10-121517379-A-G

Variant summary

Our verdict is Pathogenic. Variant got 19 ACMG points: 19P and 0B. PM1PM2PM5PP2PP3_StrongPP5_Very_Strong

The NM_000141.5(FGFR2):​c.1024T>C​(p.Cys342Arg) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.000000684 in 1,461,878 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. 11/18 in silico tools predict a damaging outcome for this variant. Variant has been reported in ClinVar as Pathogenic (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. C342F) has been classified as Pathogenic.

Frequency

Genomes: not found (cov: 32)
Exomes 𝑓: 6.8e-7 ( 0 hom. )

Consequence

FGFR2
NM_000141.5 missense

Scores

13
4
1

Clinical Significance

Pathogenic criteria provided, multiple submitters, no conflicts P:13

Conservation

PhyloP100: 9.26
Variant links:
Genes affected
FGFR2 (HGNC:3689): (fibroblast growth factor receptor 2) The protein encoded by this gene is a member of the fibroblast growth factor receptor family, where amino acid sequence is highly conserved between members and throughout evolution. FGFR family members differ from one another in their ligand affinities and tissue distribution. A full-length representative protein consists of an extracellular region, composed of three immunoglobulin-like domains, a single hydrophobic membrane-spanning segment and a cytoplasmic tyrosine kinase domain. The extracellular portion of the protein interacts with fibroblast growth factors, setting in motion a cascade of downstream signals, ultimately influencing mitogenesis and differentiation. This particular family member is a high-affinity receptor for acidic, basic and/or keratinocyte growth factor, depending on the isoform. Mutations in this gene are associated with Crouzon syndrome, Pfeiffer syndrome, Craniosynostosis, Apert syndrome, Jackson-Weiss syndrome, Beare-Stevenson cutis gyrata syndrome, Saethre-Chotzen syndrome, and syndromic craniosynostosis. Multiple alternatively spliced transcript variants encoding different isoforms have been noted for this gene. [provided by RefSeq, Jan 2009]

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ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 19 ACMG points.

PM1
In a strand (size 8) in uniprot entity FGFR2_HUMAN there are 20 pathogenic changes around while only 0 benign (100%) in NM_000141.5
PM2
Very rare variant in population databases, with high coverage;
PM5
Other missense variant is known to change same aminoacid residue: Variant chr10-121517378-C-A is described in Lovd as [Pathogenic].
PP2
Missense variant in the FGFR2 gene, where missense mutations are typically associated with disease (based on misZ statistic). The gene has 114 curated pathogenic missense variants (we use a threshold of 10). The gene has 24 curated benign missense variants. Gene score misZ: 2.402 (below the threshold of 3.09). Trascript score misZ: 4.4365 (above the threshold of 3.09). GenCC associations: The gene is linked to Pfeiffer syndrome type 3, Antley-Bixler syndrome, Pfeiffer syndrome type 2, Saethre-Chotzen syndrome, Beare-Stevenson cutis gyrata syndrome, Crouzon syndrome, Jackson-Weiss syndrome, Pfeiffer syndrome type 1, LADD syndrome 1, Pfeiffer syndrome, bent bone dysplasia syndrome 1, Antley-Bixler syndrome without genital anomalies or disordered steroidogenesis, familial scaphocephaly syndrome, McGillivray type, Apert syndrome, LADD syndrome.
PP3
MetaRNN computational evidence supports a deleterious effect, 0.993
PP5
Variant 10-121517379-A-G is Pathogenic according to our data. Variant chr10-121517379-A-G is described in ClinVar as [Pathogenic]. Clinvar id is 13266.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr10-121517379-A-G is described in Lovd as [Pathogenic]. Variant chr10-121517379-A-G is described in Lovd as [Likely_pathogenic].

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
FGFR2NM_000141.5 linkc.1024T>C p.Cys342Arg missense_variant Exon 8 of 18 ENST00000358487.10 NP_000132.3 P21802-1

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
FGFR2ENST00000358487.10 linkc.1024T>C p.Cys342Arg missense_variant Exon 8 of 18 1 NM_000141.5 ENSP00000351276.6 P21802-1
FGFR2ENST00000613048.4 linkc.757T>C p.Cys253Arg missense_variant Exon 7 of 17 5 ENSP00000484154.1 D2CGD1
FGFR2ENST00000478859.5 linkc.340T>C p.Cys114Arg missense_variant Exon 7 of 17 1 ENSP00000474011.1 S4R381
FGFR2ENST00000457416.7 linkc.1087+1303T>C intron_variant Intron 8 of 17 1 ENSP00000410294.2 P21802-3
FGFR2ENST00000369056.5 linkc.1087+1303T>C intron_variant Intron 7 of 16 1 ENSP00000358052.1 P21802-17
FGFR2ENST00000369058.7 linkc.1087+1303T>C intron_variant Intron 8 of 16 1 ENSP00000358054.3 A0A5S6RJB7
FGFR2ENST00000369061.8 linkc.749-2060T>C intron_variant Intron 5 of 14 1 ENSP00000358057.4 P21802-23
FGFR2ENST00000369059.5 linkc.742+1303T>C intron_variant Intron 6 of 15 5 ENSP00000358055.1 E7EVR7
FGFR2ENST00000360144.7 linkc.820+1303T>C intron_variant Intron 7 of 16 2 ENSP00000353262.3 P21802-22
FGFR2ENST00000604236.5 linkn.*71T>C non_coding_transcript_exon_variant Exon 7 of 17 1 ENSP00000474109.1 S4R3B2
FGFR2ENST00000604236.5 linkn.*71T>C 3_prime_UTR_variant Exon 7 of 17 1 ENSP00000474109.1 S4R3B2

Frequencies

GnomAD3 genomes
Cov.:
32
GnomAD4 exome
AF:
6.84e-7
AC:
1
AN:
1461878
Hom.:
0
Cov.:
31
AF XY:
0.00
AC XY:
0
AN XY:
727238
show subpopulations
Gnomad4 AFR exome
AF:
0.0000299
Gnomad4 AMR exome
AF:
0.00
Gnomad4 ASJ exome
AF:
0.00
Gnomad4 EAS exome
AF:
0.00
Gnomad4 SAS exome
AF:
0.00
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.00
Gnomad4 OTH exome
AF:
0.00
GnomAD4 genome
Cov.:
32

ClinVar

Significance: Pathogenic
Submissions summary: Pathogenic:13
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Pfeiffer syndrome Pathogenic:3
Aug 27, 2019
Johns Hopkins Genomics, Johns Hopkins University
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

This previously reported FGFR2 variant (rs121918488) is absent from large population datasets. Two submitters in ClinVar classify this variant as pathogenic. Multiple different missense changes have been reported in the same residue that have been shown to affect protein functionality. Two bioinformatic tools queried predict that the substitution would be possibly damaging, but these algorithms have low specificity, especially for predicting gain of function variants. This variant is considered pathogenic. -

Sep 17, 2016
Genomic Diagnostic Laboratory, Division of Genomic Diagnostics, Children's Hospital of Philadelphia
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Jan 01, 2000
OMIM
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: literature only

- -

not provided Pathogenic:3
-
Joint Genome Diagnostic Labs from Nijmegen and Maastricht, Radboudumc and MUMC+
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing

- -

-
Clinical Genetics DNA and cytogenetics Diagnostics Lab, Erasmus MC, Erasmus Medical Center
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing

- -

Feb 02, 2022
GeneDx
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

Not observed at significant frequency in large population cohorts (gnomAD); In silico analysis, which includes protein predictors and evolutionary conservation, supports a deleterious effect; This variant is associated with the following publications: (PMID: 23754559, 9385368, 28901406, 8528214, 25759925, 7987400, 7719345, 25517871, 11343324, 8755573, 16418739, 11173845, 31837199, 12884424, 27228464, 24127277, 28600064, 29436723, 10633130, 10712195, 24656465, 10394936, 24411056, 27596331) -

FGFR2-related craniosynostosis Pathogenic:2
Aug 21, 2024
Labcorp Genetics (formerly Invitae), Labcorp
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

This sequence change replaces cysteine, which is neutral and slightly polar, with arginine, which is basic and polar, at codon 342 of the FGFR2 protein (p.Cys342Arg). This variant is not present in population databases (gnomAD no frequency). This missense change has been observed in individuals with Crouzon or Pfeiffer syndromes (PMID: 7987400, 12884424, 24127277, 25759925). ClinVar contains an entry for this variant (Variation ID: 13266). Invitae Evidence Modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) indicates that this missense variant is expected to disrupt FGFR2 protein function with a positive predictive value of 95%. This variant disrupts the p.Cys342 amino acid residue in FGFR2. Other variant(s) that disrupt this residue have been determined to be pathogenic (PMID: 24127277). This suggests that this residue is clinically significant, and that variants that disrupt this residue are likely to be disease-causing. For these reasons, this variant has been classified as Pathogenic. -

Jul 01, 2023
Division of Human Genetics, National Health Laboratory Service/University of the Witwatersrand
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: research

- -

Crouzon syndrome Pathogenic:2
Jan 01, 2000
OMIM
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: literature only

- -

-
Juno Genomics, Hangzhou Juno Genomics, Inc
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

PM2_Supporting+PM5+PP3_Strong+PP2+PS2_Moderate+PS4+PP4 -

Antley-Bixler syndrome without genital anomalies or disordered steroidogenesis Pathogenic:2
-
Kasturba Medical College, Manipal, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Jan 01, 2000
OMIM
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: literature only

- -

Jackson-Weiss syndrome Pathogenic:1
Jan 01, 2000
OMIM
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: literature only

- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
1.0
BayesDel_addAF
Pathogenic
0.58
D
BayesDel_noAF
Pathogenic
0.59
CADD
Pathogenic
33
DANN
Uncertain
1.0
DEOGEN2
Pathogenic
0.95
.;.;D;.;.;.;D;.
Eigen
Pathogenic
0.95
Eigen_PC
Pathogenic
0.90
FATHMM_MKL
Pathogenic
0.99
D
LIST_S2
Uncertain
0.95
D;D;D;D;D;D;D;D
M_CAP
Pathogenic
0.53
D
MetaRNN
Pathogenic
0.99
D;D;D;D;D;D;D;D
MetaSVM
Pathogenic
1.0
D
MutationAssessor
Pathogenic
4.4
.;.;H;.;.;H;.;.
PROVEAN
Pathogenic
-9.2
D;.;D;.;D;D;.;D
REVEL
Pathogenic
0.94
Sift
Uncertain
0.0060
D;.;D;.;D;D;.;D
Sift4G
Uncertain
0.013
D;D;D;D;D;D;D;.
Polyphen
0.97
D;.;.;.;P;.;.;.
Vest4
0.99
MutPred
0.98
.;.;Gain of methylation at C342 (P = 0.043);.;.;Gain of methylation at C342 (P = 0.043);.;.;
MVP
0.96
ClinPred
1.0
D
GERP RS
5.9
Varity_R
0.98

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.13
Details are displayed if max score is > 0.2

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

Publications

LitVar

Below is the list of publications found by LitVar. It may be empty.

Other links and lift over

dbSNP: rs121918488; hg19: chr10-123276893; API