Genetic testing resulted in three VUS genetic variants including RSPH4A, DNAAF3, and DNAH11. Although none of these genetic VUS had been associated with PCD pathogenic phenotype; the medical history, clinical findings, electron microscopy, and the severity of her pulmonary disease evidenced by pulmonary function test and imaging, highly suggest PCD. The gene discussed is DNAH11; the disease is primary ciliary dyskinesia.