The presentation of AD included urinary complaints (retention, dysuria, incontinence, and hesitancy; 61.5%, n = 8), bowel dysregulation (diarrhea (61.5%, n = 8), gastroparesis (53.8%, n = 7), ileus (100%, n = 13), Ogilvie syndrome with cecal dilation >10 cm (15.4%, n = 2), labile blood glucose levels requiring frequent insulin dose adjustments (61.5%, n = 8), tachycardia-bradycardia syndrome (15.4%, n = 2), sweating paroxysms with new-onset peripheral neuropathy (7.7%, n = 1), and dry mouth with oral mucosal fragility (7.7%, n = 1) (Table 2; Figure 1). The gene discussed is INS; the disease is Tachycardia.