2-240868890-AC-A
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Variant summary
Our verdict is Pathogenic. Variant got 14 ACMG points: 14P and 0B. PVS1_StrongPM2PP5_Very_Strong
The NM_000030.3(AGXT):βc.33delCβ(p.Lys12fs) variant causes a frameshift change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.00000745 in 1,610,482 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Likely pathogenic (β β ).
Frequency
Genomes: π 0.0000066 ( 0 hom., cov: 33)
Exomes π: 0.0000075 ( 0 hom. )
Consequence
AGXT
NM_000030.3 frameshift
NM_000030.3 frameshift
Scores
Not classified
Clinical Significance
Conservation
PhyloP100: 0.775
Genes affected
AGXT (HGNC:341): (alanine--glyoxylate aminotransferase) This gene is expressed only in the liver and the encoded protein is localized mostly in the peroxisomes, where it is involved in glyoxylate detoxification. Mutations in this gene, some of which alter subcellular targetting, have been associated with type I primary hyperoxaluria. [provided by RefSeq, Jul 2008]
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ACMG classification
Classification made for transcript
Verdict is Pathogenic. Variant got 14 ACMG points.
PVS1
Loss of function variant, product does not undergo nonsense mediated mRNA decay. Variant located near the start codon (<100nt), not predicted to undergo nonsense mediated mRNA decay. There are 12 pathogenic variants in the truncated region.
PM2
Very rare variant in population databases, with high coverage;
PP5
Variant 2-240868890-AC-A is Pathogenic according to our data. Variant chr2-240868890-AC-A is described in ClinVar as [Likely_pathogenic]. Clinvar id is 188775.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-240868890-AC-A is described in Lovd as [Pathogenic].
Transcripts
RefSeq
Ensembl
Frequencies
GnomAD3 genomes AF: 0.00000662 AC: 1AN: 151010Hom.: 0 Cov.: 33
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GnomAD4 exome AF: 0.00000754 AC: 11AN: 1459472Hom.: 0 Cov.: 31 AF XY: 0.00000827 AC XY: 6AN XY: 725938
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GnomAD4 genome AF: 0.00000662 AC: 1AN: 151010Hom.: 0 Cov.: 33 AF XY: 0.0000136 AC XY: 1AN XY: 73730
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ClinVar
Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:8
Revision: criteria provided, multiple submitters, no conflicts
LINK: link
Submissions by phenotype
Primary hyperoxaluria, type I Pathogenic:5
Pathogenic, criteria provided, single submitter | curation | Clinical Biochemistry Laboratory, Health Services Laboratory | Oct 27, 2023 | ACMG:PVS1 PM2 PM3 PP4 - |
Pathogenic, criteria provided, single submitter | clinical testing | Baylor Genetics | Feb 10, 2024 | - - |
Likely pathogenic, criteria provided, single submitter | literature only | Counsyl | May 01, 2014 | - - |
Pathogenic, criteria provided, single submitter | clinical testing | Neuberg Centre For Genomic Medicine, NCGM | - | The frame shift c.33del (p.Lys12ArgfsTer34) variant has been reported previously in homozygous state in patients affected with Hyperoxaluria (Coulter-Mackie MB et al). This p.Lys12ArgfsTer34 variant has allele frequency of 0.0017% in the gnomAD and is novel (not in any individuals) in 1000 Genomes. This variant has been reported to the ClinVar database as Pathogenic. This variant causes a frameshift starting with codon Lysine 12, changes this amino acid to Arginine residue, and creates a premature Stop codon at position 34 of the new reading frame, denoted p.Lys12ArgfsTer34. This variant is predicted to cause loss of normal protein function through protein truncation. Loss of function variants have been previously reported to be disease causing. For these reasons, this variant has been classified as Pathogenic. - |
Pathogenic, no assertion criteria provided | clinical testing | Natera, Inc. | Aug 17, 2020 | - - |
AGXT-related disorder Pathogenic:1
Pathogenic, no assertion criteria provided | clinical testing | PreventionGenetics, part of Exact Sciences | Oct 18, 2023 | The AGXT c.33delC variant is predicted to result in a frameshift and premature protein termination (p.Lys12Argfs*34). This variant has been reported in multiple individuals with hyperoxaluria (for example see: Coulter-Mackie et al. 2005. PubMed ID: 15963748; Williams et al. 2007. PubMed ID: 17495019). This variant is reported in 0.017% of alleles in individuals of East Asian descent in gnomAD (http://gnomad.broadinstitute.org/variant/2-241808307-AC-A). Frameshift variants in AGXT are expected to be pathogenic. This variant is interpreted as pathogenic. - |
Primary hyperoxaluria Pathogenic:1
Pathogenic, criteria provided, single submitter | clinical testing | Women's Health and Genetics/Laboratory Corporation of America, LabCorp | Feb 08, 2019 | Variant summary: AGXT c.33delC (p.Lys12ArgfsX34) results in a premature termination codon, predicted to cause a truncation of the encoded protein or absence of the protein due to nonsense mediated decay, which are commonly known mechanisms for disease. Truncations downstream of this position have been classified as pathogenic by our laboratory (e.g. p.Lys12fsX156, p.Ser275fsX38). The variant was absent in 242874 control chromosomes (gnomAD). c.33delC has been reported in the literature in homozygous individuals affected with Primary Hyperoxaluria Type 1 (Amoroso 2001, Williams 2007, Hoyer-Kuhn_2014). These data indicate that the variant is likely to be associated with disease. One of these publications also measured liver AGT activity in a homozygous patient, and demonstrated a pronounced variant effect, resulting in <10% of normal activity (Williams 2007). No clinical diagnostic laboratories have submitted clinical-significance assessments for this variant to ClinVar after 2014. Based on the evidence outlined above, the variant was classified as pathogenic. - |
not provided Pathogenic:1
Pathogenic, criteria provided, single submitter | clinical testing | Labcorp Genetics (formerly Invitae), Labcorp | Dec 26, 2023 | This sequence change creates a premature translational stop signal (p.Lys12Argfs*34) in the AGXT gene. It is expected to result in an absent or disrupted protein product. Loss-of-function variants in AGXT are known to be pathogenic (PMID: 19479957). The frequency data for this variant in the population databases is considered unreliable, as metrics indicate poor data quality at this position in the gnomAD database. This premature translational stop signal has been observed in individuals with hyperoxaluria (PMID: 15963748, 17495019, 26383609). ClinVar contains an entry for this variant (Variation ID: 188775). Algorithms developed to predict the effect of sequence changes on RNA splicing suggest that this variant may create or strengthen a splice site. For these reasons, this variant has been classified as Pathogenic. - |
Computational scores
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