Remarkably, the remaining 23 rare nonsynonymous germline variants associated with shorter telomere length and were clustered in genes previously associated with autosomal dominant dyskeratosis congenita and/or pulmonary fibrosis (IPF) (ACD (Online Mendelian Inheritance in Man (OMIM): 609377), PARN (OMIM: 604212), RTEL1 (OMIM: 608833), NAF1 (OMIM: 620365) and TERT (OMIM: 613989)). Here, ACD is linked to pulmonary fibrosis.