16-56872436-C-T

Variant summary

Our verdict is Pathogenic. Variant got 12 ACMG points: 12P and 0B. PM1PM2PP5_Very_Strong

The NM_001126108.2(SLC12A3):​c.938C>T​(p.Ala313Val) variant causes a missense change. The variant allele was found at a frequency of 0.0000502 in 1,613,896 control chromosomes in the GnomAD database, including 1 homozygotes. Variant has been reported in ClinVar as Likely pathogenic (★★). Synonymous variant affecting the same amino acid position (i.e. A313A) has been classified as Likely benign.

Frequency

Genomes: 𝑓 0.000033 ( 0 hom., cov: 33)
Exomes 𝑓: 0.000052 ( 1 hom. )

Consequence

SLC12A3
NM_001126108.2 missense

Scores

2
5
12

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:8

Conservation

PhyloP100: 5.37
Variant links:
Genes affected
SLC12A3 (HGNC:10912): (solute carrier family 12 member 3) This gene encodes a renal thiazide-sensitive sodium-chloride cotransporter that is important for electrolyte homeostasis. This cotransporter mediates sodium and chloride reabsorption in the distal convoluted tubule. Mutations in this gene cause Gitelman syndrome, a disease similar to Bartter's syndrome, that is characterized by hypokalemic alkalosis combined with hypomagnesemia, low urinary calcium, and increased renin activity associated with normal blood pressure. This cotransporter is the target for thiazide diuretics that are used for treating high blood pressure. Multiple transcript variants encoding different isoforms have been found for this gene. [provided by RefSeq, Jul 2008]

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ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 12 ACMG points.

PM1
In a hotspot region, there are 2 aminoacids with missense pathogenic changes in the window of +-8 aminoacids around while only 2 benign, 4 uncertain in NM_001126108.2
PM2
Very rare variant in population databases, with high coverage;
PP5
Variant 16-56872436-C-T is Pathogenic according to our data. Variant chr16-56872436-C-T is described in ClinVar as [Likely_pathogenic]. Clinvar id is 448400.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE UniProt
SLC12A3NM_001126108.2 linkuse as main transcriptc.938C>T p.Ala313Val missense_variant 7/26 ENST00000563236.6
SLC12A3NM_000339.3 linkuse as main transcriptc.938C>T p.Ala313Val missense_variant 7/26
SLC12A3NM_001126107.2 linkuse as main transcriptc.935C>T p.Ala312Val missense_variant 7/26
SLC12A3NM_001410896.1 linkuse as main transcriptc.935C>T p.Ala312Val missense_variant 7/26

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Appris UniProt
SLC12A3ENST00000563236.6 linkuse as main transcriptc.938C>T p.Ala313Val missense_variant 7/261 NM_001126108.2 A1P55017-1
SLC12A3ENST00000438926.6 linkuse as main transcriptc.938C>T p.Ala313Val missense_variant 7/261 A1P55017-2
SLC12A3ENST00000566786.5 linkuse as main transcriptc.935C>T p.Ala312Val missense_variant 7/261 P4P55017-3
SLC12A3ENST00000262502.5 linkuse as main transcriptc.935C>T p.Ala312Val missense_variant 7/265 A1

Frequencies

GnomAD3 genomes
AF:
0.0000328
AC:
5
AN:
152242
Hom.:
0
Cov.:
33
show subpopulations
Gnomad AFR
AF:
0.0000482
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00
Gnomad ASJ
AF:
0.00
Gnomad EAS
AF:
0.00
Gnomad SAS
AF:
0.00
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.0000441
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.0000199
AC:
5
AN:
251358
Hom.:
0
AF XY:
0.0000221
AC XY:
3
AN XY:
135876
show subpopulations
Gnomad AFR exome
AF:
0.0000615
Gnomad AMR exome
AF:
0.00
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad SAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.0000352
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000520
AC:
76
AN:
1461654
Hom.:
1
Cov.:
31
AF XY:
0.0000550
AC XY:
40
AN XY:
727156
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:
0.00
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.0000684
Gnomad4 OTH exome
AF:
0.00
GnomAD4 genome
AF:
0.0000328
AC:
5
AN:
152242
Hom.:
0
Cov.:
33
AF XY:
0.0000403
AC XY:
3
AN XY:
74374
show subpopulations
Gnomad4 AFR
AF:
0.0000482
Gnomad4 AMR
AF:
0.00
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.00
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.0000441
Gnomad4 OTH
AF:
0.00
Alfa
AF:
0.0000329
Hom.:
0
Bravo
AF:
0.0000227
TwinsUK
AF:
0.000270
AC:
1
ALSPAC
AF:
0.00
AC:
0
ESP6500AA
AF:
0.000227
AC:
1
ESP6500EA
AF:
0.00
AC:
0
ExAC
AF:
0.0000247
AC:
3
EpiCase
AF:
0.0000545
EpiControl
AF:
0.000178

ClinVar

Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:8
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Familial hypokalemia-hypomagnesemia Pathogenic:5
Likely pathogenic, no assertion criteria providedclinical testingNatera, Inc.Sep 16, 2020- -
Likely pathogenic, criteria provided, single submitterclinical testingGenome-Nilou LabJul 15, 2021- -
Likely pathogenic, criteria provided, single submitterclinical testingEuropean Hospital Georges Pompidou Genetics Department, Assistance Publique - Hôpitaux de Paris AP-HPApr 27, 2022ACMG criteria used:PS4 PM1 PM2 PP5 -
Likely pathogenic, criteria provided, single submitterclinical testingFulgent Genetics, Fulgent GeneticsDec 19, 2021- -
Pathogenic, criteria provided, single submitterclinical testingVictorian Clinical Genetics Services, Murdoch Childrens Research InstituteMay 06, 2021Based on the classification scheme VCGS_Germline_v1.3.4, this variant is classified as Pathogenic. Following criteria are met: 0102 - Loss of function is a known mechanism of disease in this gene and is associated with Gitelman syndrome (MIM#263800). (I) 0106 - This gene is associated with autosomal recessive disease. (I) 0200 - Variant is predicted to result in a missense amino acid change from alanine to valine. (I) 0251 - This variant is heterozygous. (I) 0304 - Variant is present in gnomAD <0.01 for a recessive condition (v2: 6 heterozygotes, 0 homozygotes). (SP) 0502 - Missense variant with conflicting in silico predictions and uninformative conservation. (I) 0600 - Variant is located in the annotated AA_permease domain (DECIPHER). (I) 0801 - This variant has strong previous evidence of pathogenicity in unrelated individuals. It has been reported in at least ten Gitelman Syndrome patients both as homozygous and compound heterozygous (PMID: 25012174, 22009145, 21415153, ClinVar). (SP) 1208 - Inheritance information for this variant is not currently available in this individual. (I) Legend: (SP) - Supporting pathogenic, (I) - Information, (SB) - Supporting benign -
not provided Pathogenic:2
Pathogenic, criteria provided, single submitterclinical testingLabcorp Genetics (formerly Invitae), LabcorpJan 31, 2024This sequence change replaces alanine, which is neutral and non-polar, with valine, which is neutral and non-polar, at codon 313 of the SLC12A3 protein (p.Ala313Val). This variant is present in population databases (rs140551719, gnomAD 0.004%). This missense change has been observed in individual(s) with Gitelman syndrome (PMID: 11168953, 15824853, 21415153, 22009145). In at least one individual the data is consistent with being in trans (on the opposite chromosome) from a pathogenic variant. ClinVar contains an entry for this variant (Variation ID: 448400). 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) has been performed at Invitae for this missense variant, however the output from this modeling did not meet the statistical confidence thresholds required to predict the impact of this variant on SLC12A3 protein function. For these reasons, this variant has been classified as Pathogenic. -
Likely pathogenic, criteria provided, single submitterclinical testingAthena DiagnosticsAug 16, 2016- -
SLC12A3-related disorder Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingPreventionGenetics, part of Exact SciencesFeb 17, 2023The SLC12A3 c.938C>T variant is predicted to result in the amino acid substitution p.Ala313Val. This variant has been reported in the homozygous or compound heterozygous state in patients with Gitelman syndrome (Table S1a, Vargas-Poussou et al. 2011. PubMed ID: 21415153; Cruz et al. 2001. PubMed ID: 11168953; Table S1, Hureaux et al. 2019. PubMed ID: 31672324). This variant is reported in 0.0040% of alleles in individuals of African descent in gnomAD (http://gnomad.broadinstitute.org/variant/16-56906348-C-T). This variant is interpreted as pathogenic. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.078
BayesDel_addAF
Pathogenic
0.17
D
BayesDel_noAF
Pathogenic
0.18
CADD
Uncertain
24
DANN
Uncertain
1.0
DEOGEN2
Uncertain
0.65
.;.;D;T
Eigen
Benign
-0.031
Eigen_PC
Benign
0.20
FATHMM_MKL
Uncertain
0.84
D
LIST_S2
Uncertain
0.92
D;D;D;D
M_CAP
Benign
0.033
D
MetaRNN
Uncertain
0.58
D;D;D;D
MetaSVM
Benign
-0.95
T
MutationAssessor
Benign
0.52
.;N;N;.
MutationTaster
Benign
0.56
N;N;N;N
PrimateAI
Benign
0.46
T
PROVEAN
Benign
-1.1
N;N;N;N
REVEL
Benign
0.10
Sift
Benign
0.17
T;T;T;T
Sift4G
Benign
0.25
T;T;T;T
Polyphen
0.011
B;B;B;.
Vest4
0.67
MVP
0.94
MPC
0.12
ClinPred
0.22
T
GERP RS
5.7
Varity_R
0.17
gMVP
0.89

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.0
Details are displayed if max score is > 0.2

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: rs140551719; hg19: chr16-56906348; API