NM_001370658.1:c.185C>T

Variant names:

• chr3-15635624-C-T
• rs397507171
• NM_001370658.1:c.185C>T

Variant summary

Our verdict is Likely pathogenic. The variant received 8 ACMG points: 8P and 0B. PM1 PM2 PP2 PP3_Moderate PP5

The NM_001370658.1(BTD):​c.185C>T​(p.Ala62Val) variant causes a missense change. The variant allele was found at a frequency of 0.00000547 in 1,461,894 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars).

• Frequency:
  • Genomes: not found (cov: 32)
  • Exomes 𝑓: 0.0000055 (0 hom.)
• Consequence: BTD NM_001370658.1 missense
• Clinical Significance: Conflicting classifications of pathogenicity criteria provided, conflicting classifications P:3 U:3
• Conservation: PhyloP100: 6.89
• Publications: 1 publications found

Genes affected

BTD (HGNC:1122): (biotinidase) The protein encoded by this gene functions to recycle protein-bound biotin by cleaving biocytin (biotin-epsilon-lysine), a normal product of carboxylase degradation, resulting in regeneration of free biotin. The encoded protein has also been shown to have biotinyl transferase activity. Mutations in this gene are associated with biotinidase deficiency. Multiple transcript variants encoding different isoforms have been described. [provided by RefSeq, Aug 2013]

BTD Gene-Disease associations (from GenCC):

• biotinidase deficiency

  Inheritance: AR Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Myriad Women’s Health, ClinGen, Orphanet, Ambry Genetics, G2P, Labcorp Genetics (formerly Invitae)
• Leigh syndrome

  Inheritance: AR Classification: MODERATE Submitted by: ClinGen

ACMG classification

Our verdict: Likely_pathogenic. The variant received 8 ACMG points.

• PM1: In a hotspot region, there are 5 aminoacids with missense pathogenic changes in the window of +-8 aminoacids around while only 1 benign, 7 uncertain in NM_001370658.1
• PM2: Very rare variant in population databases, with high coverage
• PP2: Missense variant in the gene, where a lot of missense mutations are associated with disease in ClinVar. The gene has 88 curated pathogenic missense variants (we use a threshold of 10). The gene has 9 curated benign missense variants. Gene score misZ: -0.52516 (below the threshold of 3.09). Trascript score misZ: 0.15371 (below the threshold of 3.09). GenCC associations: The gene is linked to Leigh syndrome, biotinidase deficiency.
• PP3: MetaRNN computational evidence supports a deleterious effect, 0.932
• PP5: Variant 3-15635624-C-T is Pathogenic according to our data. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989. Variant chr3-15635624-C-T is described in CliVar as Conflicting_classifications_of_pathogenicity. Clinvar id is 24989.

Transcripts

RefSeq

Gene	Transcript	HGVSc	HGVSp	Effect	Exon rank	MANE	Protein	UniProt
BTD	NM_001370658.1	c.185C>T	p.Ala62Val	missense_variant	Exon 2 of 4	ENST00000643237.3	NP_001357587.1

Ensembl

Gene	Transcript	HGVSc	HGVSp	Effect	Exon rank	TSL	MANE	Protein	Appris	UniProt
BTD	ENST00000643237.3	c.185C>T	p.Ala62Val	missense_variant	Exon 2 of 4		NM_001370658.1	ENSP00000495254.2

Frequencies

GnomAD3 genomes Cov.: 32

GnomAD2 exomes AF: 0.00000796 AC: 2 AN: 251408 AF XY: 0.00000736

Gnomad AFR exome AF: 0.00

Gnomad AMR exome AF: 0.0000289

Gnomad ASJ exome AF: 0.00

Gnomad EAS exome AF: 0.00

Gnomad FIN exome AF: 0.00

Gnomad NFE exome AF: 0.00000880

Gnomad OTH exome AF: 0.00

GnomAD4 exome AF: 0.00000547 AC: 8 AN: 1461894 Hom.: 0 Cov.: 32 AF XY: 0.00000413 AC XY: 3 AN XY: 727248

African (AFR) AF: 0.00 AC: 0 AN: 33480

American (AMR) AF: 0.0000224 AC: 1 AN: 44724

Ashkenazi Jewish (ASJ) AF: 0.00 AC: 0 AN: 26136

East Asian (EAS) AF: 0.00 AC: 0 AN: 39700

South Asian (SAS) AF: 0.00 AC: 0 AN: 86258

European-Finnish (FIN) AF: 0.00 AC: 0 AN: 53420

Middle Eastern (MID) AF: 0.00 AC: 0 AN: 5768

European-Non Finnish (NFE) AF: 0.00000629 AC: 7 AN: 1112012

Other (OTH) AF: 0.00 AC: 0 AN: 60396

GnomAD4 genome Cov.: 32

ClinVar

Significance: Conflicting classifications of pathogenicity

Submissions summary: Pathogenic:3 Uncertain:3

Revision: criteria provided, conflicting classifications

Submissions by phenotype

Biotinidase deficiency Pathogenic:2 Uncertain:1

Mar 23, 2018

Counsyl

Significance: Uncertain significance

Review Status: no assertion criteria provided

Collection Method: clinical testing

This submission and the accompanying classification are no longer maintained by the submitter. For more information on current observations and classification, please contact variantquestions@myriad.com. -

Dec 21, 2024

Labcorp Genetics (formerly Invitae), Labcorp

Significance: Pathogenic

Review Status: criteria provided, single submitter

Collection Method: clinical testing

This sequence change replaces alanine, which is neutral and non-polar, with valine, which is neutral and non-polar, at codon 82 of the BTD protein (p.Ala82Val). This variant is present in population databases (rs397507171, gnomAD 0.003%). This missense change has been observed in individual(s) with biotinidase deficiency (PMID: 26810761). ClinVar contains an entry for this variant (Variation ID: 24989). Invitae Evidence Modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) indicates that this missense variant is expected to disrupt BTD protein function with a positive predictive value of 95%. This variant disrupts the p.Ala82 amino acid residue in BTD. Other variant(s) that disrupt this residue have been observed in individuals with BTD-related conditions (PMID: 29995633), which suggests that this may be a clinically significant amino acid residue. For these reasons, this variant has been classified as Pathogenic. -

Mar 15, 2024

Fulgent Genetics, Fulgent Genetics

Significance: Likely pathogenic

Review Status: criteria provided, single submitter

Collection Method: clinical testing

- -

not specified Uncertain:2

Jun 24, 2025

Women's Health and Genetics/Laboratory Corporation of America, LabCorp

Significance: Uncertain significance

Review Status: criteria provided, single submitter

Collection Method: clinical testing

Variant summary: BTD c.185C>T (p.Ala62Val) results in a non-conservative amino acid change in the encoded protein sequence. Algorithms developed to predict the effect of missense changes on protein structure and function all suggest that this variant is likely to be disruptive. The variant allele was found at a frequency of 8e-06 in 251408 control chromosomes. The available data on variant occurrences in the general population are insufficient to allow any conclusion about variant significance. c.185C>T has been reported in the literature at a compound heterozygous state along with a pathogenic missense in at-least one individual affected with Biotinidase Deficiency (example, Procter_2016). These data do not allow any conclusion about variant significance. To our knowledge, no experimental evidence demonstrating an impact on protein function has been reported. Additionally, at least two variants at the Ala62 residue have been reported as DM in HGMD (p.A62D and p.A62G), suggesting that this codon might be functionally important. However, further evidence is needed to validate the pathogenicity of those two variants. The following publication have been ascertained in the context of this evaluation (PMID: 26810761). ClinVar contains an entry for this variant (Variation ID: 24989). Based on the evidence outlined above, the variant was classified as uncertain significance. -

May 20, 2021

Quest Diagnostics Nichols Institute San Juan Capistrano

Significance: Uncertain significance

Review Status: criteria provided, single submitter

Collection Method: clinical testing

- -

not provided Pathogenic:1

Feb 01, 2020

CeGaT Center for Human Genetics Tuebingen

Significance: Pathogenic

Review Status: criteria provided, single submitter

Collection Method: clinical testing

- -

Computational scores

Source: dbNSFP v4.3

Name	Calibrated prediction	Score	Prediction
AlphaMissense	Pathogenic	0.63
BayesDel_addAF	Pathogenic	0.22	D
BayesDel_noAF	Pathogenic	0.17
CADD	Uncertain	26
DANN	Pathogenic	1.0
DEOGEN2	Pathogenic	0.87	.;.;D;.;.;.;.;T;.;.
Eigen	Pathogenic	0.76
Eigen_PC	Pathogenic	0.68
FATHMM_MKL	Uncertain	0.95	D
LIST_S2	Pathogenic	0.97	.;D;D;.;D;.;D;D;D;D
M_CAP	Pathogenic	0.44	D
MetaRNN	Pathogenic	0.93	D;D;D;D;D;D;D;D;D;D
MetaSVM	Pathogenic	1.0	D
MutationAssessor	Pathogenic	3.4	.;.;M;.;.;.;.;.;.;.
PhyloP100		6.9
PrimateAI	Uncertain	0.53	T
PROVEAN	Uncertain	-3.7	.;D;.;.;.;.;D;D;D;.
REVEL	Pathogenic	0.80
Sift	Pathogenic	0.0	.;D;.;.;.;.;D;D;D;.
Sift4G	Pathogenic	0.0	.;D;.;.;.;.;D;D;D;.
Polyphen		1.0	.;.;D;.;.;.;.;.;.;.
Vest4		0.83, 0.83, 0.84
MutPred		0.76		.;.;Gain of sheet (P = 0.0085);.;Gain of sheet (P = 0.0085);.;.;.;.;.;
MVP		0.99
MPC		0.42
ClinPred		0.99	D
GERP RS		4.7
PromoterAI		-0.044	Neutral
RBP_binding_hub_radar		0.0
RBP_regulation_power_radar		1.1
Varity_R		0.96
gMVP		0.91
Mutation Taster		=2/98	disease causing (ClinVar)

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

dbSNP: rs397507171; hg19: chr3-15677131;