22-42619922-C-T

Variant summary

Our verdict is Pathogenic. Variant got 12 ACMG points: 12P and 0B. PM1PM2PP5_Very_Strong

The NM_000398.7(CYB5R3):​c.757G>A​(p.Val253Met) variant causes a missense change. The variant allele was found at a frequency of 0.0000629 in 1,605,364 control chromosomes in the GnomAD database, including 1 homozygotes. Variant has been reported in ClinVar as Likely pathogenic (★★).

Frequency

Genomes: 𝑓 0.000059 ( 0 hom., cov: 33)
Exomes 𝑓: 0.000063 ( 1 hom. )

Consequence

CYB5R3
NM_000398.7 missense

Scores

8
10
1

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:10

Conservation

PhyloP100: 4.50
Variant links:
Genes affected
CYB5R3 (HGNC:2873): (cytochrome b5 reductase 3) This gene encodes cytochrome b5 reductase, which includes a membrane-bound form in somatic cells (anchored in the endoplasmic reticulum, mitochondrial and other membranes) and a soluble form in erythrocytes. The membrane-bound form exists mainly on the cytoplasmic side of the endoplasmic reticulum and functions in desaturation and elongation of fatty acids, in cholesterol biosynthesis, and in drug metabolism. The erythrocyte form is located in a soluble fraction of circulating erythrocytes and is involved in methemoglobin reduction. The membrane-bound form has both membrane-binding and catalytic domains, while the soluble form has only the catalytic domain. Alternate splicing results in multiple transcript variants. Mutations in this gene cause methemoglobinemias. [provided by RefSeq, Jan 2010]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 12 ACMG points.

PM1
In a chain NADH-cytochrome b5 reductase 3 (size 299) in uniprot entity NB5R3_HUMAN there are 51 pathogenic changes around while only 3 benign (94%) in NM_000398.7
PM2
Very rare variant in population databases, with high coverage;
PP5
Variant 22-42619922-C-T is Pathogenic according to our data. Variant chr22-42619922-C-T is described in ClinVar as [Likely_pathogenic]. Clinvar id is 505719.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr22-42619922-C-T is described in Lovd as [Pathogenic].

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
CYB5R3NM_000398.7 linkc.757G>A p.Val253Met missense_variant Exon 9 of 9 ENST00000352397.10 NP_000389.1 P00387-1

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
CYB5R3ENST00000352397.10 linkc.757G>A p.Val253Met missense_variant Exon 9 of 9 1 NM_000398.7 ENSP00000338461.6 P00387-1
ENSG00000289517ENST00000617178.5 linkn.292G>A non_coding_transcript_exon_variant Exon 4 of 14 1 ENSP00000482500.2 A0A087WZB1

Frequencies

GnomAD3 genomes
AF:
0.0000591
AC:
9
AN:
152190
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:
0.000132
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.000103
AC:
24
AN:
232778
Hom.:
0
AF XY:
0.0000873
AC XY:
11
AN XY:
125968
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.000121
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad SAS exome
AF:
0.0000351
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.000182
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000633
AC:
92
AN:
1453174
Hom.:
1
Cov.:
32
AF XY:
0.0000776
AC XY:
56
AN XY:
722066
show subpopulations
Gnomad4 AFR exome
AF:
0.00
Gnomad4 AMR exome
AF:
0.000137
Gnomad4 ASJ exome
AF:
0.00
Gnomad4 EAS exome
AF:
0.00
Gnomad4 SAS exome
AF:
0.0000236
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.0000713
Gnomad4 OTH exome
AF:
0.0000500
GnomAD4 genome
AF:
0.0000591
AC:
9
AN:
152190
Hom.:
0
Cov.:
33
AF XY:
0.0000404
AC XY:
3
AN XY:
74340
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:
0.000132
Gnomad4 OTH
AF:
0.00
Alfa
AF:
0.000150
Hom.:
0
Bravo
AF:
0.0000718
ESP6500AA
AF:
0.00
AC:
0
ESP6500EA
AF:
0.000233
AC:
2
ExAC
AF:
0.0000990
AC:
12

ClinVar

Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:10
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Deficiency of cytochrome-b5 reductase Pathogenic:4
May 17, 2024
Women's Health and Genetics/Laboratory Corporation of America, LabCorp
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

Variant summary: CYB5R3 c.757G>A (p.Val253Met) results in a conservative amino acid change located in the Oxidoreductase NAD-binding domain of the encoded protein sequence. Three of five in-silico tools predict a damaging effect of the variant on protein function. The variant allele was found at a frequency of 0.0001 in 232778 control chromosomes. c.757G>A has been reported in the literature in multiple individuals affected with Deficiency Of Cytochrome-B5 Reductase. These data indicate that the variant is very likely to be associated with disease. Two patients who were homozygotes for the c.757G>A mutation showed almost no metHb reductase activity. ClinVar contains an entry for this variant (Variation ID: 505719). Based on the evidence outlined above, the variant was classified as pathogenic. -

-
Institute of Human Genetics, University Hospital of Duesseldorf
Significance: Likely pathogenic
Review Status: criteria provided, single submitter
Collection Method: not provided

- -

Feb 25, 2023
Revvity Omics, Revvity
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Jul 09, 2021
Fulgent Genetics, Fulgent Genetics
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

not provided Pathogenic:4
Oct 16, 2024
Labcorp Genetics (formerly Invitae), Labcorp
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

This sequence change replaces valine, which is neutral and non-polar, with methionine, which is neutral and non-polar, at codon 253 of the CYB5R3 protein (p.Val253Met). This variant is present in population databases (rs144071404, gnomAD 0.01%). This missense change has been observed in individuals with methemoglobinemia (PMID: 11159544, 11295830, 12756024, 16310381, 21349748). It has also been observed to segregate with disease in related individuals. This variant is also known as V252M. ClinVar contains an entry for this variant (Variation ID: 505719). Invitae Evidence Modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) has been performed for this missense variant. However, the output from this modeling did not meet the statistical confidence thresholds required to predict the impact of this variant on CYB5R3 protein function. Experimental studies have shown that this missense change affects CYB5R3 function (PMID: 16310381). For these reasons, this variant has been classified as Pathogenic. -

Jun 01, 2024
CeGaT Center for Human Genetics Tuebingen
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

CYB5R3: PM3:Strong, PP1:Strong, PM2, PS3:Supporting -

Mar 30, 2022
GeneDx
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

Published functional studies demonstrate a damaging effect: decreased catalytic efficiency and reduced protein stability (PMID: 16310381); In silico analysis supports that this missense variant has a deleterious effect on protein structure/function; This variant is associated with the following publications: (PMID: 11159544, 21349748, 34426522, 30609409, 11295830, 16310381, 12756024, 24266649) -

Mar 18, 2021
ARUP Laboratories, Molecular Genetics and Genomics, ARUP Laboratories
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Hereditary methemoglobinemia Pathogenic:1
Mar 30, 2020
Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

proposed classification - variant undergoing re-assessment, contact laboratory -

Central core myopathy Pathogenic:1
Dec 18, 2024
Genomic Medicine Center of Excellence, King Faisal Specialist Hospital and Research Centre
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
0.78
BayesDel_addAF
Pathogenic
0.20
D
BayesDel_noAF
Pathogenic
0.27
CADD
Pathogenic
27
DANN
Uncertain
1.0
DEOGEN2
Uncertain
0.58
.;D;.;.;.
Eigen
Pathogenic
0.73
Eigen_PC
Pathogenic
0.67
FATHMM_MKL
Uncertain
0.82
D
LIST_S2
Uncertain
0.87
D;D;.;.;D
M_CAP
Uncertain
0.26
D
MetaRNN
Uncertain
0.64
D;D;D;D;D
MetaSVM
Pathogenic
0.94
D
MutationAssessor
Pathogenic
3.1
.;M;.;.;.
PrimateAI
Uncertain
0.68
T
PROVEAN
Uncertain
-2.6
D;D;D;D;D
REVEL
Pathogenic
0.85
Sift
Uncertain
0.017
D;D;D;D;D
Sift4G
Uncertain
0.058
T;T;T;T;T
Polyphen
0.99
.;D;.;.;.
Vest4
0.53
MVP
0.99
MPC
0.22
ClinPred
0.72
D
GERP RS
4.6
Varity_R
0.81
gMVP
0.65

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: rs144071404; hg19: chr22-43015928; API