Abstract
Introduction: Physicians often search for a single underlying cause that explains all of a patient’s signs and symptoms. However, evidence from the literature suggests that the concurrent presence of two rare diseases, although uncommon, poses significant diagnostic challenges. Precision medicine is increasingly important in these scenarios, enabling more rapid diagnosis and tailored treatments. Case Presentation: This report discusses a patient involving a consanguineous Brazilian family, where two sisters are diagnosed with autosomal recessive KLHL24-related hypertrophic cardiomyopathy. Additionally, one sister is diagnosed with Char syndrome due to a TFAP2B deletion. Conclusion: This case underscores the possibility that multiple rare genetic disorders can coexist, contributing to complex clinical phenotypes. Whole-exome sequencing proves to be a critical tool in identifying the genetic underpinnings of such complex cases, facilitating precise diagnosis and genetic counseling. The discovery of a homozygous KLHL24 variant further broadens the known mutation spectrum and underscores its significance in autosomal recessive hypertrophic cardiomyopathy.
