Our verdict is Pathogenic. Variant got 12 ACMG points: 12P and 0B. PVS1PM2PP5_Moderate
The NM_000368.5(TSC1):c.737_737+1dupGG variant causes a splice donor, intron change involving the alteration of a conserved nucleotide. The variant was absent in control chromosomes in GnomAD project. Variant has been reported in ClinVar as Pathogenic (★).
TSC1 (HGNC:12362): (TSC complex subunit 1) This gene is a tumor suppressor gene that encodes the growth inhibitory protein hamartin. The encoded protein interacts with and stabilizes the GTPase activating protein tuberin. This hamartin-tuberin complex negatively regulates mammalian target of rapamycin complex 1 (mTORC1) signaling which is a major regulator of anabolic cell growth. This protein also functions as a co-chaperone for Hsp90 that inhibits its ATPase activity. This protein functions as a facilitator of Hsp90-mediated folding of kinase and non-kinase clients, including TSC2 and thereby preventing their ubiquitination and proteasomal degradation. Mutations in this gene have been associated with tuberous sclerosis and lymphangioleiomyomatosis. [provided by RefSeq, May 2022]
Verdict is Pathogenic. Variant got 12 ACMG points.
PVS1
Splicing +-2 bp (donor or acceptor) variant, LoF is a know mechanism of disease, No cryptic splice site detected. Exon removal results in frameshift change.
PM2
Very rare variant in population databases, with high coverage;
PP5
Variant 9-132921361-A-ACC is Pathogenic according to our data. Variant chr9-132921361-A-ACC is described in ClinVar as [Pathogenic]. Clinvar id is 207646.Status of the report is criteria_provided_single_submitter, 1 stars.
Review Status: criteria provided, single submitter
Collection Method: clinical testing
c.737_737+1dupGG in exon 8 of the TSC1 gene (NM_000368.4). Using uppercase to denote exonic nucleotides and lowercase to denote intronic nucleotides, the normal sequence with the bases that are duplicated in braces is: CGAA{Gg}tata. The c.737_737+1dupGG splice site mutation in the TSC1 gene duplicates the last base of exon 8 and the first base of intron 8. This mutation destroys the canonical splice donor site in intron 8 and is predicted to cause abnormal gene splicing, either leading to an abnormal message that is subject to nonsense-mediated mRNA decay or to an abnormal protein product if the message is used for protein translation. Although this mutation has not been previously reported to our knowledge, its presence is consistent with a diagnosis of tuberous sclerosis. The variant is found in EPILEPSY panel(s). -