7-150947795-GC-GCC
Variant summary
Our verdict is Pathogenic. The variant received 18 ACMG points: 18P and 0B. PVS1PM2PP5_Very_Strong
The NM_000238.4(KCNH2):c.2775dupG(p.Pro926AlafsTer14) variant causes a frameshift change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.00000196 in 1,532,044 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Pathogenic (★★). Synonymous variant affecting the same amino acid position (i.e. G925G) has been classified as Likely benign. Variant results in nonsense mediated mRNA decay.
Frequency
Consequence
NM_000238.4 frameshift
Scores
Clinical Significance
Conservation
Publications
- long QT syndromeInheritance: AD Classification: DEFINITIVE Submitted by: ClinGen
- long QT syndrome 2Inheritance: AD Classification: DEFINITIVE, STRONG Submitted by: Labcorp Genetics (formerly Invitae), Ambry Genetics, G2P
- short QT syndromeInheritance: AD Classification: DEFINITIVE, SUPPORTIVE Submitted by: Orphanet, ClinGen
- short QT syndrome type 1Inheritance: AD Classification: DEFINITIVE, STRONG, MODERATE Submitted by: Labcorp Genetics (formerly Invitae), G2P, Ambry Genetics
- Brugada syndromeInheritance: AD Classification: MODERATE, NO_KNOWN Submitted by: ClinGen, Genomics England PanelApp
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ACMG classification
Our verdict: Pathogenic. The variant received 18 ACMG points.
Transcripts
RefSeq
| Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | MANE | Protein | UniProt |
|---|---|---|---|---|---|---|---|---|
| KCNH2 | NM_000238.4 | c.2775dupG | p.Pro926AlafsTer14 | frameshift_variant | Exon 12 of 15 | ENST00000262186.10 | NP_000229.1 |
Ensembl
| Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | TSL | MANE | Protein | Appris | UniProt |
|---|---|---|---|---|---|---|---|---|---|---|
| KCNH2 | ENST00000262186.10 | c.2775dupG | p.Pro926AlafsTer14 | frameshift_variant | Exon 12 of 15 | 1 | NM_000238.4 | ENSP00000262186.5 |
Frequencies
GnomAD3 genomes AF: 0.0000132 AC: 2AN: 151982Hom.: 0 Cov.: 33 show subpopulations
GnomAD2 exomes AF: 0.00000783 AC: 1AN: 127658 AF XY: 0.00 show subpopulations
GnomAD4 exome AF: 7.25e-7 AC: 1AN: 1380062Hom.: 0 Cov.: 36 AF XY: 0.00000147 AC XY: 1AN XY: 680378 show subpopulations ⚠️ The allele balance in gnomAD version 4 Exomes is significantly skewed from the expected value of 0.5.
GnomAD4 genome AF: 0.0000132 AC: 2AN: 151982Hom.: 0 Cov.: 33 AF XY: 0.0000269 AC XY: 2AN XY: 74230 show subpopulations
ClinVar
Submissions by phenotype
not provided Pathogenic:2
Frameshift variant predicted to result in protein truncation or nonsense mediated decay in a gene for which loss of function is a known mechanism of disease; Not observed at significant frequency in large population cohorts (gnomAD); This variant is associated with the following publications: (PMID: 22988594, 21215473, 21419236, 24065925, 23304551, 28363160, 10973849, 20181576, 22956155, 30369311, 26669661, 29739726, 16922724, 32383558, 34319147, 34127479, 27000522)
The KCNH2 c.2775dup; p.Pro926Alafs*14 variant (rs794728455) is reported in the literature in multiple individuals in the heterozygous state affected with Long QT syndrome (Choi 2021, Nof 2010, Westphal 2020, Zarraga 2011). This variant is reported in ClinVar (Variation ID: 200672) and is only observed on one allele in the Genome Aggregation Database, indicating it is not a common polymorphism. In vitro/In vivo functional analyses demonstrate reduced cellular currents (Nof 2010, Zarraga 2011). This variant causes a frameshift by inserting a single nucleotide, so it is predicted to result in a truncated protein or mRNA subject to nonsense-mediated decay. Based on available information, this variant is considered to be pathogenic. References: Choi SH et al. Rare Coding Variants Associated with Electrocardiographic Intervals Identify Monogenic Arrhythmia Susceptibility Genes: A Multi-Ancestry Analysis. Circ Genom Precis Med. 2021. PMID: 34319147. Nof E et al. A common single nucleotide polymorphism can exacerbate long-QT type 2 syndrome leading to sudden infant death. Circ Cardiovasc Genet. 2010. PMID: 20181576. Westphal DS. Reclassification of genetic variants in children with long QT syndrome. Mol Genet Genomic Med. 2020. PMID: 32383558. Zarraga IG et al. Nonsense-mediated mRNA decay caused by a frameshift mutation in a large kindred of type 2 long QT syndrome. Heart Rhythm. 2011. PMID: 21419236.
Long QT syndrome Pathogenic:2
This sequence change creates a premature translational stop signal (p.Pro926Alafs*14) in the KCNH2 gene. It is expected to result in an absent or disrupted protein product. Loss-of-function variants in KCNH2 are known to be pathogenic (PMID: 10973849, 19862833). The frequency data for this variant in the population databases is considered unreliable, as metrics indicate poor data quality at this position in the gnomAD database. This premature translational stop signal has been observed in individual(s) with long QT syndrome (PMID: 10973849, 20181576, 21419236). ClinVar contains an entry for this variant (Variation ID: 200672). For these reasons, this variant has been classified as Pathogenic.
This variant causes a duplication of 1 nucleotide in exon 12 of the KCNH2 gene, creating a frameshift and premature translation stop signal. This variant is expected to result in an absent or non-functional protein product. Functional studies have shown that this variant causes decreased expression of KCNH2 resulting in a reduction in channel current density in HEK293 cells (PMID: 20181576, 21419236). This variant has been reported in at least eight unrelated individuals affected with long QT syndrome (PMID: 10973849, 21419236, 20181576, 26669661, 30369311, 32383558). It has been shown that this variant segregates with disease in multiple individuals from two of these families (PMID: 20181576, 21419236). This variant has also been reported in an individual affected with sudden cardiac death (PMID: 27000522). This variant has been identified in 1/127658 chromosomes in the general population by the Genome Aggregation Database (gnomAD). Loss of KCNH2 function is a known mechanism of disease (clinicalgenome.org). Based on the available evidence, this variant is classified as Pathogenic.
Cardiovascular phenotype Pathogenic:2
The c.2775dupG pathogenic mutation, located in coding exon 12 of the KCNH2 gene, results from a duplication of G at nucleotide position 2775, causing a translational frameshift with a predicted alternate stop codon (p.P926Afs*14). This variant was identified in one or more individuals with features consistent with long QT syndrome and segregated with disease in at least one family (Nof E et al. Circ Cardiovasc Genet. 2010;3(2):199-206; Zarraga IG et al. Heart Rhythm. 2011;8(8):1200-6; Cann F et al, 2017 01;91:22-29). In assays testing KCNH2 function, this variant showed a functionally abnormal result (Nof E et al. Circ Cardiovasc Genet. 2010;3(2):199-206; Zarraga IG et al. Heart Rhythm. 2011;8(8):1200-6). This alteration is expected to result in loss of function by premature protein truncation or nonsense-mediated mRNA decay. As such, this alteration is interpreted as a disease-causing mutation.
Long QT syndrome 2 Pathogenic:1
Long QT syndrome 1/2, digenic Pathogenic:1
Cardiac arrhythmia Pathogenic:1
This variant causes a duplication of 1 nucleotide in exon 12 of the KCNH2 gene, creating a frameshift and premature translation stop signal. This variant is expected to result in an absent or non-functional protein product. Functional studies have shown that this variant causes decreased expression of KCNH2 resulting in a reduction in channel current density in HEK293 cells (PMID: 20181576, 21419236). This variant has been reported in at least eight unrelated individuals affected with long QT syndrome (PMID: 10973849, 21419236, 20181576, 26669661, 30369311, 32383558). It has been shown that this variant segregates with disease in multiple individuals from two of these families (PMID: 20181576, 21419236). This variant has also been reported in an individual affected with sudden cardiac death (PMID: 27000522). This variant has been identified in 1/127658 chromosomes in the general population by the Genome Aggregation Database (gnomAD). Loss of KCNH2 function is a known mechanism of disease (clinicalgenome.org). Based on the available evidence, this variant is classified as Pathogenic.
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at