Rare Disease Diagnostics · Powered by PacBio HiFi

End the diagnostic odyssey.
Resolve the unresolved.

When short-read exomes and panels return negative, the search isn't over. Our 4Power WGS HiFi long-read sequencing detects the structural variants, repeat expansions, and complex rearrangements that standard testing misses — delivering molecular answers for your most challenging rare disease cases.

93%
Variant detection rate with HiFi vs 41% for short-read
13+ yrs
Clinical genomics expertise in India
99.9%
Per-read accuracy, 15–25 kb read lengths
29K+
Physicians in our network
Clinical Infrastructure
South Asia's 1st PacBio Sequel II & Revio
ACMG-Compliant Reporting
End-to-End: Sample → Counseling
Trio & Proband Testing
10–20%
of the genome remains unresolved by short-read sequencing
✕ Negative exome / panel result
✕ Repeat biochemical testing
✕ Referral to specialist → another negative
✕ Years without a molecular diagnosis
The Diagnostic Odyssey

Standard tests leave families stranded

Short-read sequencing (SRS) is cost-effective for basic variant detection, but it struggles with repetitive sequences, large structural variants, and homologous regions — leaving 10–20% of the genome unresolved. For patients with rare genetic disorders, this means initial tests fail to identify causative variants.

The result is a "diagnostic odyssey": years of repeated testing, misdiagnoses, missed treatment windows, and emotional toll on families — especially in consanguineous populations where autosomal recessive disorders are prevalent.

The variants you're missing aren't rare. Structural variants affect more base pairs of the human genome than all SNVs and small indels combined — yet they are the variants most often undetectable by short-read tools.
The HiFi Advantage

Why long reads change everything

PacBio HiFi sequencing generates reads of 15–25 kb at >99.9% accuracy, enabling de novo assembly, precise phasing, and methylation detection in a single workflow — revealing the variants short reads cannot reach.

Short-Read Sequencing

Illumina SRS

The standard — powerful, but blind to the hardest regions

  • Misses large structural variants & complex rearrangements
  • Cannot resolve repeat expansions & STRs
  • Fails in homologous regions & pseudogenes
  • Limited phasing — cannot determine parental allele
  • No native methylation / epigenetic detection
Detection of 145 known challenging variants
41%
Automated detection rate (2025 benchmark, 100 samples)
PacBio HiFi Long-Read

4Power WGS HiFi

Long, accurate reads that see the whole genome

  • Detects SVs, CNVs, inversions & complex rearrangements
  • Resolves repeat expansions & short tandem repeats
  • Spans homologous regions & pseudogenes (e.g. STRC)
  • Native phasing — parental allele & de novo determination
  • Methylation & imprinting detection in a single run
Detection of 145 known challenging variants
93%
At ~30× coverage — including SVs, STRs & imprinting defects
4Power

When standard tests fail, 4Power WGS HiFi delivers answers.

Our flagship whole-genome HiFi test is built specifically for undiagnosed rare disease and complex cancer cases — the patients left without answers after exome, panel, or short-read WGS.

Whole-genome coverage

Coding & non-coding regions — intergenic, intronic, deep intronic variants

All variant classes

SNVs, indels, SVs, CNVs, repeat expansions, mobile element insertions

Trio & proband options

De novo detection with parental phasing for precise inheritance mapping

ACMG-compliant report

Classified variants with clinical interpretation & genetic counseling

Order 4Power WGS HiFi

Variant classes detected Single Test

SNVs & Indels
Structural Variants
Copy-Number Variants
Repeat Expansions
Mobile Element Ins.
Inversions
Methylation / Imprinting
Phasing (Parental)
Test Portfolio

A test for every clinical question

From targeted panels to whole-genome HiFi, choose the right depth for your patient's presentation and prior testing history.

Flagship · Undiagnosed

4Power WGS HiFi

Whole-genome PacBio HiFi for unresolved cases after negative exome or panel. Detects SVs, repeat expansions, imprinting defects, and complex rearrangements in a single test.

Trio or Proband ~30× coverage All variant classes
First-line · Broad

Clinical Exome Sequencing

Comprehensive coding-region analysis for suspected Mendelian disorders. Cost-effective first-line test covering >1,750 disease-associated genes with AI-driven variant prioritization.

WES Trio available ACMG reporting
Ophthalmology

Inherited Retinal Dystrophy Panel

Targeted HiFi panel for retinitis pigmentosa, Stargardt, Leber congenital amaurosis & macular dystrophies. Resolves the ~40% of IRD cases unsolved by exome — deep intronic & SV variants.

DrSerq Saliva or blood Gene-therapy eligible
Pediatric · Preventive

Newborn WGS HiFi Screening

Early detection of treatable rare diseases from dried blood spots — Pompe, SMA, lysosomal storage disorders, urea cycle defects. Identifies conditions missed by biochemical NBS panels.

Dried blood spot Low-input DNA Pre-symptomatic
Neurology

Neurodevelopmental & Ataxia Panel

HiFi detection for intellectual disability, autism spectrum, spinocerebellar ataxias, Friedreich ataxia & myotonic dystrophy. Captures repeat expansions invisible to short-read sequencing.

STR expansions Trio recommended De novo SVs
Reproductive Health

Carrier & Prenatal Screening

Pre-conception carrier screening and prenatal diagnostics for high-risk families. Informed by India-specific population diversity and recurrence-risk counseling for recessive disorders.

Carrier screening Prenatal Counseling included
The Evidence

More answers, fewer tests

Across global benchmarks and Nucleome's own pipeline, HiFi long-read sequencing consistently outperforms short-read methods on the variants that matter most for rare disease — often replacing multiple complementary tests with a single run.

93%
Detection of 145 known challenging germline variants at ~30× HiFi coverage, vs 41% automated detection with short-read sequencing (2025 evaluation, 100 samples).
+10–20%
Solve-rate boost in programs like Solve-RD and Genomic Answers for Kids, uncovering pathogenic aberrations invisible to short reads.
38%
Candidates identified in 34 families with autosomal recessive disease negative after SRS exome — using HiFi at just ~10× coverage.

Source: PacBio benchmark studies & Nucleome Informatics rare disease pipeline (2023–2025).

Diagnostic yield by disease domain — HiFi vs short-read

Neurodevelopmental Disorders 8 trios, 2023
Short-read
0%
HiFi
24 SVs found
Neurodegenerative Disease 96 probands, 2023
Short-read
0%
HiFi
16 solved
Sensorineural Hearing Loss 19 pediatric, 2023
Short-read
0%
HiFi
21% solved
Autosomal Recessive (post-exome) 34 families
Short-read
0%
HiFi
38% candidates
Clinical Evidence

Cases that short-read could not solve

Real-world examples of how HiFi sequencing delivered molecular diagnoses where standard testing failed — and how Nucleome brings this capability home to Indian families.

Neurodevelopmental

Resolving structural variants in NDDs

Eight family trios with children affected by unsolved intellectual disability & autism. Prior SRS exome identified no clear causes.

24de novo SVs revealed by HiFi, missed by short-read
Key findings

123-bp intronic duplication in NXPE3 (de novo, neurodevelopment); 303-bp insertion in TAOK3 intron (intellectual disability); multiple de novo repeat expansions disrupting gene regulation.

NXPE3TAOK3de novo SVs
Neuromuscular

Repeat expansions in neurodegenerative disease

96 probands with suspected ataxia & dementia, unsolved by SRS trio sequencing. HiFi at ~26× coverage found explanations in 16 cases.

40%+long-read-exclusive variants: CNVs, inversions, MEIs, STR expansions
Key findings

FXN (GAA)n expansion in Friedreich ataxia; CNBP STR expansion in myotonic dystrophy type 2; NF1 mobile element insertion in neurofibromatosis type 1 — all in repetitive/GC-rich regions undetectable by SRS.

FXNCNBPNF1
Sensory

Complex rearrangements in hearing & vision loss

19 pediatric patients with unsolved sensorineural hearing loss. HiFi at 24–32× identified causes in 21%, including pseudogene-resistant calls.

3/3unsolved inherited retinal dystrophies solved by HiFi
Key findings

Hemizygous OTOA deletion; STRC loss-of-function + CNVs resolved despite pseudogene homology; copy-neutral MITF inversion. In IRDs: deep intronic variants, exon deletions & complex SVs.

OTOASTRCMITFOPN1LW/MW
Imprinting

Imprinting defects & large-scale cohorts

34 families with suspected autosomal recessive disease, negative after SRS exomes. HiFi at ~10× coverage identified candidates in 38%.

38%candidate rate even at low ~10× HiFi coverage
Key findings

MECP2 inversions causing haploinsufficiency in Rett syndrome-like cases (100,000 Genomes Project); maternal uniparental heterodisomy on chr14 detected via methylation tools — Temple syndrome. Nucleome has diagnosed novel SCN1A mutations in pediatric epilepsy.

MECP2chr14 UPDSCN1A
From Sample to Answer

A clear path, end to end

We handle the entire journey — from sample collection to clinical report and genetic counseling — so your team can focus on patient care.

1

Sample Intake

Blood, saliva, or dried blood spot. Trio or proband. Order via DrSeq portal.

Day 0
2

HiFi Sequencing

PacBio Revio / Sequel II. 15–25 kb reads, >99.9% accuracy, ~30× coverage.

Week 1–2
3

AI Bioinformatics

Variant calling, phasing, SV/CNV/STR detection, methylation analysis.

Week 2–3
4

Clinical Interpretation

ACMG-compliant variant classification, AI-driven prioritization & curation.

Week 3–4
5

Report & Counseling

Actionable clinical report with genetic counseling & recurrence-risk guidance.

Week 4–5
Why Nucleome

Built for the Indian clinical context

We combine global-grade HiFi infrastructure with deep expertise in India's genetic diversity — reducing reliance on overseas labs and accelerating answers for your patients.

South Asia's first PacBio Revio

We operate the region's most advanced long-read infrastructure — Sequel II & Revio platforms — alongside Illumina and Bionano for hybrid assemblies, ensuring >99% genome coverage.

India-specific genetic diversity

13+ years of clinical expertise with Indian populations — including consanguineous cohorts where autosomal recessive disorders are prevalent. Our reference data reflects the patients you actually see.

ACMG-compliant, actionable reports

Every report follows ACMG variant classification guidelines, with AI-enhanced prioritization and integrated genetic counseling — so results translate directly into clinical decisions.

AI-driven variant prioritization

Custom ML pipelines for SV detection, phasing, and epigenetic insights — turning raw HiFi data into a ranked, clinically interpretable variant shortlist, fast.

End-to-end support

From sample collection to genetic counseling, we support your team at every step — with a web-based ordering portal (DrSeq) designed for clinical workflows.

Cost-effective, in-country

Bringing global HiFi advancements home — reducing reliance on international labs, accelerating turnaround, and making advanced rare disease testing accessible across India.

Trusted By Clinicians

What referring scientists say

“

Thank you for providing us with good quality PacBio reads. I am highly satisfied with the quality of services, sequence reads and read length. I am looking forward to many more such sequencing services from your company.

Dr. Arun Kumar KP Staff Scientist & Head, Laboratory of Molecular Genetics, CDFD
“

I had a very fruitful discussion regarding the project, and very detailed analysis of the complete pipeline. The team gave useful insights on the data and different ways of analysis. The feedback regarding the quality of the data is encouraging — I am excited by the chromosome-wise distribution.

Dr. Bhavani Shankar Head, Immunology Section
“

I would like to appreciate the help we got from the entire team. Being a new explorer in the NGS field, we were not very familiar with the area, but Team Nucleome was helpful and guided us to explore various associated fields. Thank you to Mr. Dushyant and his team.

Dr. Vipul Kr Reddy Scientific Officer, BARC
Clinician FAQ

Questions before you refer

Order 4Power WGS HiFi when a clinical exome or targeted panel has returned negative or inconclusive in a patient with a strong clinical suspicion of a genetic disorder. It is also first-line when the suspected mechanism involves structural variants, repeat expansions (e.g. ataxias, myotonic dystrophy), imprinting defects, or variants in pseudogene/homologous regions (e.g. STRC). For broad first-line Mendelian screening where cost is the primary constraint, clinical exome remains a reasonable starting point.
We accept peripheral blood (standard for trio and proband WGS), saliva (used in our DrSerq IRD test), and dried blood spots (for newborn screening). HiFi WGS works effectively on low-input DNA from dried blood spots — as demonstrated in cystic fibrosis research where pathogenic CFTR variants were phased over long distances without parental samples. Specific volume requirements are provided at order confirmation via the DrSeq portal.
Yes. Trio sequencing (proband + both parents) is strongly recommended for neurodevelopmental disorders and de novo variant detection. HiFi's native long-read phasing determines which allele a variant occurs on and whether it is de novo — a critical advantage over short-read methods. In the 2023 neurodevelopmental study, trio HiFi revealed 24 de novo SVs that short-read exome had entirely missed.
All reports follow ACMG variant classification guidelines. Our pipeline combines AI-driven variant prioritization with expert curation, classifying each variant along the pathogenic/likely pathogenic/VUS/likely benign/benign spectrum. Reports include clinical interpretation, recurrence-risk information, and integrated genetic counseling support for the family.
Typical end-to-end turnaround is approximately 4–5 weeks: sample intake and QC (Day 0), HiFi sequencing (Week 1–2), AI bioinformatics and variant calling (Week 2–3), clinical interpretation and ACMG classification (Week 3–4), and final report with counseling (Week 4–5). Urgent cases — such as critically ill NICU infants — can be expedited; contact our team to discuss rapid-turnaround options.
You can order through our DrSeq web-based ordering portal, or contact our clinical team directly at info@nucleomeinfo.com or +91 40 4011 4169. Our team will guide you through test selection based on the patient's clinical presentation and prior testing history, arrange sample collection, and keep you updated throughout the workflow.
Start a Referral

Resolve your next undiagnosed case.

Whether you're tackling a single diagnostic odyssey or building a rare disease program, our clinical team will help you select the right test and guide your patient from sample to answer.

NKC Centre, Hitech City, Hyderabad