NM_000444.6:c.1A>T

Variant names:

• chrX-22033006-A-T
• NM_000444.6:c.1A>T

Variant summary

Our verdict is Pathogenic. The variant received 12 ACMG points: 12P and 0B. PVS1 PM2 PP5_Moderate

The NM_000444.6(PHEX):​c.1A>T​(p.Met1?) variant causes a initiator codon change. 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 (★). Synonymous variant affecting the same amino acid position has been classified as Pathogenic.

• Frequency: Genomes: not found (cov: 22)
• Consequence: PHEX NM_000444.6 initiator_codon
• Clinical Significance: Pathogenic criteria provided, single submitter P:1
• Conservation: PhyloP100: 5.75
• Publications: 0 publications found

Genes affected

PHEX (HGNC:8918): (phosphate regulating endopeptidase X-linked) The protein encoded by this gene is a transmembrane endopeptidase that belongs to the type II integral membrane zinc-dependent endopeptidase family. The protein is thought to be involved in bone and dentin mineralization and renal phosphate reabsorption. Mutations in this gene cause X-linked hypophosphatemic rickets. Alternative splicing results in multiple transcript variants. [provided by RefSeq, Sep 2013]

PHEX Gene-Disease associations (from GenCC):

• X-linked dominant hypophosphatemic rickets

  Inheritance: XL Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Labcorp Genetics (formerly Invitae), Illumina, Orphanet, ClinGen

ACMG classification

Our verdict: Pathogenic. The variant received 12 ACMG points.

• PVS1: Start lost variant, next in-frame start position is after 69 pathogenic variants. Next in-frame start position is after 98 codons. Genomic position: 22047154. Lost 0.130 part of the original CDS.
• PM2: Very rare variant in population databases, with high coverage
• PP5: Variant X-22033006-A-T is Pathogenic according to our data. Variant chrX-22033006-A-T is described in ClinVar as Pathogenic. ClinVar VariationId is 2012752.Status of the report is criteria_provided_single_submitter, 1 stars.

Variant Effect in Transcripts

ACMG analysis was done for transcript: NM_000444.6. You can select a different transcript below to see updated ACMG assignments.

RefSeq Transcripts

Sel.	Gene	Transcript	Tags	HGVSc	HGVSp	Effect	Exon Rank	Protein	UniProt
	PHEX	NM_000444.6	MANE Select	c.1A>T	p.Met1?	initiator_codon	Exon 1 of 22	NP_000435.3
	PHEX	NM_001282754.2		c.1A>T	p.Met1?	initiator_codon	Exon 1 of 21	NP_001269683.1

Ensembl Transcripts

Sel.	Gene	Transcript	Tags	HGVSc	HGVSp	Effect	Exon Rank	Protein	UniProt
	PHEX	ENST00000379374.5	TSL:1 MANE Select	c.1A>T	p.Met1?	initiator_codon	Exon 1 of 22	ENSP00000368682.4	P78562
	PHEX	ENST00000684143.1		c.1A>T	p.Met1?	initiator_codon	Exon 1 of 11	ENSP00000508264.1	A0A804HLA0
	PHEX	ENST00000475778.2	TSL:5	n.427A>T		non_coding_transcript_exon	Exon 1 of 9

Frequencies

GnomAD3 genomes Cov.: 22

GnomAD4 exome Cov.: 28

GnomAD4 genome Cov.: 22

ClinVar

ClinVar submissions as Germline

Significance: Pathogenic

Revision: criteria provided, single submitter

Pathogenic	VUS	Benign	Condition
1	-	-	not provided (1)

Computational scores

Source: dbNSFP v4.9

Name	Calibrated prediction	Score	Prediction
BayesDel_addAF	Pathogenic	0.45	D
BayesDel_noAF	Pathogenic	0.41
CADD	Benign	19
DANN	Benign	0.96
DEOGEN2	Benign	0.24	T
FATHMM_MKL	Uncertain	0.96	D
LIST_S2	Uncertain	0.90	D
M_CAP	Pathogenic	0.79	D
MetaRNN	Pathogenic	0.86	D
MetaSVM	Uncertain	-0.062	T
PhyloP100		5.7
PROVEAN	Benign	-0.26	N
REVEL	Uncertain	0.50
Sift	Benign	0.19	T
Sift4G	Pathogenic	0.0	D
Polyphen		0.17	B
Vest4		0.85
MutPred		0.61		Gain of stability (P = 0.2886)
MVP		0.98
ClinPred		0.97	D
GERP RS		5.3
PromoterAI		0.0071	Neutral
Varity_R		0.36
gMVP		0.81
Mutation Taster		=6/194	disease causing

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

Other links and lift over

hg19: chrX-22051124;