Our verdict is Pathogenic. The variant received 12 ACMG points: 12P and 0B. PVS1_ModeratePM2PP5_Very_Strong
The NM_000548.5(TSC2):c.3131+1G>A variant causes a splice donor, intron change involving the alteration of a conserved nucleotide. The variant was absent in control chromosomes in GnomAD project. In-silico tool predicts a pathogenic outcome for this variant. 2/2 splice prediction tools predicting alterations to normal splicing. Variant has been reported in ClinVar as Pathogenic (★★).
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]
TSC2 Gene-Disease associations (from GenCC):
tuberous sclerosis
Inheritance: AD Classification: DEFINITIVE Submitted by: ClinGen
tuberous sclerosis 2
Inheritance: AD Classification: DEFINITIVE, STRONG Submitted by: PanelApp Australia, Laboratory for Molecular Medicine, Labcorp Genetics (formerly Invitae), G2P, Genomics England PanelApp, Ambry Genetics
lymphangioleiomyomatosis
Inheritance: AD Classification: STRONG Submitted by: Genomics England PanelApp
tuberous sclerosis complex
Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
Our verdict: Pathogenic. The variant received 12 ACMG points.
PVS1
Splicing +-2 bp (donor or acceptor) variant, product NOT destroyed by NMD, known LOF gene, truncates exone, which is 0.030420354 fraction of the gene. No cryptic splice site detected. Exon removal is inframe change.
PM2
Very rare variant in population databases, with high coverage;
PP5
Variant 16-2079197-G-A is Pathogenic according to our data. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2079197-G-A is described in CliVar as Pathogenic. Clinvar id is 49244.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.
For these reasons, this variant has been classified as Pathogenic. Donor and acceptor splice site variants typically lead to a loss of protein function (PMID: 16199547), and loss-of-function variants in TSC2 are known to be pathogenic (PMID: 10205261, 17304050). Algorithms developed to predict the effect of sequence changes on RNA splicing suggest that this variant may disrupt the consensus splice site, but this prediction has not been confirmed by published transcriptional studies. This variant has been observed in several individuals affected with tuberous sclerosis (PMID: 15595939, 25782670). ClinVar contains an entry for this variant (Variation ID: 49244). This variant is not present in population databases (ExAC no frequency). This sequence change affects a donor splice site in intron 27 of the TSC2 gene. It is expected to disrupt RNA splicing and likely results in an absent or disrupted protein product. -
Lymphangiomyomatosis;C1846385:Isolated focal cortical dysplasia type II;C1860707:Tuberous sclerosis 2Pathogenic:1
The c.3131+1 G>A splice site variant in the TSC2 gene has been previously reported in association with tuberous sclerosis (Ali et al., 2005; Kwiatkowski et al., 2015; TSC2 LOVD) and is consistent with the diagnosis in this individual. It was not observed in approximately 6,500 individuals of European and African American ancestry in the NHLBI Exome Sequencing Project, indicating it is not a common benign variant in these populations. This pathogenic variant destroys the canonical splice donor site in intron 27, and is expected to cause abnormal gene splicing. Additionally, other canonical splicing variants in intron 27 have been reported in the Human Gene Mutation Database in association with tuberous sclerosis (Stenson et al., 2014). -