11-5225714-C-T

Variant summary

Our verdict is Likely pathogenic. Variant got 9 ACMG points: 10P and 1B. PM2PP5_Very_StrongBP4

The NM_000518.5(HBB):​c.328G>A​(p.Val110Met) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.00000137 in 1,461,816 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a benign outcome for this variant. Variant has been reported in ClinVar as Likely pathogenic (★★).

Frequency

Genomes: not found (cov: 33)
Exomes 𝑓: 0.0000014 ( 0 hom. )

Consequence

HBB
NM_000518.5 missense

Scores

1
5
13

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:5O:1

Conservation

PhyloP100: -0.202
Variant links:
Genes affected
HBB (HGNC:4827): (hemoglobin subunit beta) The alpha (HBA) and beta (HBB) loci determine the structure of the 2 types of polypeptide chains in adult hemoglobin, Hb A. The normal adult hemoglobin tetramer consists of two alpha chains and two beta chains. Mutant beta globin causes sickle cell anemia. Absence of beta chain causes beta-zero-thalassemia. Reduced amounts of detectable beta globin causes beta-plus-thalassemia. The order of the genes in the beta-globin cluster is 5'-epsilon -- gamma-G -- gamma-A -- delta -- beta--3'. [provided by RefSeq, Jul 2008]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Likely_pathogenic. Variant got 9 ACMG points.

PM2
Very rare variant in population databases, with high coverage;
PP5
Variant 11-5225714-C-T is Pathogenic according to our data. Variant chr11-5225714-C-T is described in ClinVar as [Likely_pathogenic]. Clinvar id is 15342.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.
BP4
Computational evidence support a benign effect (MetaRNN=0.29473293). . Strength limited to SUPPORTING due to the PP5.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
HBBNM_000518.5 linkc.328G>A p.Val110Met missense_variant Exon 3 of 3 ENST00000335295.4 NP_000509.1 P68871D9YZU5

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
HBBENST00000335295.4 linkc.328G>A p.Val110Met missense_variant Exon 3 of 3 1 NM_000518.5 ENSP00000333994.3 P68871

Frequencies

GnomAD3 genomes
Cov.:
33
GnomAD4 exome
AF:
0.00000137
AC:
2
AN:
1461816
Hom.:
0
Cov.:
31
AF XY:
0.00000138
AC XY:
1
AN XY:
727220
show subpopulations
Gnomad4 AFR exome
AF:
0.00
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:
0.00000180
Gnomad4 OTH exome
AF:
0.00
GnomAD4 genome
Cov.:
33

ClinVar

Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:5Other:1
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

not provided Pathogenic:2
Pathogenic, criteria provided, single submitterclinical testingARUP Laboratories, Molecular Genetics and Genomics, ARUP LaboratoriesAug 20, 2024The Hb San Diego variant (HBB: c.328G>A; p.Val110Met, also known as Val109Met in the mature protein, rs33969677, ClinVar Variant ID: 15342, HbVarID: 483) has been reported in the heterozygous state in multiple individuals with familial erythrocytosis (Bento 2013, Boster 2019, Camps 2016, Coleman 1993, Gonzalez Fernandez 2009, van Zwieten 2014, Xiong 2019). This variant is absent from the Genome Aggregation Database (v2.1.1), indicating it is not a common polymorphism. Additionally, other variants at this codon (c.328G>C, p.Val110Leu and c.328G>T, p.Val110Leu) have been reported in individuals with familial erythrocytosis (Agarwal 2007, Inoue 2012, Jones 1990). Computational analyses are uncertain whether this variant is neutral or deleterious (REVEL: 0.622). However, functional analyses of the p.Val110Met variant protein show increased oxygen affinity (reduced P50), resulting in reduced oxygen release to the tissue (Anderson 1974, Harkness 1981, Nute 1974). Based on available information, the Hb San Diego variant is considered to be pathogenic. References: Agarwal N et al. Familial polycythemia caused by a novel mutation in the beta globin gene: essential role of P50 in evaluation of familial polycythemia. Int J Med Sci. 2007 Oct 4. PMID: 17952198 Anderson NL. Hemoglobin San Diego (beta 109 (G11) val--met). Crystal structure of the deoxy form. J Clin Invest. 1974 Jan. PMID: 4808645 Bento C et al. Molecular study of congenital erythrocytosis in 70 unrelated patients revealed a potential causal mutation in less than half of the cases (Where is/are the missing gene(s)?). Eur J Haematol. 2013 Oct. PMID: 23859443 Boster J et al. Hemoglobin San Diego: An Uncommon Cause of Hereditary Erythrocytosis Discovered Incidentally in a Military Trainee. Mil Med. 2019 May 1. PMID: 30423154 Camps C et al. Gene panel sequencing improves the diagnostic work-up of patients with idiopathic erythrocytosis and identifies new mutations. Haematologica. 2016 Nov. PMID: 27651169 Coleman MB et al. Hb San Diego [beta 109(G11)Val-->Met] in an Iranian: further evidence for a mutational hot spot at position 109 of the beta-globin gene. Hemoglobin. 1993 Dec. PMID: 8144354 Gonzalez Fernandez FA et al. Haemoglobinopathies with high oxygen affinity. Experience of Erythropathology Cooperative Spanish Group. Ann Hematol. 2009 Mar. PMID: 18818920 Harkness DR et al. Novel studies on a "silent" high affinity mutant hemoglobin (San Diego, beta 109 Val replaced by Met). Hemoglobin. 1981 PMID: 7204093 Inoue S et al. Symptomatic erythrocytosis associated with a compound heterozygosity for Hb Lepore-Boston-Washington (delta87-beta116) and Hb Johnstown [beta109(G11)Val-->Leu, GTG>TTG]. Hemoglobin. 2012 PMID: 22563907 Jones RT et al. Hb Johnstown [beta 109 (G11) Val----Leu]: a new electrophoretically silent variant that causes erythrocytosis. Hemoglobin. 1990 PMID: 2272838 Link to HbVar database: https://globin.bx.psu.edu/hbvar/menu.html Nute PE et al. Hemoglobinopathic erythrocytosis due to a new electrophoretically silent variant, hemoglobin San Diego (beta109 (G11)val--met). J Clin Invest. 1974 Jan. PMID: 4808644 van Zwieten R et al. Hemoglobin analyses in the Netherlands reveal more than 80 different variants including six novel ones. Hemoglobin. 2014 PMID: 24200101 Xiong H et al. First Description of Hb San Diego (HBB: c.328G>A) in a Chinese Family with Congenital Erythrocytosis. Hemoglobin. 2019 Mar. PMID: 31304856 -
Pathogenic, criteria provided, single submitterclinical testingQuest Diagnostics Nichols Institute San Juan CapistranoSep 26, 2022This variant has not been reported in large, multi-ethnic general populations (http://gnomad.broadinstitute.org). In the published literature, the variant has been reported in multiple individuals and families affected with erythrocytosis (PMIDs: 1201208 (1975), 7204093 (1981), 6863429 (1983), 18818920 (2009), 23859443 (2013), and 27651169 (2016). This variant has also been shown to co-segregate with erythrocytosis (PMIDs: 18793248 (2009), 30423154 (2019), and 31304856 (2019)). This variant has also been shown to co-segregate with erythrocytosis (PMIDs: 18793248 (2009) and 30423154 (2019)). Analysis of this variant using bioinformatics tools for the prediction of the effect of amino acid changes on protein structure and function yielded conflicting predictions that this variant is deleterious or benign. Based on the available information, this variant is classified as pathogenic. -
Erythrocytosis, familial, 6 Pathogenic:1
Pathogenic, no assertion criteria providedliterature onlyOMIMJan 01, 1995- -
Hemoglobinopathy Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingWomen's Health and Genetics/Laboratory Corporation of America, LabCorpJul 16, 2021Variant summary: HBB c.328G>A (p.Val110Met), also known as Hb San Diego, results in a conservative amino acid change in the encoded protein sequence. Five of five in-silico tools predict a benign effect of the variant on protein function. The variant was absent in 251212 control chromosomes. c.328G>A has been reported in the literature in multiple individuals and families affected with idopathic or familial erythrocytosis (Nute_1974, Rumi_2008, Bento_2013, Boster_2019, Camps_2016, Gonzalez Fernandez_2009, Xiong_2019). Additionally, the variant was reported to co-segregate with erythrocytosis in two- and three-generation families in an autosomal dominant manner (Gonzalez Fernandez_2009, Xiong_2019). These data indicate that the variant is very likely to be associated with familial erythrocytosis. P50 values were shown to be reduced in affected indviduals and family members (Nute_1974, Rumi_2008). Two clinical diagnostic laboratories have submitted clinical-significance assessments for this variant to ClinVar after 2014 without evidence for independent evaluation. All laboratories classified the variant as pathogenic/likely pathogenic. To our knowledge, Hb San Diego has not been reported in the homozygous state, in combination with beta thalassemia or other beta globin variants, therefore its pathogenicity in regards to beta thalassemia is unknown. Based on the evidence outlined above, the variant was classified as pathogenic for erythrocytosis. -
beta Thalassemia Pathogenic:1
Likely pathogenic, criteria provided, single submitterliterature onlyCounsylFeb 17, 2015- -
HEMOGLOBIN SAN DIEGO Other:1
other, no assertion criteria providedliterature onlyOMIMDec 12, 2017- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.25
BayesDel_addAF
Pathogenic
0.20
D
BayesDel_noAF
Uncertain
0.050
CADD
Benign
15
DANN
Uncertain
0.99
DEOGEN2
Benign
0.058
T;T
Eigen
Benign
-0.41
Eigen_PC
Benign
-0.45
FATHMM_MKL
Benign
0.086
N
LIST_S2
Uncertain
0.90
.;D
M_CAP
Uncertain
0.19
D
MetaRNN
Benign
0.29
T;T
MetaSVM
Benign
-0.37
T
MutationAssessor
Benign
1.4
L;L
PrimateAI
Benign
0.41
T
PROVEAN
Benign
-0.85
N;.
REVEL
Uncertain
0.62
Sift
Benign
0.33
T;.
Sift4G
Benign
0.20
T;.
Polyphen
0.85
P;P
Vest4
0.39
MutPred
0.66
Loss of stability (P = 0.2717);Loss of stability (P = 0.2717);
MVP
0.67
MPC
0.045
ClinPred
0.24
T
GERP RS
0.68
Varity_R
0.18
gMVP
0.81

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.010
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: rs33969677; hg19: chr11-5246944; API