6-32040952-C-T

Variant summary

Our verdict is Likely benign. Variant got -4 ACMG points: 0P and 4B. BP4_Strong

The NM_000500.9(CYP21A2):​c.1306C>T​(p.Arg436Cys) variant causes a missense change involving the alteration of a non-conserved nucleotide. In-silico tool predicts a benign outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars).

Frequency

Genomes: 𝑓 0.00089 ( 0 hom., cov: 33)
Exomes 𝑓: 0.00084 ( 0 hom. )
Failed GnomAD Quality Control

Consequence

CYP21A2
NM_000500.9 missense

Scores

4
6
4

Clinical Significance

Conflicting classifications of pathogenicity criteria provided, conflicting classifications U:3B:1

Conservation

PhyloP100: 0.448
Variant links:
Genes affected
CYP21A2 (HGNC:2600): (cytochrome P450 family 21 subfamily A member 2) This gene encodes a member of the cytochrome P450 superfamily of enzymes. The cytochrome P450 proteins are monooxygenases which catalyze many reactions involved in drug metabolism and synthesis of cholesterol, steroids and other lipids. This protein localizes to the endoplasmic reticulum and hydroxylates steroids at the 21 position. Its activity is required for the synthesis of steroid hormones including cortisol and aldosterone. Mutations in this gene cause congenital adrenal hyperplasia. A related pseudogene is located near this gene; gene conversion events involving the functional gene and the pseudogene are thought to account for many cases of steroid 21-hydroxylase deficiency. Two transcript variants encoding different isoforms have been found for this gene. [provided by RefSeq, Jul 2008]
TNXB (HGNC:11976): (tenascin XB) This gene encodes a member of the tenascin family of extracellular matrix glycoproteins. The tenascins have anti-adhesive effects, as opposed to fibronectin which is adhesive. This protein is thought to function in matrix maturation during wound healing, and its deficiency has been associated with the connective tissue disorder Ehlers-Danlos syndrome. This gene localizes to the major histocompatibility complex (MHC) class III region on chromosome 6. It is one of four genes in this cluster which have been duplicated. The duplicated copy of this gene is incomplete and is a pseudogene which is transcribed but does not encode a protein. The structure of this gene is unusual in that it overlaps the CREBL1 and CYP21A2 genes at its 5' and 3' ends, respectively. Multiple transcript variants encoding different isoforms have been found for this gene. [provided by RefSeq, Jul 2008]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Likely_benign. Variant got -4 ACMG points.

BP4
Computational evidence support a benign effect (MetaRNN=0.015557289).

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
CYP21A2NM_000500.9 linkc.1306C>T p.Arg436Cys missense_variant Exon 10 of 10 ENST00000644719.2 NP_000491.4 P08686Q16874Q08AG9
TNXBNM_001365276.2 linkc.*397G>A downstream_gene_variant ENST00000644971.2 NP_001352205.1

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
CYP21A2ENST00000644719.2 linkc.1306C>T p.Arg436Cys missense_variant Exon 10 of 10 NM_000500.9 ENSP00000496625.1 Q16874
TNXBENST00000644971.2 linkc.*397G>A downstream_gene_variant NM_001365276.2 ENSP00000496448.1 P22105-3

Frequencies

GnomAD3 genomes
AF:
0.000889
AC:
134
AN:
150780
Hom.:
0
Cov.:
33
show subpopulations
Gnomad AFR
AF:
0.000218
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00125
Gnomad ASJ
AF:
0.00
Gnomad EAS
AF:
0.0196
Gnomad SAS
AF:
0.00
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.000104
Gnomad OTH
AF:
0.00145
GnomAD3 exomes
AF:
0.00214
AC:
287
AN:
134056
Hom.:
0
AF XY:
0.00187
AC XY:
136
AN XY:
72886
show subpopulations
Gnomad AFR exome
AF:
0.000452
Gnomad AMR exome
AF:
0.0000817
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.0259
Gnomad SAS exome
AF:
0.000133
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.000211
Gnomad OTH exome
AF:
0.000489
GnomAD4 exome
Data not reliable, filtered out with message: AS_VQSR
AF:
0.000839
AC:
868
AN:
1034512
Hom.:
0
Cov.:
15
AF XY:
0.000789
AC XY:
414
AN XY:
524402
show subpopulations
Gnomad4 AFR exome
AF:
0.000110
Gnomad4 AMR exome
AF:
0.0000567
Gnomad4 ASJ exome
AF:
0.00
Gnomad4 EAS exome
AF:
0.0193
Gnomad4 SAS exome
AF:
0.000148
Gnomad4 FIN exome
AF:
0.0000259
Gnomad4 NFE exome
AF:
0.000162
Gnomad4 OTH exome
AF:
0.00165
GnomAD4 genome
Data not reliable, filtered out with message: AS_VQSR
AF:
0.000888
AC:
134
AN:
150896
Hom.:
0
Cov.:
33
AF XY:
0.000733
AC XY:
54
AN XY:
73630
show subpopulations
Gnomad4 AFR
AF:
0.000217
Gnomad4 AMR
AF:
0.00125
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.0194
Gnomad4 SAS
AF:
0.00
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.000104
Gnomad4 OTH
AF:
0.00191
Alfa
AF:
0.000528
Hom.:
0
ExAC
AF:
0.000313
AC:
15

ClinVar

Significance: Conflicting classifications of pathogenicity
Submissions summary: Uncertain:3Benign:1
Revision: criteria provided, conflicting classifications
LINK: link

Submissions by phenotype

Classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency Uncertain:2
May 28, 2019
Mendelics
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Mar 16, 2022
Fulgent Genetics, Fulgent Genetics
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

not provided Uncertain:1Benign:1
Feb 14, 2017
Eurofins Ntd Llc (ga)
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Dec 01, 2023
CeGaT Center for Human Genetics Tuebingen
Significance: Likely benign
Review Status: criteria provided, single submitter
Collection Method: clinical testing

CYP21A2: PP2, PP3, BS1 -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
BayesDel_addAF
Benign
-0.12
T
BayesDel_noAF
Uncertain
0.070
CADD
Uncertain
24
DANN
Pathogenic
1.0
Eigen
Uncertain
0.54
Eigen_PC
Uncertain
0.39
FATHMM_MKL
Benign
0.28
N
MetaRNN
Benign
0.016
T;T;T;T
MetaSVM
Uncertain
0.21
D
PrimateAI
Uncertain
0.76
T
PROVEAN
Pathogenic
-5.5
D;.;D;.
REVEL
Uncertain
0.61
Sift
Pathogenic
0.0
D;.;D;.
Sift4G
Pathogenic
0.0
D;.;D;.
Polyphen
1.0
D;D;.;D
Vest4
0.77
MutPred
0.92
Loss of methylation at R436 (P = 0.0139);Loss of methylation at R436 (P = 0.0139);.;Loss of methylation at R436 (P = 0.0139);
MVP
0.93
MPC
3.5
ClinPred
0.16
T
GERP RS
4.5
gMVP
0.68

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: rs767333157; hg19: chr6-32008729; COSMIC: COSV64478243; COSMIC: COSV64478243; API