11-5227157-G-C

Variant summary

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

The ENST00000647020.1(HBB):​c.-136C>G variant causes a 5 prime UTR change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.0000054 in 555,416 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: 0.0000054 ( 0 hom. )

Consequence

HBB
ENST00000647020.1 5_prime_UTR

Scores

2

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:9O:1

Conservation

PhyloP100: 2.48
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 11-5227157-G-C is Pathogenic according to our data. Variant chr11-5227157-G-C is described in ClinVar as [Likely_pathogenic]. Clinvar id is 15465.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr11-5227157-G-C is described in Lovd as [Pathogenic].
BP4
Computational evidence support a benign effect (BayesDel_noAF=-0.59). . Strength limited to SUPPORTING due to the PP5.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
HBBNM_000518.5 linkc.-136C>G upstream_gene_variant ENST00000335295.4 NP_000509.1 P68871D9YZU5

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
HBBENST00000335295.4 linkc.-136C>G upstream_gene_variant 1 NM_000518.5 ENSP00000333994.3 P68871

Frequencies

GnomAD3 genomes
Cov.:
33
GnomAD4 exome
AF:
0.00000540
AC:
3
AN:
555416
Hom.:
0
Cov.:
5
AF XY:
0.00000998
AC XY:
3
AN XY:
300506
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:
0.0000484
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.00
Gnomad4 OTH exome
AF:
0.00
GnomAD4 genome
Cov.:
33
Bravo
AF:
0.00000378

ClinVar

Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:9Other:1
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

not provided Pathogenic:4
Apr 29, 2022
GeneDx
Significance: Likely pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

Not observed at significant frequency in presumably healthy individuals tested at GeneDx; Also known as -86C>G; This variant is associated with the following publications: (PMID: 2197725, 2393018, 26202972, 31395865, 1550780, 28385923, 23637309, 30173596, 22563936, 26291972, 1517101) -

Nov 08, 2021
Labcorp Genetics (formerly Invitae), Labcorp
Significance: Likely pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

This variant occurs in a non-coding region of the HBB gene. It does not change the encoded amino acid sequence of the HBB protein. This variant is not present in population databases (gnomAD no frequency). This variant has been observed in individuals with autosomal recessive beta thalassemia intermedia (PMID: 1550780, 30173596). This variant is also known as c.-86C>G. ClinVar contains an entry for this variant (Variation ID: 15465). Algorithms developed to predict the effect of sequence changes on RNA splicing suggest that this variant may create or strengthen a splice site. In summary, the currently available evidence indicates that the variant is pathogenic, but additional data are needed to prove that conclusively. Therefore, this variant has been classified as Likely Pathogenic. -

Aug 05, 2024
ARUP Laboratories, Molecular Genetics and Genomics, ARUP Laboratories
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

The HBB c.-136C>G variant (rs33994806, HbVar ID: 761), also known as -86 (C>G), has been reported in multiple homozygous individuals affected with beta(+)-thalassemia, as well as heterozygous individuals with beta-thalassemia trait (Bravo-Urquiola, 2012, He 2015, Moassas 2018, Thein 1990, HbVar database). This variant is absent from general population databases (Exome Variant Server, Genome Aggregation Database), indicating it is not a common polymorphism. This variant occurs in the functionally important proximal CACCC box in the HBB promoter, and variants in this promoter element are known to be associated with beta(+) thalassemia (Ropero 2017, Thein 2013). Based on available information, the c.-136C>G variant is considered to be pathogenic. References: HbVar database link: https://globin.bx.psu.edu/hbvar/menu.html Bravo-Urquiola M et al. Molecular spectrum of beta-thalassemia mutations in the admixed Venezuelan population, and their linkage to beta-globin gene haplotypes. Hemoglobin. 2012;36(3):209-18. PMID: 22563936. He S et al. First Description of a beta-Thalassemia Mutation, -86 (C>G) (HBB: c.-136C>G), in a Chinese Family. Hemoglobin. 2015;39(6):448-50. PMID: 26291972 Moassas F et al. Description of a Rare beta-Globin Gene Mutation: -86 (C>G) (HBB: c.-136C>G) Observed in a Syrian Family. Hemoglobin. 2018 May;42(3):203-205. PMID: 30173596. Ropero P et al. Phenotype of mutations in the promoter region of the beta-globin gene. J Clin Pathol. 2017 Oct;70(10):874-878. PMID: 28385923. Thein SL. The molecular basis of beta-thalassemia. Cold Spring Harb Perspect Med. 2013 May 1;3(5):a011700. PMID: 23637309. Thein SL et al. The molecular basis of beta-thalassemia in Thailand: application to prenatal diagnosis. Am J Hum Genet. 1990 Sep;47(3):369-75. PMID: 2393018. -

Apr 25, 2023
Quest Diagnostics Nichols Institute San Juan Capistrano
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

The HBB c.-136C>G variant (also known as -86C>G) is located in an important region in the promoter of the beta-globin gene and is expected to cause decreased transcription. This variant is associated with mild beta(+)-thalassemia (PMIDs: 2197725 (1990), 2393018 (1990), 22563936 (2012), 26291972 (2015), 30173596 (2018)). This variant has not been reported in large, multi-ethnic general populations (http://gnomad.broadinstitute.org). Based on the available information, this variant is classified as pathogenic. -

beta Thalassemia Pathogenic:3Other:1
-
GeneReviews
Significance: not provided
Review Status: no classification provided
Collection Method: literature only

- -

Nov 25, 2019
The ITHANET community portal, The Cyprus Institute of Neurology and Genetics
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: curation

- -

Apr 03, 2015
Women's Health and Genetics/Laboratory Corporation of America, LabCorp
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing

- -

Sep 16, 2024
Molecular Genetics Laboratory, BC Children's and BC Women's Hospitals
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing

- -

Beta-thalassemia HBB/LCRB Pathogenic:1
May 07, 2024
MOLECULAR BIOLOGY AND HUMAN GENETICS DIVISION, THE UNIVERSITY OF BURDWAN
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing

The HBB c.-136C>G is a beta+ type of mutation located in the promoter of beta globin gene. When this variant present with other pathogenic HBB mutation leads to severe type of thalassemia. Patients needing blood transfusion, often presented with hepatosplenomegaly, Iron overload. The frequency of the variant among thalassemia patient in Eastern India is 0.09 % as per our multicentric project - A Genetic Diagnostic Algorithm Based Study for Thalassemia in Northern and Eastern Indian Populations, Funded by Dept. of Biotechnology , Govt of India [Project No. BT/PR26461/MED/12/821/2018] -

Beta-plus-thalassemia Pathogenic:1
Jun 01, 1992
OMIM
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: literature only

- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
BayesDel_noAF
Benign
-0.59
CADD
Benign
12
DANN
Benign
0.73

Splicing

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: rs33994806; hg19: chr11-5248387; API