Maruo et al described a patient with 3 variants including a c.381insGG frameshift change often associated with CNS type 1, a c.674T>G (p. V225G) more often associated with CNS type 2 and a promoter variant A(TA)7TAA more commonly associated with GS.9 Please note that the degree of UGT1A1 enzyme expression and resulting hyperbilirubinemia likely depends on whether the frameshift change was in cis or trans with other changes. The gene discussed is UGT1A1; the disease is Gerstmann syndrome.