Our verdict is Pathogenic. Variant got 12 ACMG points: 12P and 0B. PVS1PM2PP5_Moderate
The NM_000548.5(TSC2):c.598C>T(p.Gln200*) variant causes a stop gained, splice region change. The variant was absent in control chromosomes in GnomAD project. In-silico tool predicts a pathogenic outcome for this variant. 2/3 splice prediction tools predict no significant impact on normal splicing. Variant has been reported in ClinVar as Pathogenic (★). Variant results in nonsense mediated mRNA decay.
TSC2 (HGNC:12363): (TSC complex subunit 2) This gene is a tumor suppressor gene that encodes the growth inhibitory protein tuberin. Tuberin interacts with hamartin to form the TSC protein complex which functions in the control of cell growth. This TSC protein complex negatively regulates mammalian target of rapamycin complex 1 (mTORC1) signaling which is a major regulator of anabolic cell growth. Mutations in this gene have been associated with tuberous sclerosis and lymphangioleiomyomatosis. [provided by RefSeq, May 2022]
Verdict is Pathogenic. Variant got 12 ACMG points.
PVS1
Loss of function variant, product undergoes nonsense mediated mRNA decay. LoF is a known mechanism of disease.
PM2
Very rare variant in population databases, with high coverage;
PP5
Variant 16-2055518-C-T is Pathogenic according to our data. Variant chr16-2055518-C-T is described in ClinVar as [Pathogenic]. Clinvar id is 49376.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr16-2055518-C-T is described in Lovd as [Pathogenic]. Variant chr16-2055518-C-T is described in Lovd as [Pathogenic].
Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing
The p.Gln200X variant in TSC2 has been previously reported in 1 individual with Tuberous Sclerosis Complex (TSC) (Langkau 2002). It was absent from large popula tion studies (dbSNP rs45517115). This nonsense variant leads to a premature term ination codon at position 200, which is predicted to lead to a truncated or abse nt protein. Heterozygous loss of TSC2 function is an established disease mechani sm in TSC. In summary, this variant meets our criteria to be classified as path ogenic for TSC in an autosomal dominant manner. -