceRange:
          high: 21
          low: 10
          unit:
            id: LOINC:56844-4
            label: Intraocular pressure of Eye
        unit:
          id: UCUM:mm
          label: millimeter
        value: 5.21
    observationMoment: &11
      age:
        iso8601duration: P71Y1M1D
    timeObserved: *11
  - assayCode:
      id: NCIT:C156778
      label: Vision Assessment
    measurementValue:
      typedQuantities:
      - quantity:
          unit:
            id: NCIT:C48570
            label: Percent Unit
          value: 100
        quantityType:
          id: NCIT:C87149
          label: Visual Acuity
    observationMoment: &12
      age:
        iso8601duration: P70Y1W
    timeObserved: *12
  - assayCode:
      id: LOINC:79895-9
      label: Subjective refraction method
    measurementValue:
      quantity:
        referenceRange:
          high: 30
          low: -30
          unit:
            id: LOINC:79895-9
            label: Subjective refraction method
        unit:
          id: UCUM:[diop]
          label: diopter
        value: -0.25
    observationMoment: &13
      age:
        iso8601duration: P70Y1W
    timeObserved: *13
  - assayCode:
      id: SNOMEDCT:252886007
      label: Refraction assessment (procedure)
    measurementValue:
      typedQuantities:
      - quantity:
          referenceRange:
            high: 30
            low: -30
            unit:
              id: LOINC:79895-9
              label: Subjective refraction method
          unit:
            id: UCUM:[diop]
            label: diopter
          value: -0.5
        quantityType:
          id: LOINC:79846-2
          label: Right eye cylindrical refraction
      - quantity:
          referenceRange:
            high: 30
            low: -30
            unit:
              id: LOINC:79895-9
              label: Subjective refraction method
          unit:
            id: UCUM:degree
            label: degree (plane angle)
          value: 110
        quantityType:
          id: LOINC:9829-8
          label: Recht eye cylindrical degree
    observationMoment: &14
      age:
        iso8601duration: P70Y1W
    timeObserved: *14
  - assayCode:
      id: LOINC:79850-4
      label: Right eye spherical refraction
    measurementValue:
      quantity:
        referenceRange:
          high: 30
          low: -30
          unit:
            id: LOINC:79895-9
            label: Subjective refraction method
        unit:
          id: UCUM:[diop]
          label: diopter
        value: -0.25
    observationMoment: &15
      age:
        iso8601duration: P70Y1W
    timeObserved: *15
  - assayCode:
      id: LOINC:79892-6
      label: Right eye Intraocular pressure
    measurementValue:
      quantity:
        referenceRange:
          high: 21
          low: 10
          unit:
            id: LOINC:56844-4
            label: Intraocular pressure of Eye
        unit:
          id: UCUM:mm[Hg]
          label: millimetres of mercury
        value: 29
    observationMoment: &16
      age:
        iso8601duration: P71Y1M
    timeObserved: *16
  phenotypicFeatures:
  - excluded: 1
    featureType:
      id: HP:0000539
      label: Abnormality of refraction
    modifiers:
    - id: HP:0012834
      label: Right
    onset:
      age:
        iso8601duration: P70Y
  - excluded: 0
    featureType:
      id: HP:0000545
      label: Myopia
    modifiers:
    - id: HP:0012834
      label: Right
    onset:
      age:
        iso8601duration: P71Y1M
  - excluded: 0
    featureType:
      id: NCIT:C50618
      label: Intraocular Pressure Increased
    modifiers:
    - id: HP:0012834
      label: Right
    onset:
      age:
        iso8601duration: P71Y1M
  - excluded: 1
    featureType:
      id: HP:0007686
      label: Abnormal pupillary function
  - excluded: 1
    featureType:
      id: HP:0012629
      label: Phakodonesis
  - excluded: 1
    featureType:
      id: SNOMEDCT:414775001
      label: monovision
  sex: *7
  treatments:
  - doseIntervals:
    - interval:
        end: 2022-07-07T00:00:00Z
        start: 2022-07-07T00:00:00Z
      quantity:
        unit:
          id: UCUM:mg.kg-1
          label: milligram per kilogram
        value: 0.002
      scheduleFrequency:
        id: NCIT:C64576
        label: Once
    drugType: UNKNOWN_DRUG_TYPE
    routeOfAdministration:
      id: NCIT:C29302
      label: Ophthalmic Solution
    treatmentCode:
      id: DrugCentral:395
      label: brimonidine
- diseases:
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      age:
        iso8601duration: P4M
    clinicalTnmFinding:
    - id: NCIT:C140678
      label: Retinoblastoma cM0 TNM Finding v8
    diseaseCode:
      id: NCIT:C7541
      label: Retinoblastoma
    diseaseStage:
    - id: LOINC:LA24739-7
      label: Group E
    excluded: 0
    primarySite:
      id: UBERON:0004548
      label: left eye
  id: proband A
  info:
    phenopacket:
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      - files:
        - fileAttributes:
            fileFormat: VCF
            genomeAssembly: GRCh38
          individualToFileIdentifiers:
            biosample.1: specimen.1
          uri: file://data/fileSomaticWgs.vcf.gz
        id: biosample.1
        measurements:
        - assay:
            id: LOINC:33728-7
            label: Size.maximum dimension in Tumor
          timeObserved:
            age:
              iso8601duration: P8M2W
          value:
            quantity:
              unit:
                id: UCUM:mm
                label: millimeter
              value: 15
        pathologicalTnmFinding:
        - id: NCIT:C140720
          label: Retinoblastoma pT3 TNM Finding v8
        - id: NCIT:C140711
          label: Retinoblastoma pN0 TNM Finding v8
        phenotypicFeatures:
        - excluded: 0
          type:
            id: NCIT:C35941
            label: Flexner-Wintersteiner Rosette Formation
        - excluded: 0
          type:
            id: NCIT:C132485
            label: Apoptosis and Necrosis
        procedure:
          bodySite:
            id: UBERON:0004548
            label: left eye
          code:
            id: NCIT:C48601
            label: Enucleation
          performed:
            age:
              iso8601duration: P8M2W
        sampledTissue:
          id: UBERON:0000970
          label: eye
        tumorProgression:
          id: NCIT:C8509
          label: Primary Neoplasm
      files:
      - fileAttributes:
          fileFormat: VCF
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