7-150951712-C-T

Variant summary

Our verdict is Pathogenic. Variant got 18 ACMG points: 18P and 0B. PM1PM2PM5PP3_StrongPP5_Very_Strong

The NM_000238.4(KCNH2):​c.1681G>A​(p.Ala561Thr) 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 Pathogenic (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. A561P) has been classified as Pathogenic.

Frequency

Genomes: not found (cov: 34)
Exomes 𝑓: 0.0 ( 0 hom. )
Failed GnomAD Quality Control

Consequence

KCNH2
NM_000238.4 missense

Scores

12
6
1

Clinical Significance

Pathogenic criteria provided, multiple submitters, no conflicts P:3O:1

Conservation

PhyloP100: 7.72
Variant links:
Genes affected
KCNH2 (HGNC:6251): (potassium voltage-gated channel subfamily H member 2) This gene encodes a component of a voltage-activated potassium channel found in cardiac muscle, nerve cells, and microglia. Four copies of this protein interact with one copy of the KCNE2 protein to form a functional potassium channel. Mutations in this gene can cause long QT syndrome type 2 (LQT2). Transcript variants encoding distinct isoforms have been identified. [provided by RefSeq, May 2022]

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ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 18 ACMG points.

PM1
In a transmembrane_region Helical; Name=Segment S5 (size 20) in uniprot entity KCNH2_HUMAN there are 14 pathogenic changes around while only 0 benign (100%) in NM_000238.4
PM2
Very rare variant in population databases, with high coverage;
PM5
Other missense variant is known to change same aminoacid residue: Variant chr7-150951712-C-G is described in Lovd as [Pathogenic].
PP3
MetaRNN computational evidence supports a deleterious effect, 0.99
PP5
Variant 7-150951712-C-T is Pathogenic according to our data. Variant chr7-150951712-C-T is described in ClinVar as [Pathogenic]. Clinvar id is 67229.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-150951712-C-T is described in Lovd as [Pathogenic].

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE Protein UniProt
KCNH2NM_000238.4 linkuse as main transcriptc.1681G>A p.Ala561Thr missense_variant 7/15 ENST00000262186.10 NP_000229.1

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Protein Appris UniProt
KCNH2ENST00000262186.10 linkuse as main transcriptc.1681G>A p.Ala561Thr missense_variant 7/151 NM_000238.4 ENSP00000262186 P1Q12809-1

Frequencies

GnomAD3 genomes
Cov.:
34
GnomAD4 exome
Data not reliable, filtered out with message: AC0
AF:
0.00
AC:
0
AN:
1461720
Hom.:
0
Cov.:
36
AF XY:
0.00
AC XY:
0
AN XY:
727136
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:
0.00
Gnomad4 OTH exome
AF:
0.00
GnomAD4 genome
Cov.:
34

ClinVar

Significance: Pathogenic
Submissions summary: Pathogenic:3Other:1
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

not provided Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingGeneDxApr 22, 2024This variant has also been reported in the heterozgyous and homozygous state in individuals with sudden cardiac death (PMID: 15120823); Published functional studies demonstrate that the p.(A561T) mutant channel expressed in human embryonic kidney cells failed to generate HERG current and causes defective trafficking of the KCNH2 protein to the plasma membrane (PMID: 23303164, 15120823); 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: 28883014, 16432067, 26669661, 27761161, 18441445, 23470493, 8877771, 16379539, 28855170, 10973849, 20197117, 15828882, 10220144, 11222472, 11854117, 15280442, 19716085, 16253912, 27251404, 18808722, 21367833, 32383558, 32600061, 34546463, 31557540, 23303164, 15840476, 15120823) -
Long QT syndrome Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingLabcorp Genetics (formerly Invitae), LabcorpJul 19, 2022Algorithms developed to predict the effect of missense changes on protein structure and function are either unavailable or do not agree on the potential impact of this missense change (SIFT: "Deleterious"; PolyPhen-2: "Probably Damaging"; Align-GVGD: "Class C0"). For these reasons, this variant has been classified as Pathogenic. This variant disrupts the p.Ala561 amino acid residue in KCNH2. Other variant(s) that disrupt this residue have been determined to be pathogenic (PMID: 7889573, 10753933, 12354768, 16432067, 18593567, 22949429, 24606995, 24623279). This suggests that this residue is clinically significant, and that variants that disrupt this residue are likely to be disease-causing. Experimental studies have shown that this missense change affects KCNH2 function (PMID: 16432067, 23303164, 23470493). ClinVar contains an entry for this variant (Variation ID: 67229). This missense change has been observed in individuals with clinical features of long QT syndrome and congestive heart failure (PMID: 8877771, 10973849, 28855170). It has also been observed to segregate with disease in related individuals. This variant is not present in population databases (gnomAD no frequency). This sequence change replaces alanine, which is neutral and non-polar, with threonine, which is neutral and polar, at codon 561 of the KCNH2 protein (p.Ala561Thr). -
Cardiovascular phenotype Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingAmbry GeneticsJul 19, 2019The p.A561T pathogenic mutation (also known as c.1681G>A), located in coding exon 7 of the KCNH2 gene, results from a G to A substitution at nucleotide position 1681. The alanine at codon 561 is replaced by threonine, an amino acid with similar properties, and is located in the S5 transmembrane domain. This mutation has been reported in numerous unrelated individuals with long-QT syndrome (LQTS) and was shown to segregate with disease in a family (Dausse E et al. J Mol Cell Cardiol. 1996;28(8):1609-15; Splawski I et al. Circulation. 2000;102(10):1178-85; Kapplinger JD et al. Heart Rhythm. 2009;6(9):1297-303; Matsa E et al. Eur Heart J. 2011;32(8):952-62). Functional assays have demonstrated that the mutation has a dominant negative effect on protein localization and function (Bellocq C et al. Mol Pharmacol. 2004;66(5):1093-102; Chugh SS et al. J Am Coll Cardiol. 2004;43(9):1625-9; Anderson CL et al. Circulation. 2006;113(3):365-73; Mehta A et al. Cardiovasc Res. 2014; 102(3):497-506). In addition, allele-specific knockdown of the mutant allele was able to rescue cardiomyocytes derived from a LQTS patient who was heterozygous for the p.A561T mutation (Matsa E et al. Eur Heart J. 2014;35(16):1078-87). Furthermore, other alterations in the same codon, p.A561P and p.A561V, have also been detected in patients with LQTS (Bellocq C et al. Mol. Pharmacol. 2004 Nov; 66(5):1093-102; Curran ME et al. Cell 1995 Mar; 80(5):795-803). Based on the supporting evidence, this alteration is interpreted as a disease-causing mutation. -
Congenital long QT syndrome Other:1
not provided, no classification providedliterature onlyCardiovascular Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust-This variant has been reported as associated with Long QT syndrome in the following publications (PMID:8877771;PMID:10973849;PMID:11222472;PMID:11854117;PMID:15120823;PMID:15840476;PMID:16379539;PMID:16432067;PMID:18441445;PMID:19716085). This is a literature report, and does not necessarily reflect the clinical interpretation of the Imperial College / Royal Brompton Cardiovascular Genetics laboratory. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
0.99
BayesDel_addAF
Pathogenic
0.55
D
BayesDel_noAF
Pathogenic
0.55
CADD
Pathogenic
29
DANN
Uncertain
1.0
DEOGEN2
Pathogenic
0.97
.;D;D
Eigen
Uncertain
0.61
Eigen_PC
Uncertain
0.54
FATHMM_MKL
Pathogenic
0.98
D
LIST_S2
Pathogenic
0.99
D;D;D
M_CAP
Pathogenic
0.92
D
MetaRNN
Pathogenic
0.99
D;D;D
MetaSVM
Pathogenic
1.1
D
MutationAssessor
Uncertain
2.6
.;M;.
MutationTaster
Benign
1.0
D;D;D;D
PrimateAI
Pathogenic
0.87
D
PROVEAN
Uncertain
-3.9
D;D;.
REVEL
Pathogenic
0.96
Sift
Pathogenic
0.0
D;D;.
Sift4G
Uncertain
0.0060
D;D;D
Polyphen
0.99
D;D;.
Vest4
0.92
MutPred
0.91
.;Loss of stability (P = 0.1197);.;
MVP
1.0
MPC
2.1
ClinPred
0.99
D
GERP RS
4.4
RBP_binding_hub_radar
0.0
RBP_regulation_power_radar
1.1
Varity_R
0.84
gMVP
0.96

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.010
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: rs199472921; hg19: chr7-150648800; COSMIC: COSV51139156; API