12-32802499-GGGTGTG-GG
Variant summary
Our verdict is Pathogenic. Variant got 16 ACMG points: 16P and 0B. PVS1PP5_Very_Strong
The NM_001005242.3(PKP2):c.2066_2070delACACC(p.His689ProfsTer8) variant causes a frameshift change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.00007 in 1,613,546 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Pathogenic (★★). Synonymous variant affecting the same amino acid position (i.e. H689H) has been classified as Likely benign. Variant results in nonsense mediated mRNA decay.
Frequency
Consequence
NM_001005242.3 frameshift
Scores
Clinical Significance
Conservation
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ACMG classification
Verdict is Pathogenic. Variant got 16 ACMG points.
Transcripts
RefSeq
Ensembl
Frequencies
GnomAD3 genomes AF: 0.0000197 AC: 3AN: 152100Hom.: 0 Cov.: 32
GnomAD3 exomes AF: 0.0000159 AC: 4AN: 251356Hom.: 0 AF XY: 0.0000221 AC XY: 3AN XY: 135832
GnomAD4 exome AF: 0.0000753 AC: 110AN: 1461446Hom.: 0 AF XY: 0.0000743 AC XY: 54AN XY: 727052
GnomAD4 genome AF: 0.0000197 AC: 3AN: 152100Hom.: 0 Cov.: 32 AF XY: 0.0000135 AC XY: 1AN XY: 74290
ClinVar
Submissions by phenotype
Arrhythmogenic right ventricular dysplasia 9 Pathogenic:4
The variant NM_001005242.3:c.2066_2070del (chr12:32802499) in PKP2 was detected in 137 heterozygotes out of 58K WGS Icelanders (MAF= 0,118%). Following imputation in a set of 166K Icelanders (305 imputed heterozygotes) we observed an association with atrial fibrillation and flutter using 20168 cases and 351419 controls (OR= 2.31, P= 2.75e-05) and cardiomyopathy using 1974 cases and 365360 controls (OR= 4.11, P= 1.75e-04). This variant has been reported in ClinVar previously as pathogenic. Based on ACMG criteria (PVS1, PS4, PP5) this variant classifies as pathogenic. -
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PKP2 NM_004572.3 exon 11 p.His733Alafs*8 (c.2197_2202delinsG): This variant has been reported in the literature in several individuals with ARVC, segregating with disease in at least 4 affected family members (Syrris 2006 PMID:16415378, den Haan 2009 PMID:20031617, Fressart 2010 PMID:20400443, Xu 2010 PMID:20152563, Walsh 2017 PMID:27532257, Hoorntje 2018 PMID:30161220). This variant is not present in large control databases; of note, another variant with a similar amino acid impact (p.His733Profs*8) is present in 0.003% (5/129074) of European controls in the Genome Aggregation Database (http://gnomad.broadinstitute.org/variant/12-32955433-GGGTGT-G). This variant is present in ClinVar, with several labs classifying this variant as pathogenic (Variation ID:45063). Evolutionary conservation and computational predictive tools for this variant are limited or unavailable. This variant represents a deletion of 6 nucleotides and an insertion of 1 nucleotide; this indel creates a premature stop codon 8 amino acids downstream from this location which results in an absent or abnormal protein. Loss of function variants are a known mechanism of disease for this gene (Rasmussen 2014 PMID:24704780). In summary, this variant is classified as pathogenic. -
not provided Pathogenic:3
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Frameshift variant predicted to result in protein truncation or nonsense mediated decay in a gene for which loss-of-function is a known mechanism of disease; Not observed at a significant frequency in large population cohorts (Lek et al., 2016); This variant is associated with the following publications: (PMID: 30700137, 30161220) -
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Arrhythmogenic right ventricular cardiomyopathy Pathogenic:1
The p.His733ProfsX8 variant in PKP2 has not been previously reported in individuals with ARVC or in the large population studies, though a similar variant (His733AlafsX8) has been reported in >20 individuals and is classified as pathogenic by our laboratory. This p.His733ProfsX8 rameshift variant is predicted to alter the protein’s amino acid sequence beginning at position 733 and lead to a premature termination codon 8 amino acids downstream. This alteration is then predicted to lead to a truncated or absent protein. Heterozygous loss of PKP2 function is an established disease mechanism in individuals with ARVC. In summary, this variant meets our criteria to be classified as pathogenic (http://personalizedmedicine.partners.org/Laboratory-For-Molecular-Medicine/). -
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at