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20-63413526-C-T

Variant summary

Our verdict is Pathogenic. Variant got 19 ACMG points: 19P and 0B. PM1PM2PM5PP2PP3_StrongPP5_Very_Strong

The NM_172107.4(KCNQ2):​c.1687G>A​(p.Asp563Asn) variant causes a missense change involving the alteration of a conserved nucleotide. The variant was absent in control chromosomes in GnomAD project. In-silico tool predicts a pathogenic outcome for this variant. 12/21 in silico tools predict a damaging outcome for this variant. Variant has been reported in ClinVar as Pathogenic (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. D563E) has been classified as Uncertain significance.

Frequency

Genomes: not found (cov: 33)

Consequence

KCNQ2
NM_172107.4 missense

Scores

10
3
1

Clinical Significance

Pathogenic criteria provided, multiple submitters, no conflicts P:10O:1

Conservation

PhyloP100: 7.75
Variant links:
Genes affected
KCNQ2 (HGNC:6296): (potassium voltage-gated channel subfamily Q member 2) The M channel is a slowly activating and deactivating potassium channel that plays a critical role in the regulation of neuronal excitability. The M channel is formed by the association of the protein encoded by this gene and a related protein encoded by the KCNQ3 gene, both integral membrane proteins. M channel currents are inhibited by M1 muscarinic acetylcholine receptors and activated by retigabine, a novel anti-convulsant drug. Defects in this gene are a cause of benign familial neonatal convulsions type 1 (BFNC), also known as epilepsy, benign neonatal type 1 (EBN1). At least five transcript variants encoding five 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 19 ACMG points.

PM1
In a hotspot region, there are 7 aminoacids with missense pathogenic changes in the window of +-8 aminoacids around while only 0 benign, 7 uncertain in NM_172107.4
PM2
Very rare variant in population databases, with high coverage;
PM5
Other missense variant is known to change same aminoacid residue: Variant chr20-63413524-G-T is described in ClinVar as [Pathogenic]. Clinvar id is 2855247.Status of the report is criteria_provided_single_submitter, 1 stars.
PP2
Missense variant where missense usually causes diseases, KCNQ2
PP3
MetaRNN computational evidence supports a deleterious effect, 0.944
PP5
Variant 20-63413526-C-T is Pathogenic according to our data. Variant chr20-63413526-C-T is described in ClinVar as [Pathogenic]. Clinvar id is 205917.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE UniProt
KCNQ2NM_172107.4 linkuse as main transcriptc.1687G>A p.Asp563Asn missense_variant 15/17 ENST00000359125.7

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Appris UniProt
KCNQ2ENST00000359125.7 linkuse as main transcriptc.1687G>A p.Asp563Asn missense_variant 15/171 NM_172107.4 A1O43526-1

Frequencies

GnomAD3 genomes
Cov.:
33
GnomAD4 exome
Cov.:
32
GnomAD4 genome
Cov.:
33

ClinVar

Significance: Pathogenic
Submissions summary: Pathogenic:10Other:1
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

not provided Pathogenic:5
Pathogenic, criteria provided, single submitterclinical testingAiLife Diagnostics, AiLife DiagnosticsMay 01, 2020- -
Pathogenic, criteria provided, single submitterclinical testingCeGaT Center for Human Genetics TuebingenMar 01, 2020- -
Pathogenic, criteria provided, single submitterclinical testingGeneDxSep 15, 2020Published functional studies demonstrate a decrease in PIP2 apparent affinity and a reduction in channel function; reported using alternate nomenclature D535N (Ambrosino et al., 2018); The majority of missense variants in this gene are considered pathogenic (Stenson et al., 2014); Not observed in large population cohorts (Lek et al., 2016); This substitution is predicted to be within the C-terminal cytoplasmic domain; This variant is associated with the following publications: (PMID: 24107868, 23621294, 31172278, 25959266, 26007637, 27334371, 29383681, 32581083, 30669290, 32651551) -
Pathogenic, criteria provided, single submitterclinical testingRevvity Omics, RevvityFeb 22, 2022- -
Pathogenic, criteria provided, single submitterclinical testingCenter for Pediatric Genomic Medicine, Children's Mercy Hospital and ClinicsDec 27, 2016- -
Developmental and epileptic encephalopathy, 7 Pathogenic:1Other:1
not provided, no classification providedliterature onlyGeneReviews-EE (epileptic encephalopathy) -
Pathogenic, no assertion criteria providedresearchCenter of Excellence for Medical Genomics, Chulalongkorn UniversityAug 19, 2022- -
Inborn genetic diseases Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingAmbry GeneticsJun 09, 2016The p.D563N pathogenic mutation (also known as c.1687G>A), located in coding exon 15 of the KCNQ2 gene, results from a G to A substitution at nucleotide position 1687. The aspartic acid at codon 563 is replaced by asparagine, an amino acid with highly similar properties. This mutation has been detected as a de novo occurrence with confirmed paternity in three unrelated individuals with neonatal epileptic encephalopathy diagnoses before age one month (Weckhuysen S, et al. Neurology 2013;81(19):1697-703; Milh M, et al. Am. J. Med. Genet. A 2015; 167A(10):2314-8). In addition, a different alteration located at the same position, p.D563E, was detected as a de novo occurrence with confirmed paternity in an individual with early onset epileptic encephalopathy (Kato M, et al. Epilepsia 2013 Jul; 54(7):1282-7). Based on the supporting evidence, p.D563N is interpreted as a disease-causing mutation. -
Early infantile epileptic encephalopathy with suppression bursts Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingInvitaeMar 23, 2023For these reasons, this variant has been classified as Pathogenic. This variant disrupts the p.Asp563 amino acid residue in KCNQ2. Other variant(s) that disrupt this residue have been determined to be pathogenic (PMID: 23621294, 27334371). This suggests that this residue is clinically significant, and that variants that disrupt this residue are likely to be disease-causing. Experimental studies have shown that this missense change affects KCNQ2 function (PMID: 29383681). An algorithm developed to predict the effect of missense changes on protein structure and function (PolyPhen-2) suggests that this variant is likely to be disruptive. ClinVar contains an entry for this variant (Variation ID: 205917). This variant is also known as D535N. This missense change has been observed in individual(s) with benign familial neonatal seizures (PMID: 24107868, 26007637). In at least one individual the variant was observed to be de novo. This variant is not present in population databases (gnomAD no frequency). This sequence change replaces aspartic acid, which is acidic and polar, with asparagine, which is neutral and polar, at codon 563 of the KCNQ2 protein (p.Asp563Asn). -
Seizures, benign familial neonatal, 1 Pathogenic:1
Pathogenic, no assertion criteria providedresearchCenter of Excellence for Medical Genomics, Chulalongkorn UniversitySep 08, 2002- -
Seizures, benign familial neonatal, 1;C3150986:Developmental and epileptic encephalopathy, 7 Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingFulgent Genetics, Fulgent GeneticsOct 31, 2018- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
0.99
BayesDel_addAF
Pathogenic
0.21
D
BayesDel_noAF
Uncertain
0.070
CADD
Pathogenic
27
DANN
Pathogenic
1.0
Eigen
Pathogenic
0.72
Eigen_PC
Uncertain
0.61
FATHMM_MKL
Pathogenic
0.98
D
LIST_S2
Pathogenic
1.0
D;D;D;D;D;D;D;D;D;D;D
M_CAP
Pathogenic
0.96
D
MetaRNN
Pathogenic
0.94
D;D;D;D;D;D;D;D;D;D;D
MetaSVM
Pathogenic
0.90
D
MutationTaster
Benign
1.0
D;D;D;D;D;D;D;D;D;D
PrimateAI
Pathogenic
0.91
D
Sift4G
Uncertain
0.0030
D;D;D;D;D;.;D;D;D;D;D
Polyphen
1.0
D;.;.;.;.;.;D;.;D;D;.
Vest4
0.99
MutPred
0.72
.;.;.;.;.;.;Gain of MoRF binding (P = 0.0504);.;.;.;.;
MVP
0.96
MPC
1.6
ClinPred
1.0
D
GERP RS
5.0
Varity_R
0.95
gMVP
0.99

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: rs796052653; hg19: chr20-62044879; COSMIC: COSV60541595; COSMIC: COSV60541595; API