Our verdict is Likely pathogenic. The variant received 8 ACMG points: 8P and 0B. PM1PM2PM5PP5_Moderate
The NM_001360.3(DHCR7):c.89G>A(p.Gly30Asp) variant causes a missense change. The variant allele was found at a frequency of 0.00000657 in 152,242 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Likely pathogenic (★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. G30S) has been classified as Likely pathogenic.
DHCR7 (HGNC:2860): (7-dehydrocholesterol reductase) This gene encodes an enzyme that removes the C(7-8) double bond in the B ring of sterols and catalyzes the conversion of 7-dehydrocholesterol to cholesterol. This gene is ubiquitously expressed and its transmembrane protein localizes to the endoplasmic reticulum membrane and nuclear outer membrane. Mutations in this gene cause Smith-Lemli-Opitz syndrome (SLOS); a syndrome that is metabolically characterized by reduced serum cholesterol levels and elevated serum 7-dehydrocholesterol levels and phenotypically characterized by cognitive disability, facial dysmorphism, syndactyly of second and third toes, and holoprosencephaly in severe cases to minimal physical abnormalities and near-normal intelligence in mild cases. Alternative splicing results in multiple transcript variants that encode the same protein.[provided by RefSeq, Aug 2009]
Our verdict: Likely_pathogenic. The variant received 8 ACMG points.
PM1
In a hotspot region, there are 2 aminoacids with missense pathogenic changes in the window of +-8 aminoacids around while only 1 benign, 7 uncertain in NM_001360.3
PM2
Very rare variant in population databases, with high coverage;
PM5
Other missense variant is known to change same aminoacid residue: Variant chr11-71444865-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 1934663.
PP5
Variant 11-71444864-C-T is Pathogenic according to our data. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr11-71444864-C-T is described in CliVar as Likely_pathogenic. Clinvar id is 2720743.Status of the report is criteria_provided_single_submitter, 1 stars.
This sequence change replaces glycine, which is neutral and non-polar, with aspartic acid, which is acidic and polar, at codon 30 of the DHCR7 protein (p.Gly30Asp). This variant is not present in population databases (gnomAD no frequency). This variant has not been reported in the literature in individuals affected with DHCR7-related conditions. Advanced modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) performed at Invitae indicates that this missense variant is expected to disrupt DHCR7 protein function with a positive predictive value of 95%. This variant disrupts the p.Gly30 amino acid residue in DHCR7. Other variant(s) that disrupt this residue have been determined to be pathogenic (PMID: 17497248, 17994283, 34958143). This suggests that this residue is clinically significant, and that variants that disrupt this residue are likely to be disease-causing. 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. -
Gain of disorder (P = 0.1749);Gain of disorder (P = 0.1749);Gain of disorder (P = 0.1749);Gain of disorder (P = 0.1749);Gain of disorder (P = 0.1749);Gain of disorder (P = 0.1749);Gain of disorder (P = 0.1749);