2-240868890-AC-A

Variant summary

Our verdict is Pathogenic. Variant got 18 ACMG points: 18P and 0B. PVS1PM2PP5_Very_Strong

The NM_000030.3(AGXT):​c.33del​(p.Lys12ArgfsTer34) 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˜…). Synonymous variant affecting the same amino acid position (i.e. T9T) has been classified as Likely benign.

Frequency

Genomes: 𝑓 0.0000066 ( 0 hom., cov: 33)
Exomes 𝑓: 0.0000075 ( 0 hom. )

Consequence

AGXT
NM_000030.3 frameshift

Scores

Not classified

Clinical Significance

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

Conservation

PhyloP100: 0.775
Variant links:
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]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 18 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 250 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

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE UniProt
AGXTNM_000030.3 linkuse as main transcriptc.33del p.Lys12ArgfsTer34 frameshift_variant 1/11 ENST00000307503.4

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Appris UniProt
AGXTENST00000307503.4 linkuse as main transcriptc.33del p.Lys12ArgfsTer34 frameshift_variant 1/111 NM_000030.3 P1
AGXTENST00000472436.1 linkuse as main transcriptn.53del non_coding_transcript_exon_variant 1/52

Frequencies

GnomAD3 genomes
AF:
0.00000662
AC:
1
AN:
151010
Hom.:
0
Cov.:
33
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:
0.0000148
Gnomad OTH
AF:
0.00
GnomAD4 exome
AF:
0.00000754
AC:
11
AN:
1459472
Hom.:
0
Cov.:
31
AF XY:
0.00000827
AC XY:
6
AN XY:
725938
show subpopulations
Gnomad4 AFR exome
AF:
0.0000299
Gnomad4 AMR exome
AF:
0.00
Gnomad4 ASJ exome
AF:
0.0000383
Gnomad4 EAS exome
AF:
0.0000757
Gnomad4 SAS exome
AF:
0.0000349
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.00000270
Gnomad4 OTH exome
AF:
0.00
GnomAD4 genome
AF:
0.00000662
AC:
1
AN:
151010
Hom.:
0
Cov.:
33
AF XY:
0.0000136
AC XY:
1
AN XY:
73730
show subpopulations
Gnomad4 AFR
AF:
0.00
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:
0.0000148
Gnomad4 OTH
AF:
0.00
Bravo
AF:
0.00000378

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 submitterclinical testingBaylor GeneticsFeb 10, 2024- -
Pathogenic, criteria provided, single submittercurationClinical Biochemistry Laboratory, Health Services LaboratoryOct 27, 2023ACMG:PVS1 PM2 PM3 PP4 -
Likely pathogenic, criteria provided, single submitterliterature onlyCounsylMay 01, 2014- -
Pathogenic, criteria provided, single submitterclinical testingNeuberg 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 providedclinical testingNatera, Inc.Aug 17, 2020- -
AGXT-related disorder Pathogenic:1
Pathogenic, no assertion criteria providedclinical testingPreventionGenetics, part of Exact SciencesOct 18, 2023The 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 submitterclinical testingWomen's Health and Genetics/Laboratory Corporation of America, LabCorpFeb 08, 2019Variant 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 submitterclinical testingLabcorp Genetics (formerly Invitae), LabcorpDec 26, 2023This 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

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.12
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: rs180177201; hg19: chr2-241808307; API