NM_003839.4:c.46_63dupCTGCTCTGCGCGCTGCTC

Variant names:

• chr18-62325397-G-GCTGCTCTGCGCGCTGCTC
• rs879253796
• NM_003839.4:c.46_63dupCTGCTCTGCGCGCTGCTC

Variant summary

Our verdict is Uncertain significance. The variant received 1 ACMG points: 2P and 1B. PP5_Moderate BP3

The NM_003839.4(TNFRSF11A):​c.46_63dupCTGCTCTGCGCGCTGCTC​(p.Leu16_Leu21dup) variant causes a conservative inframe insertion change involving the alteration of a non-conserved nucleotide. The variant was absent in control chromosomes in GnomAD project. It is difficult to determine the true allele frequency of this variant because it is of type INS_BIG, and the frequency of such variant types in population databases may be underestimated and unreliable. Variant has been reported in ClinVar as Likely pathogenic (★).

• Frequency: Genomes: not found (cov: 32)
• Consequence: TNFRSF11A NM_003839.4 conservative_inframe_insertion
• Clinical Significance: Likely pathogenic criteria provided, single submitter P:2
• Conservation: PhyloP100: -0.0170
• Publications: 1 publications found

Genes affected

TNFRSF11A (HGNC:11908): (TNF receptor superfamily member 11a) The protein encoded by this gene is a member of the TNF-receptor superfamily. This receptors can interact with various TRAF family proteins, through which this receptor induces the activation of NF-kappa B and MAPK8/JNK. This receptor and its ligand are important regulators of the interaction between T cells and dendritic cells. This receptor is also an essential mediator for osteoclast and lymph node development. Mutations at this locus have been associated with familial expansile osteolysis, autosomal recessive osteopetrosis, and Paget disease of bone. Alternatively spliced transcript variants have been described for this locus. [provided by RefSeq, Aug 2012]

TNFRSF11A Gene-Disease associations (from GenCC):

• Paget disease of bone 2, early-onset

  Inheritance: AD Classification: STRONG, MODERATE Submitted by: Ambry Genetics, Labcorp Genetics (formerly Invitae)
• autosomal recessive osteopetrosis 7

  Inheritance: AR Classification: STRONG, SUPPORTIVE Submitted by: Labcorp Genetics (formerly Invitae), Genomics England PanelApp, Ambry Genetics, Orphanet
• familial expansile osteolysis

  Inheritance: AD Classification: MODERATE, SUPPORTIVE Submitted by: Orphanet, Ambry Genetics
• dysosteosclerosis

  Inheritance: AR Classification: SUPPORTIVE, LIMITED Submitted by: Ambry Genetics, Orphanet
• osteosarcoma

  Inheritance: AD Classification: LIMITED Submitted by: Genomics England PanelApp

ACMG classification

Our verdict: Uncertain_significance. The variant received 1 ACMG points.

• PP5: Variant 18-62325397-G-GCTGCTCTGCGCGCTGCTC is Pathogenic according to our data. Variant chr18-62325397-G-GCTGCTCTGCGCGCTGCTC is described in ClinVar as Likely_pathogenic. ClinVar VariationId is 6299.Status of the report is criteria_provided_single_submitter, 1 stars.
• BP3: Nonframeshift variant in repetitive region in NM_003839.4

Variant Effect in Transcripts

ACMG analysis was done for transcript: NM_003839.4. You can select a different transcript below to see updated ACMG assignments.

RefSeq Transcripts

Selected	Gene	Transcript	Tags	HGVSc	HGVSp	Effect	Exon Rank	Protein	UniProt
	TNFRSF11A	NM_003839.4	MANE Select	c.46_63dupCTGCTCTGCGCGCTGCTC	p.Leu16_Leu21dup	conservative_inframe_insertion	Exon 1 of 10	NP_003830.1
	TNFRSF11A	NM_001278268.2		c.46_63dupCTGCTCTGCGCGCTGCTC	p.Leu16_Leu21dup	conservative_inframe_insertion	Exon 1 of 10	NP_001265197.1
	TNFRSF11A	NM_001270950.2		c.46_63dupCTGCTCTGCGCGCTGCTC	p.Leu16_Leu21dup	conservative_inframe_insertion	Exon 1 of 8	NP_001257879.1

Ensembl Transcripts

Selected	Gene	Transcript	Tags	HGVSc	HGVSp	Effect	Exon Rank	Protein	UniProt
	TNFRSF11A	ENST00000586569.3	TSL:1 MANE Select	c.46_63dupCTGCTCTGCGCGCTGCTC	p.Leu16_Leu21dup	conservative_inframe_insertion	Exon 1 of 10	ENSP00000465500.1
	TNFRSF11A	ENST00000269485.11	TSL:1	c.46_63dupCTGCTCTGCGCGCTGCTC	p.Leu16_Leu21dup	conservative_inframe_insertion	Exon 1 of 7	ENSP00000269485.7
	TNFRSF11A	ENST00000592013.1	TSL:2	n.73_90dupCTGCTCTGCGCGCTGCTC		non_coding_transcript_exon	Exon 1 of 2

Frequencies

GnomAD3 genomes Cov.: 32

GnomAD4 exome Cov.: 30

GnomAD4 genome Cov.: 32

ClinVar

Significance: Likely pathogenic

Submissions summary: Pathogenic:2

Revision: criteria provided, single submitter

Submissions by phenotype

Familial expansile osteolysis Pathogenic:2

Feb 11, 2022

Genetics and Molecular Pathology, SA Pathology

Significance: Likely pathogenic

Review Status: criteria provided, single submitter

Collection Method: clinical testing

Jan 01, 2007

OMIM

Significance: Pathogenic

Review Status: no assertion criteria provided

Collection Method: literature only

Computational scores

Source: dbNSFP v4.9

Name	Calibrated prediction	Score	Prediction
PhyloP100		-0.017
Mutation Taster		=78/22	disease causing (ClinVar)

Splicing

Find out detailed SpliceAI scores and Pangolin per-transcript scores at spliceailookup.broadinstitute.org

Other links and lift over

dbSNP: rs879253796; hg19: chr18-59992630;