1-241519721-A-G

Variant summary

Our verdict is Pathogenic. The variant received 13 ACMG points: 13P and 0B. PVS1PS1_ModeratePM2PP5

The NM_000143.4(FH):​c.2T>C​(p.Met1?) variant causes a start lost change. The variant allele was found at a frequency of 0.00000324 in 1,543,612 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars).

Frequency

Genomes: 𝑓 0.000013 ( 0 hom., cov: 33)
Exomes 𝑓: 0.0000022 ( 0 hom. )

Consequence

FH
NM_000143.4 start_lost

Scores

7
6
2

Clinical Significance

Conflicting classifications of pathogenicity criteria provided, conflicting classifications P:1U:1

Conservation

PhyloP100: 4.81

Publications

6 publications found
Variant links:
Genes affected
FH (HGNC:3700): (fumarate hydratase) The protein encoded by this gene is an enzymatic component of the tricarboxylic acid (TCA) cycle, or Krebs cycle, and catalyzes the formation of L-malate from fumarate. It exists in both a cytosolic form and an N-terminal extended form, differing only in the translation start site used. The N-terminal extended form is targeted to the mitochondrion, where the removal of the extension generates the same form as in the cytoplasm. It is similar to some thermostable class II fumarases and functions as a homotetramer. Mutations in this gene can cause fumarase deficiency and lead to progressive encephalopathy. [provided by RefSeq, Jul 2008]
FH Gene-Disease associations (from GenCC):
  • hereditary leiomyomatosis and renal cell cancer
    Inheritance: AD Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Genomics England PanelApp, Labcorp Genetics (formerly Invitae), Orphanet, G2P, ClinGen, Ambry Genetics
  • fumaric aciduria
    Inheritance: AR Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Orphanet, Ambry Genetics, G2P, Labcorp Genetics (formerly Invitae)
  • pheochromocytoma-paraganglioma
    Inheritance: AD Classification: STRONG Submitted by: Ambry Genetics
  • leiomyosarcoma
    Inheritance: AD Classification: MODERATE Submitted by: Genomics England PanelApp
  • hereditary pheochromocytoma-paraganglioma
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Pathogenic. The variant received 13 ACMG points.

PVS1
Start lost variant, next in-frame start position is after 30 pathogenic variants. Next in-frame start position is after 44 codons. Genomic position: 241519593. Lost 0.085 part of the original CDS.
PS1
Another start lost variant in NM_000143.4 (FH) was described as [Likely_pathogenic] in ClinVar
PM2
Very rare variant in population databases, with high coverage;
PP5
Variant 1-241519721-A-G is Pathogenic according to our data. Variant chr1-241519721-A-G is described in ClinVar as Conflicting_classifications_of_pathogenicity. ClinVar VariationId is 822533.

Variant Effect in Transcripts

ACMG analysis was done for transcript: NM_000143.4. You can select a different transcript below to see updated ACMG assignments.

RefSeq Transcripts

Sel.
GeneTranscriptTagsHGVScHGVSpEffectExon RankProteinUniProt
FH
NM_000143.4
MANE Select
c.2T>Cp.Met1?
start_lost
Exon 1 of 10NP_000134.2

Ensembl Transcripts

Sel.
GeneTranscriptTagsHGVScHGVSpEffectExon RankProteinUniProt
FH
ENST00000366560.4
TSL:1 MANE Select
c.2T>Cp.Met1?
start_lost
Exon 1 of 10ENSP00000355518.4P07954-1
FH
ENST00000958409.1
c.2T>Cp.Met1?
start_lost
Exon 1 of 10ENSP00000628468.1
FH
ENST00000932939.1
c.2T>Cp.Met1?
start_lost
Exon 1 of 10ENSP00000602998.1

Frequencies

GnomAD3 genomes
AF:
0.0000131
AC:
2
AN:
152172
Hom.:
0
Cov.:
33
show subpopulations
Gnomad AFR
AF:
0.0000241
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.0000654
Gnomad ASJ
AF:
0.00
Gnomad EAS
AF:
0.00
Gnomad SAS
AF:
0.00
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.00
Gnomad OTH
AF:
0.00
GnomAD4 exome
AF:
0.00000216
AC:
3
AN:
1391322
Hom.:
0
Cov.:
31
AF XY:
0.00000292
AC XY:
2
AN XY:
685408
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
31108
American (AMR)
AF:
0.00
AC:
0
AN:
35396
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
25018
East Asian (EAS)
AF:
0.00
AC:
0
AN:
35454
South Asian (SAS)
AF:
0.00
AC:
0
AN:
78584
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
48490
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
4282
European-Non Finnish (NFE)
AF:
0.00000279
AC:
3
AN:
1075466
Other (OTH)
AF:
0.00
AC:
0
AN:
57524
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.492
Heterozygous variant carriers
0
1
1
2
2
3
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome Het
Variant carriers
0
2
4
6
8
10
<30
30-35
35-40
40-45
45-50
50-55
55-60
60-65
65-70
70-75
75-80
>80
Age
GnomAD4 genome
AF:
0.0000131
AC:
2
AN:
152290
Hom.:
0
Cov.:
33
AF XY:
0.0000269
AC XY:
2
AN XY:
74486
show subpopulations
African (AFR)
AF:
0.0000240
AC:
1
AN:
41580
American (AMR)
AF:
0.0000653
AC:
1
AN:
15308
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3470
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5168
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4830
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10616
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
294
European-Non Finnish (NFE)
AF:
0.00
AC:
0
AN:
67996
Other (OTH)
AF:
0.00
AC:
0
AN:
2116
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.550
Heterozygous variant carriers
0
0
1
1
2
2
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Genome Het
Variant carriers
0
2
4
6
8
10
<30
30-35
35-40
40-45
45-50
50-55
55-60
60-65
65-70
70-75
75-80
>80
Age
Alfa
AF:
0.00
Hom.:
0
Bravo
AF:
0.0000113
ESP6500AA
AF:
0.00
AC:
0
ESP6500EA
AF:
0.000132
AC:
1
ExAC
AF:
0.0000165
AC:
1

ClinVar

ClinVar submissions
Significance:Conflicting classifications of pathogenicity
Revision:criteria provided, conflicting classifications
View on ClinVar
Pathogenic
VUS
Benign
Condition
-
1
-
Hereditary cancer-predisposing syndrome (1)
1
-
-
not provided (1)

Computational scores

Source: dbNSFP v4.9

Name
Calibrated prediction
Score
Prediction
BayesDel_addAF
Pathogenic
0.43
D
BayesDel_noAF
Pathogenic
0.40
CADD
Uncertain
24
DANN
Uncertain
0.98
DEOGEN2
Benign
0.31
T
Eigen
Uncertain
0.41
Eigen_PC
Uncertain
0.45
FATHMM_MKL
Pathogenic
0.98
D
LIST_S2
Uncertain
0.90
D
M_CAP
Pathogenic
0.97
D
MetaRNN
Pathogenic
0.86
D
MetaSVM
Pathogenic
1.1
D
PhyloP100
4.8
PROVEAN
Benign
-0.46
N
REVEL
Pathogenic
0.72
Sift
Uncertain
0.0020
D
Sift4G
Uncertain
0.0030
D
Polyphen
0.72
P
Vest4
0.93
MVP
0.98
ClinPred
0.93
D
GERP RS
5.3
PromoterAI
0.15
Neutral
RBP_binding_hub_radar
0.0
RBP_regulation_power_radar
1.7
Varity_R
0.66
gMVP
0.74
Mutation Taster
=35/165
disease causing (ClinVar)

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.0
Details are displayed if max score is > 0.2

Find out detailed SpliceAI scores and Pangolin per-transcript scores at spliceailookup.broadinstitute.org

Publications

Other links and lift over

dbSNP: rs201261794; hg19: chr1-241683021; API