19-11111621-A-T

Variant names:

• chr19-11111621-A-T
• rs879254811
• NM_000527.5:c.1168A>T

Variant summary

Our verdict is Pathogenic. The variant received 18 ACMG points: 18P and 0B. PVS1 PM2 PP5_Very_Strong

The NM_000527.5(LDLR):​c.1168A>T​(p.Lys390*) variant causes a stop gained change involving the alteration of a non-conserved nucleotide. The variant was absent in control chromosomes in GnomAD project. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Pathogenic (★★). Variant results in nonsense mediated mRNA decay.

• Frequency: Genomes: not found (cov: 31)
• Consequence: LDLR NM_000527.5 stop_gained
• Clinical Significance: Pathogenic criteria provided, multiple submitters, no conflicts P:2
• Conservation: PhyloP100: 0.932
• Publications: 1 publications found

Genes affected

LDLR (HGNC:6547): (low density lipoprotein receptor) The low density lipoprotein receptor (LDLR) gene family consists of cell surface proteins involved in receptor-mediated endocytosis of specific ligands. The encoded protein is normally bound at the cell membrane, where it binds low density lipoprotein/cholesterol and is taken into the cell. Lysosomes release the cholesterol, which is made available for repression of microsomal enzyme 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase, the rate-limiting step in cholesterol synthesis. At the same time, a reciprocal stimulation of cholesterol ester synthesis takes place. Mutations in this gene cause the autosomal dominant disorder, familial hypercholesterolemia. Alternate splicing results in multiple transcript variants.[provided by RefSeq, May 2022]

LDLR Gene-Disease associations (from GenCC):

• hypercholesterolemia, familial, 1

  Inheritance: AD, SD Classification: DEFINITIVE, STRONG Submitted by: Genomics England PanelApp, Labcorp Genetics (formerly Invitae), Laboratory for Molecular Medicine, ClinGen
• homozygous familial hypercholesterolemia

  Inheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet

ACMG classification

Our verdict: Pathogenic. The variant received 18 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 19-11111621-A-T is Pathogenic according to our data. Variant chr19-11111621-A-T is described in CliVar as Pathogenic. Clinvar id is 251694.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr19-11111621-A-T is described in CliVar as Pathogenic. Clinvar id is 251694.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr19-11111621-A-T is described in CliVar as Pathogenic. Clinvar id is 251694.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr19-11111621-A-T is described in CliVar as Pathogenic. Clinvar id is 251694.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr19-11111621-A-T is described in CliVar as Pathogenic. Clinvar id is 251694.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr19-11111621-A-T is described in CliVar as Pathogenic. Clinvar id is 251694.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr19-11111621-A-T is described in CliVar as Pathogenic. Clinvar id is 251694.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr19-11111621-A-T is described in CliVar as Pathogenic. Clinvar id is 251694.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr19-11111621-A-T is described in CliVar as Pathogenic. Clinvar id is 251694.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr19-11111621-A-T is described in CliVar as Pathogenic. Clinvar id is 251694.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr19-11111621-A-T is described in CliVar as Pathogenic. Clinvar id is 251694.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr19-11111621-A-T is described in CliVar as Pathogenic. Clinvar id is 251694.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr19-11111621-A-T is described in CliVar as Pathogenic. Clinvar id is 251694.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr19-11111621-A-T is described in CliVar as Pathogenic. Clinvar id is 251694.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr19-11111621-A-T is described in CliVar as Pathogenic. Clinvar id is 251694.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr19-11111621-A-T is described in CliVar as Pathogenic. Clinvar id is 251694.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr19-11111621-A-T is described in CliVar as Pathogenic. Clinvar id is 251694.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr19-11111621-A-T is described in CliVar as Pathogenic. Clinvar id is 251694.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr19-11111621-A-T is described in CliVar as Pathogenic. Clinvar id is 251694.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr19-11111621-A-T is described in CliVar as Pathogenic. Clinvar id is 251694.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr19-11111621-A-T is described in CliVar as Pathogenic. Clinvar id is 251694.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr19-11111621-A-T is described in CliVar as Pathogenic. Clinvar id is 251694.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr19-11111621-A-T is described in CliVar as Pathogenic. Clinvar id is 251694.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr19-11111621-A-T is described in CliVar as Pathogenic. Clinvar id is 251694.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr19-11111621-A-T is described in CliVar as Pathogenic. Clinvar id is 251694.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr19-11111621-A-T is described in CliVar as Pathogenic. Clinvar id is 251694.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.

Transcripts

RefSeq

Gene	Transcript	HGVSc	HGVSp	Effect	Exon rank	MANE	Protein	UniProt
LDLR	NM_000527.5	c.1168A>T	p.Lys390*	stop_gained	Exon 8 of 18	ENST00000558518.6	NP_000518.1

Ensembl

Gene	Transcript	HGVSc	HGVSp	Effect	Exon rank	TSL	MANE	Protein	Appris	UniProt
LDLR	ENST00000558518.6	c.1168A>T	p.Lys390*	stop_gained	Exon 8 of 18	1	NM_000527.5	ENSP00000454071.1

Frequencies

GnomAD3 genomes Cov.: 31

GnomAD4 exome Cov.: 32

GnomAD4 genome Cov.: 31

ClinVar

Significance: Pathogenic

Submissions summary: Pathogenic:2

Revision: criteria provided, multiple submitters, no conflicts

Submissions by phenotype

Hypercholesterolemia, familial, 1 Pathogenic:1

Mar 25, 2016

LDLR-LOVD, British Heart Foundation

Significance: Pathogenic

Review Status: criteria provided, single submitter

Collection Method: literature only

- -

Familial hypercholesterolemia Pathogenic:1

Oct 01, 2024

Labcorp Genetics (formerly Invitae), Labcorp

Significance: Pathogenic

Review Status: criteria provided, single submitter

Collection Method: clinical testing

This sequence change creates a premature translational stop signal (p.Lys390*) in the LDLR gene. It is expected to result in an absent or disrupted protein product. Loss-of-function variants in LDLR are known to be pathogenic (PMID: 20809525, 28645073). This variant is not present in population databases (gnomAD no frequency). This premature translational stop signal has been observed in individual(s) with familial hypercholesterolemia (PMID: 8535447, 36105085). This variant is also known as K369X. ClinVar contains an entry for this variant (Variation ID: 251694). For these reasons, this variant has been classified as Pathogenic. -

Computational scores

Source: dbNSFP v4.3

Name	Calibrated prediction	Score	Prediction
BayesDel_addAF	Pathogenic	0.63	D
BayesDel_noAF	Pathogenic	0.30
CADD	Pathogenic	36
DANN	Benign	0.95
Eigen	Benign	-0.30
Eigen_PC	Benign	-0.64
FATHMM_MKL	Benign	0.59	D
PhyloP100		0.93
Vest4		0.88
GERP RS		-1.7
RBP_binding_hub_radar		0.0
RBP_regulation_power_radar		1.1
Mutation Taster		=0/200	disease causing (ClinVar)

Splicing

Name	Calibrated prediction	Score	Prediction
SpliceAI score (max)		0.35		Details are displayed if max score is > 0.2
DS_DG_spliceai		0.35		Position offset: -2

Find out detailed SpliceAI scores and Pangolin per-transcript scores at spliceailookup.broadinstitute.org

Other links and lift over

dbSNP: rs879254811; hg19: chr19-11222297;