3-38597737-C-T

Variant summary

Our verdict is Pathogenic. Variant got 17 ACMG points: 17P and 0B. PM1PM2PP2PP3_StrongPP5_Very_Strong

The NM_000335.5(SCN5A):​c.2254G>A​(p.Gly752Arg) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.00000482 in 1,451,322 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. 14/24 in silico tools predict a damaging outcome for this variant. Variant has been reported in ClinVar as Likely pathogenic (★★).

Frequency

Genomes: not found (cov: 32)
Exomes 𝑓: 0.0000048 ( 0 hom. )

Consequence

SCN5A
NM_000335.5 missense

Scores

19
1

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:4O:1

Conservation

PhyloP100: 7.82
Variant links:
Genes affected
SCN5A (HGNC:10593): (sodium voltage-gated channel alpha subunit 5) The protein encoded by this gene is an integral membrane protein and tetrodotoxin-resistant voltage-gated sodium channel subunit. This protein is found primarily in cardiac muscle and is responsible for the initial upstroke of the action potential in an electrocardiogram. Defects in this gene have been associated with long QT syndrome type 3 (LQT3), atrial fibrillation, cardiomyopathy, and Brugada syndrome 1, all autosomal dominant cardiac diseases. Alternative splicing results in several transcript variants encoding different isoforms. [provided by RefSeq, May 2022]

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ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 17 ACMG points.

PM1
In a helix (size 25) in uniprot entity SCN5A_HUMAN there are 4 pathogenic changes around while only 0 benign (100%) in NM_000335.5
PM2
Very rare variant in population databases, with high coverage;
PP2
Missense variant in the SCN5A gene, where missense mutations are typically associated with disease (based on misZ statistic). The gene has 99 curated pathogenic missense variants (we use a threshold of 10). The gene has 60 curated benign missense variants. Gene score misZ: 2.7504 (below the threshold of 3.09). Trascript score misZ: 4.8279 (above the threshold of 3.09). GenCC associations: The gene is linked to progressive familial heart block, type 1A, Brugada syndrome, familial sick sinus syndrome, short QT syndrome, paroxysmal familial ventricular fibrillation, progressive familial heart block, long QT syndrome 3, familial atrial fibrillation, catecholaminergic polymorphic ventricular tachycardia, dilated cardiomyopathy, dilated cardiomyopathy 1E, arrhythmogenic right ventricular cardiomyopathy, Brugada syndrome 1, atrial standstill, familial isolated dilated cardiomyopathy, familial long QT syndrome, sick sinus syndrome 1.
PP3
MetaRNN computational evidence supports a deleterious effect, 0.986
PP5
Variant 3-38597737-C-T is Pathogenic according to our data. Variant chr3-38597737-C-T is described in ClinVar as [Likely_pathogenic]. Clinvar id is 67723.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr3-38597737-C-T is described in Lovd as [Pathogenic].

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
SCN5ANM_001099404.2 linkc.2254G>A p.Gly752Arg missense_variant Exon 14 of 28 ENST00000413689.6 NP_001092874.1 Q14524H9KVD2
SCN5ANM_000335.5 linkc.2254G>A p.Gly752Arg missense_variant Exon 14 of 28 ENST00000423572.7 NP_000326.2 Q14524-2Q86V90

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
SCN5AENST00000413689.6 linkc.2254G>A p.Gly752Arg missense_variant Exon 14 of 28 5 NM_001099404.2 ENSP00000410257.1 H9KVD2
SCN5AENST00000423572.7 linkc.2254G>A p.Gly752Arg missense_variant Exon 14 of 28 1 NM_000335.5 ENSP00000398266.2 Q14524-2

Frequencies

GnomAD3 genomes
Cov.:
32
GnomAD3 exomes
AF:
0.00000403
AC:
1
AN:
247910
Hom.:
0
AF XY:
0.00000744
AC XY:
1
AN XY:
134372
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.00
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad SAS exome
AF:
0.0000329
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.00
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.00000482
AC:
7
AN:
1451322
Hom.:
0
Cov.:
31
AF XY:
0.00000417
AC XY:
3
AN XY:
719776
show subpopulations
Gnomad4 AFR exome
AF:
0.00
Gnomad4 AMR exome
AF:
0.00
Gnomad4 ASJ exome
AF:
0.00
Gnomad4 EAS exome
AF:
0.00
Gnomad4 SAS exome
AF:
0.00
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.00000634
Gnomad4 OTH exome
AF:
0.00
GnomAD4 genome
Cov.:
32
Alfa
AF:
0.0000712
Hom.:
0
Bravo
AF:
0.00000756

ClinVar

Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:4Other:1
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

not provided Pathogenic:2
Nov 22, 2021
GeneDx
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

Not observed at a significant frequency in large population cohorts (gnomAD); In silico analysis, which includes protein predictors and evolutionary conservation, supports a deleterious effect; Published functional studies demonstrate that G752R results in a loss of function of the sodium channel (Potet et al., 2003; Hoogendijk et al., 2010; Varga et al., 2015).; In silico analysis, which includes splice predictors and evolutionary conservation, suggests this variant may impact gene splicing. In the absence of RNA/functional studies, the actual effect of this sequence change is unknown.; This variant is associated with the following publications: (PMID: 19251209, 26283144, 18849657, 16627450, 30193851, 31729605, 12693506, 26724572, 20129283, 23874304, 25904541, 24365614, 12106943, 25650408, 20022821, 20031634, 30662450, 30919684, 32048431, 31737537, 31589614, 32880476, 33087929, 33131149) -

Jan 02, 2025
Labcorp Genetics (formerly Invitae), Labcorp
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

This sequence change replaces glycine, which is neutral and non-polar, with arginine, which is basic and polar, at codon 752 of the SCN5A protein (p.Gly752Arg). This variant is present in population databases (rs199473153, gnomAD 0.003%). This missense change has been observed in individual(s) with autosomal dominant dilated cardiomyopathy and Brugada syndrome (PMID: 12693506, 20022821, 20129283, 25904541). It has also been observed to segregate with disease in related individuals. ClinVar contains an entry for this variant (Variation ID: 67723). Invitae Evidence Modeling incorporating data from in vitro experimental studies (PMID: 32533946) did not meet the statistical confidence thresholds required to predict the impact of this variant on SCN5A function. Experimental studies have shown that this missense change affects SCN5A function (PMID: 12693506, 20022821, 26283144). 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. -

Brugada syndrome Pathogenic:1Other:1
-
Cardiovascular Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust
Significance: not provided
Review Status: no classification provided
Collection Method: literature only

This variant has been reported as associated with Brugada syndrome in the following publications (PMID:12106943;PMID:12693506;PMID:19251209;PMID:20129283). This is a literature report, and does not necessarily reflect the clinical interpretation of the Imperial College / Royal Brompton Cardiovascular Genetics laboratory. -

Apr 14, 2015
Agnes Ginges Centre for Molecular Cardiology, Centenary Institute
Significance: Likely pathogenic
Review Status: criteria provided, single submitter
Collection Method: research

The SCN5A Gly752Arg variant has been identified in several unrelated individuals with Brugada syndrome (Smits JP, et al., 2002, Meregalli PG, et al., 2009; Kapplinger JD, et al., 2010; Le Scouarnec S, et al., 2015) and was found to be absent in >1300 controls (Kapplinger, JD et al., 2010). The variant has also been reported to segregate with disease in families with Brugada syndrome (Potet F, et al., 2003; Probst V et al., 2009) with functional studies showing deleterious effects on mutant sodium channels (Potet F, et al., 2003). We identified SCN5A Gly752Arg in an Asian proband with Brugada Syndome. The proband had a cardiac arrest whilst febrile aged 2yrs and has a family history of SCD. The SCN5A Gly752Arg variant is found at a low frequency in the 1000 genomes project (MAF= 0.0004; http://www.1000genomes.org/) and is absent from the Exome Aggregation Consortium dataset (http://exac.broadinstitute.org/). Computational tools SIFT, MutationTaster, and PolyPhen-2 predict this variant to have a deleterious effect. Based on the current literature, rarity in general populations and in silico tool predictions we have evaluated this variant as "likely pathogenic". -

Cardiovascular phenotype Pathogenic:1
Sep 04, 2024
Ambry Genetics
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

The p.G752R pathogenic mutation (also known as c.2254G>A), located in coding exon 13 of the SCN5A gene, results from a G to A substitution at nucleotide position 2254. The glycine at codon 752 is replaced by arginine, an amino acid with dissimilar properties. The p.G752R variant, caused by a different nucleotide change (c.2254G>C), was shown to have strong segregation with disease in families with Brugada syndrome demonstrating varying phenotypes (Potet F et al. J Cardiovasc Electrophysiol. 2003;14(2):200-3; Probst et al. Circ Cardiovasc Genet. 2009 Dec;2(6):552-7). The c.2254G>C variant was also seen in a 3-year-old male with Brugada syndrome and atrial flutter that was induced by febrile episodes (Hassink RJ et al. Int J Cardiol. 2014;171(2):e31-4). One study demonstrated that ST-segment elevation coincided with local disappearance of initial activation in the explanted heart of a patient with this alteration (Hoogendijk MG et al. Heart Rhythm. 2010;7(2):238-48). This amino acid position is highly conserved in available vertebrate species. In addition, this alteration is predicted to be deleterious by in silico analysis. Based on the supporting evidence, this alteration is interpreted as a disease-causing mutation. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
1.0
CardioboostCm
Pathogenic
1.0
BayesDel_addAF
Pathogenic
0.50
D
BayesDel_noAF
Pathogenic
0.59
CADD
Pathogenic
34
DANN
Pathogenic
1.0
DEOGEN2
Pathogenic
0.98
.;.;.;.;.;D;.;.;.
Eigen
Pathogenic
0.82
Eigen_PC
Pathogenic
0.75
FATHMM_MKL
Pathogenic
0.99
D
LIST_S2
Pathogenic
0.99
.;D;D;D;D;D;D;.;D
M_CAP
Pathogenic
0.78
D
MetaRNN
Pathogenic
0.99
D;D;D;D;D;D;D;D;D
MetaSVM
Pathogenic
1.1
D
MutationAssessor
Pathogenic
3.9
.;H;.;.;.;H;.;.;.
PrimateAI
Pathogenic
0.88
D
PROVEAN
Pathogenic
-7.7
D;D;D;D;D;D;D;D;D
REVEL
Pathogenic
0.97
Sift
Pathogenic
0.0
D;D;D;D;D;D;D;D;D
Sift4G
Pathogenic
0.0
D;D;D;D;D;D;D;D;D
Polyphen
0.99
D;D;.;D;.;D;D;.;.
Vest4
0.99
MutPred
0.91
Loss of helix (P = 0.079);Loss of helix (P = 0.079);Loss of helix (P = 0.079);Loss of helix (P = 0.079);Loss of helix (P = 0.079);Loss of helix (P = 0.079);Loss of helix (P = 0.079);Loss of helix (P = 0.079);Loss of helix (P = 0.079);
MVP
0.97
MPC
1.2
ClinPred
1.0
D
GERP RS
4.7
Varity_R
0.98
gMVP
0.99

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.46
Details are displayed if max score is > 0.2
DS_DG_spliceai
0.46
Position offset: 4

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: rs199473153; hg19: chr3-38639228; COSMIC: COSV61125197; API