NM_002334.4:c.257G>A

Variant summary

Our verdict is Benign. The variant received -7 ACMG points: 0P and 7B. BP4_ModerateBP6BS1

The NM_002334.4(LRP4):​c.257G>A​(p.Arg86His) variant causes a missense change. The variant allele was found at a frequency of 0.000116 in 1,613,996 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a benign outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. R86P) has been classified as Uncertain significance.

Frequency

Genomes: 𝑓 0.00070 ( 0 hom., cov: 32)
Exomes 𝑓: 0.000055 ( 0 hom. )

Consequence

LRP4
NM_002334.4 missense

Scores

7
3
8

Clinical Significance

Conflicting classifications of pathogenicity criteria provided, conflicting classifications U:2B:2

Conservation

PhyloP100: 4.97

Publications

3 publications found
Variant links:
Genes affected
LRP4 (HGNC:6696): (LDL receptor related protein 4) This gene encodes a member of the low-density lipoprotein receptor-related protein family. The encoded protein may be a regulator of Wnt signaling. Mutations in this gene are associated with Cenani-Lenz syndrome. [provided by RefSeq, May 2010]
LRP4 Gene-Disease associations (from GenCC):
  • Cenani-Lenz syndactyly syndrome
    Inheritance: AR Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Orphanet, Ambry Genetics, ClinGen, Labcorp Genetics (formerly Invitae), G2P
  • congenital myasthenic syndrome 17
    Inheritance: AR Classification: STRONG, LIMITED Submitted by: ClinGen, PanelApp Australia, Genomics England PanelApp, Labcorp Genetics (formerly Invitae)
  • postsynaptic congenital myasthenic syndrome
    Inheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet
  • sclerosteosis
    Inheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet
  • sclerosteosis 2
    Inheritance: SD Classification: LIMITED Submitted by: Ambry Genetics

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Benign. The variant received -7 ACMG points.

BP4
Computational evidence support a benign effect (MetaRNN=0.08805272).
BP6
Variant 11-46900321-C-T is Benign according to our data. Variant chr11-46900321-C-T is described in ClinVar as Conflicting_classifications_of_pathogenicity. ClinVar VariationId is 535796.
BS1
Variant frequency is greater than expected in population afr. GnomAd4 allele frequency = 0.000696 (106/152194) while in subpopulation AFR AF = 0.00236 (98/41446). AF 95% confidence interval is 0.00198. There are 0 homozygotes in GnomAd4. There are 53 alleles in the male GnomAd4 subpopulation. Median coverage is 32. This position passed quality control check.

Variant Effect in Transcripts

ACMG analysis was done for transcript: NM_002334.4. You can select a different transcript below to see updated ACMG assignments.

RefSeq Transcripts

Selected
GeneTranscriptTagsHGVScHGVSpEffectExon RankProteinUniProt
LRP4
NM_002334.4
MANE Select
c.257G>Ap.Arg86His
missense
Exon 3 of 38NP_002325.2

Ensembl Transcripts

Selected
GeneTranscriptTagsHGVScHGVSpEffectExon RankProteinUniProt
LRP4
ENST00000378623.6
TSL:1 MANE Select
c.257G>Ap.Arg86His
missense
Exon 3 of 38ENSP00000367888.1
LRP4
ENST00000534404.1
TSL:5
c.110G>Ap.Arg37His
missense
Exon 2 of 4ENSP00000434763.1

Frequencies

GnomAD3 genomes
AF:
0.000696
AC:
106
AN:
152194
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.00236
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.000196
Gnomad ASJ
AF:
0.00
Gnomad EAS
AF:
0.00
Gnomad SAS
AF:
0.000207
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.00
Gnomad OTH
AF:
0.00192
GnomAD2 exomes
AF:
0.000155
AC:
39
AN:
251468
AF XY:
0.0000957
show subpopulations
Gnomad AFR exome
AF:
0.00191
Gnomad AMR exome
AF:
0.000231
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.00
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000554
AC:
81
AN:
1461802
Hom.:
0
Cov.:
31
AF XY:
0.0000426
AC XY:
31
AN XY:
727206
show subpopulations
African (AFR)
AF:
0.00179
AC:
60
AN:
33480
American (AMR)
AF:
0.000224
AC:
10
AN:
44724
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
26134
East Asian (EAS)
AF:
0.00
AC:
0
AN:
39700
South Asian (SAS)
AF:
0.0000927
AC:
8
AN:
86258
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
53384
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
5768
European-Non Finnish (NFE)
AF:
8.99e-7
AC:
1
AN:
1111966
Other (OTH)
AF:
0.0000331
AC:
2
AN:
60388
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.455
Heterozygous variant carriers
0
6
12
17
23
29
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome Het
Variant carriers
0
2
4
6
8
10
<30
30-35
35-40
40-45
45-50
50-55
55-60
60-65
65-70
70-75
75-80
>80
Age
GnomAD4 genome
AF:
0.000696
AC:
106
AN:
152194
Hom.:
0
Cov.:
32
AF XY:
0.000713
AC XY:
53
AN XY:
74346
show subpopulations
African (AFR)
AF:
0.00236
AC:
98
AN:
41446
American (AMR)
AF:
0.000196
AC:
3
AN:
15282
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3472
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5200
South Asian (SAS)
AF:
0.000207
AC:
1
AN:
4834
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10614
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
314
European-Non Finnish (NFE)
AF:
0.00
AC:
0
AN:
68032
Other (OTH)
AF:
0.00192
AC:
4
AN:
2088
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.506
Heterozygous variant carriers
0
5
11
16
22
27
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Genome Het
Variant carriers
0
2
4
6
8
10
<30
30-35
35-40
40-45
45-50
50-55
55-60
60-65
65-70
70-75
75-80
>80
Age
Alfa
AF:
0.000292
Hom.:
0
Bravo
AF:
0.000767
ESP6500AA
AF:
0.00227
AC:
10
ESP6500EA
AF:
0.000116
AC:
1
ExAC
AF:
0.000181
AC:
22

ClinVar

Significance: Conflicting classifications of pathogenicity
Submissions summary: Uncertain:2Benign:2
Revision: criteria provided, conflicting classifications
LINK: link

Submissions by phenotype

Inborn genetic diseases Uncertain:1
Mar 23, 2023
Ambry Genetics
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The c.257G>A (p.R86H) alteration is located in exon 3 (coding exon 3) of the LRP4 gene. This alteration results from a G to A substitution at nucleotide position 257, causing the arginine (R) at amino acid position 86 to be replaced by a histidine (H). Based on insufficient or conflicting evidence, the clinical significance of this alteration remains unclear.

not provided Uncertain:1
Jul 15, 2024
Revvity Omics, Revvity
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

LRP4-related disorder Benign:1
Aug 16, 2023
PreventionGenetics, part of Exact Sciences
Significance:Likely benign
Review Status:no assertion criteria provided
Collection Method:clinical testing

This variant is classified as likely benign based on ACMG/AMP sequence variant interpretation guidelines (Richards et al. 2015 PMID: 25741868, with internal and published modifications).

Cenani-Lenz syndactyly syndrome;C3280402:Sclerosteosis 2;C4225377:Congenital myasthenic syndrome 17 Benign:1
Dec 24, 2024
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

Computational scores

Source: dbNSFP v4.9

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.12
BayesDel_addAF
Benign
-0.027
T
BayesDel_noAF
Pathogenic
0.18
CADD
Pathogenic
31
DANN
Pathogenic
1.0
DEOGEN2
Benign
0.32
T
Eigen
Uncertain
0.65
Eigen_PC
Pathogenic
0.67
FATHMM_MKL
Pathogenic
0.98
D
LIST_S2
Uncertain
0.92
D
M_CAP
Uncertain
0.16
D
MetaRNN
Benign
0.088
T
MetaSVM
Pathogenic
0.93
D
MutationAssessor
Benign
1.2
L
PhyloP100
5.0
PrimateAI
Pathogenic
0.90
D
PROVEAN
Benign
-1.7
N
REVEL
Pathogenic
0.66
Sift
Benign
0.060
T
Sift4G
Benign
0.085
T
Polyphen
1.0
D
Vest4
0.77
MVP
0.84
MPC
1.1
ClinPred
0.032
T
GERP RS
5.6
RBP_binding_hub_radar
0.0
RBP_regulation_power_radar
1.7
Varity_R
0.20
gMVP
0.59
Mutation Taster
=38/62
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

Publications

Other links and lift over

dbSNP: rs138239756; hg19: chr11-46921872; API