MTO1 and hyperinsulinemic hypoglycemia, familial, 4: While the p.(Ala428Thr) and p.(Val41Gly) are predicted damaging and have been described in other patients with MTO1 deficiency, the p.(His256Arg) variant inherited in cis with the p.(Val41Gly) is predicted benign by tested tools and may not contribute to the phenotype.