Our verdict is Likely pathogenic. Variant got 6 ACMG points: 6P and 0B. PM2PP3_Strong
The NM_001177306.2(PAM):c.851T>G(p.Leu284Arg) 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. Variant has been reported in ClinVar as Uncertain significance (★).
PAM (HGNC:8596): (peptidylglycine alpha-amidating monooxygenase) This gene encodes a multifunctional protein. The encoded preproprotein is proteolytically processed to generate the mature enzyme. This enzyme includes two domains with distinct catalytic activities, a peptidylglycine alpha-hydroxylating monooxygenase (PHM) domain and a peptidyl-alpha-hydroxyglycine alpha-amidating lyase (PAL) domain. These catalytic domains work sequentially to catalyze the conversion of neuroendocrine peptides to active alpha-amidated products. Alternative splicing results in multiple transcript variants, at least one of which encodes an isoform that is proteolytically processed. [provided by RefSeq, Jan 2016]
Review Status: criteria provided, single submitter
Collection Method: clinical testing
The c.851T>G (p.L284R) alteration is located in exon 11 (coding exon 11) of the PAM gene. This alteration results from a T to G substitution at nucleotide position 851, causing the leucine (L) at amino acid position 284 to be replaced by an arginine (R). Based on insufficient or conflicting evidence, the clinical significance of this alteration remains unclear. -
Gain of methylation at L284 (P = 0.0359);Gain of methylation at L284 (P = 0.0359);Gain of methylation at L284 (P = 0.0359);Gain of methylation at L284 (P = 0.0359);Gain of methylation at L284 (P = 0.0359);