ABSTRACT Mahvash disease is a rare autosomal recessive condition caused by biallelic inactivating variants in the GCGR gene, impairing glucagon signaling and leading to alpha-cell hyperplasia and pancreatic neuroendocrine tumors (PNETs). Fewer than 20 cases have been reported, and the clinical impact of heterozygous variants remains unclear. Case Presentation: We report a family with a novel GCGR splice-site variant (c.1176+1_1176+7delGTGCCCG). The index case, a 61-year-old woman, presented with extensive pancreatic cystic disease and was found to be homozygous for the […]