19-1399548-T-C

Variant summary

Our verdict is Uncertain significance. The variant received 1 ACMG points: 2P and 1B. PM2BP4

The NM_138924.3(GAMT):​c.367A>G​(p.Thr123Ala) variant causes a missense change. The variant allele was found at a frequency of 0.0000453 in 1,612,676 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a benign outcome for this variant. Variant has been reported in ClinVar as Uncertain significance (★★). Synonymous variant affecting the same amino acid position (i.e. T123T) has been classified as Likely benign.

Frequency

Genomes: 𝑓 0.000013 ( 0 hom., cov: 32)
Exomes 𝑓: 0.000049 ( 0 hom. )

Consequence

GAMT
NM_138924.3 missense

Scores

1
4
13

Clinical Significance

Uncertain significance criteria provided, multiple submitters, no conflicts U:5

Conservation

PhyloP100: 4.92

Publications

1 publications found
Variant links:
Genes affected
GAMT (HGNC:4136): (guanidinoacetate N-methyltransferase) The protein encoded by this gene is a methyltransferase that converts guanidoacetate to creatine, using S-adenosylmethionine as the methyl donor. Defects in this gene have been implicated in neurologic syndromes and muscular hypotonia, probably due to creatine deficiency and accumulation of guanidinoacetate in the brain of affected individuals. Two transcript variants encoding different isoforms have been described for this gene. Pseudogenes of this gene are found on chromosomes 2 and 13. [provided by RefSeq, Feb 2012]
GAMT Gene-Disease associations (from GenCC):
  • guanidinoacetate methyltransferase deficiency
    Inheritance: AR Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Orphanet, G2P, Labcorp Genetics (formerly Invitae), ClinGen, Ambry Genetics

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Uncertain_significance. The variant received 1 ACMG points.

PM2
Very rare variant in population databases, with high coverage;
BP4
Computational evidence support a benign effect (MetaRNN=0.29102075).

Variant Effect in Transcripts

ACMG analysis was done for transcript: NM_138924.3. You can select a different transcript below to see updated ACMG assignments.

RefSeq Transcripts

Selected
GeneTranscriptTagsHGVScHGVSpEffectExon RankProteinUniProt
GAMT
NM_000156.6
MANE Select
c.367A>Gp.Thr123Ala
missense
Exon 3 of 6NP_000147.1
GAMT
NM_138924.3
c.367A>Gp.Thr123Ala
missense
Exon 3 of 5NP_620279.1

Ensembl Transcripts

Selected
GeneTranscriptTagsHGVScHGVSpEffectExon RankProteinUniProt
GAMT
ENST00000252288.8
TSL:1 MANE Select
c.367A>Gp.Thr123Ala
missense
Exon 3 of 6ENSP00000252288.1
GAMT
ENST00000902474.1
c.637A>Gp.Thr213Ala
missense
Exon 3 of 6ENSP00000572533.1
GAMT
ENST00000447102.8
TSL:2
c.367A>Gp.Thr123Ala
missense
Exon 3 of 5ENSP00000403536.2

Frequencies

GnomAD3 genomes
AF:
0.0000132
AC:
2
AN:
151854
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.00
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:
0.0000294
Gnomad OTH
AF:
0.00
GnomAD2 exomes
AF:
0.0000362
AC:
9
AN:
248736
AF XY:
0.0000593
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.0000290
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.0000713
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000486
AC:
71
AN:
1460822
Hom.:
0
Cov.:
32
AF XY:
0.0000592
AC XY:
43
AN XY:
726610
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
33474
American (AMR)
AF:
0.00
AC:
0
AN:
44668
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
26112
East Asian (EAS)
AF:
0.00
AC:
0
AN:
39698
South Asian (SAS)
AF:
0.00
AC:
0
AN:
86108
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
52862
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
5764
European-Non Finnish (NFE)
AF:
0.0000621
AC:
69
AN:
1111774
Other (OTH)
AF:
0.0000331
AC:
2
AN:
60362
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.458
Heterozygous variant carriers
0
3
7
10
14
17
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome Het
Variant carriers
0
4
8
12
16
20
<30
30-35
35-40
40-45
45-50
50-55
55-60
60-65
65-70
70-75
75-80
>80
Age
GnomAD4 genome
AF:
0.0000132
AC:
2
AN:
151854
Hom.:
0
Cov.:
32
AF XY:
0.0000270
AC XY:
2
AN XY:
74166
show subpopulations
⚠️ The allele balance in gnomAD version 4 Genomes is significantly skewed from the expected value of 0.5.
African (AFR)
AF:
0.00
AC:
0
AN:
41300
American (AMR)
AF:
0.00
AC:
0
AN:
15270
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3466
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5176
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4794
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10584
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
316
European-Non Finnish (NFE)
AF:
0.0000294
AC:
2
AN:
67962
Other (OTH)
AF:
0.00
AC:
0
AN:
2076
⚠️ The allele balance in gnomAD version 4 Genomes is significantly skewed from the expected value of 0.5. (p-value = 0), which strongly suggests a high chance of mosaicism in these individuals.
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.350
Heterozygous variant carriers
0
0
1
1
2
2
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Genome Het
Variant carriers
0
2
4
6
8
10
<30
30-35
35-40
40-45
45-50
50-55
55-60
60-65
65-70
70-75
75-80
>80
Age
Alfa
AF:
0.0000313
Hom.:
0
ExAC
AF:
0.0000165
AC:
2
EpiCase
AF:
0.00
EpiControl
AF:
0.000119

ClinVar

ClinVar submissions as Germline
Significance:Uncertain significance
Revision:criteria provided, multiple submitters, no conflicts
View on ClinVar
Pathogenic
VUS
Benign
Condition
-
1
-
Cerebral creatine deficiency syndrome (1)
-
1
-
Deficiency of guanidinoacetate methyltransferase (1)
-
1
-
Inborn genetic diseases (1)
-
1
-
not provided (1)
-
1
-
not specified (1)

Computational scores

Source: dbNSFP v4.9

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.061
BayesDel_addAF
Benign
-0.056
T
BayesDel_noAF
Benign
-0.14
CADD
Benign
18
DANN
Uncertain
0.97
DEOGEN2
Uncertain
0.43
T
Eigen
Benign
-0.29
Eigen_PC
Benign
-0.17
FATHMM_MKL
Pathogenic
0.98
D
LIST_S2
Benign
0.69
T
M_CAP
Uncertain
0.17
D
MetaRNN
Benign
0.29
T
MetaSVM
Benign
-0.37
T
MutationAssessor
Benign
1.8
L
PhyloP100
4.9
PrimateAI
Benign
0.44
T
PROVEAN
Benign
-1.7
N
REVEL
Uncertain
0.41
Sift
Benign
0.52
T
Sift4G
Benign
0.20
T
Polyphen
0.12
B
Vest4
0.42
MutPred
0.22
Loss of phosphorylation at T123 (P = 0.1097)
MVP
0.85
MPC
0.14
ClinPred
0.086
T
GERP RS
3.8
PromoterAI
0.045
Neutral
RBP_binding_hub_radar
0.0
RBP_regulation_power_radar
1.1
Varity_R
0.63
gMVP
0.60
Mutation Taster
=35/65
disease causing

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.020
Details are displayed if max score is > 0.2

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

Publications

Other links and lift over

dbSNP: rs771827261; hg19: chr19-1399547; API