TPM4 and Thrombocytopenia: Further evaluation becomes more complicated when the clinical phenotype is atypical due to variants in two or more genes: one child (case 32) with moderate thrombocytopenia, skin bleeding tendency, and positive family history (father with moderate thrombocytopenia and recurrent epistaxis; mother with postoperative bleeding and suspected thrombocytopathy) carried a class 3 variant in each of theGFI1B,TPM4, andFLNAgenes (Table 1).