NM_020320.5:c.419T>G

Variant names:

Variant summary

Our verdict is Pathogenic. The variant received 10 ACMG points: 10P and 0B. PM1PP5_Very_Strong

The NM_020320.5(RARS2):c.419T>G(p.Phe140Cys) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.0000397 in 1,613,180 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Likely pathogenic (★★).

Frequency

Genomes: 𝑓 0.000026 ( 0 hom., cov: 32)

Exomes 𝑓: 0.000041 ( 0 hom. )

Consequence

RARS2
NM_020320.5 missense

Scores

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:9

Conservation

PhyloP100: 7.36

Publications

7 publications found

Variant links:

Genes affected

RARS2 (HGNC:21406): (arginyl-tRNA synthetase 2, mitochondrial) This nuclear gene encodes a protein that localizes to the mitochondria, where it catalyzes the transfer of L-arginine to its cognate tRNA, an important step in translation of mitochondrially-encoded proteins. Defects in this gene are a cause of pontocerebellar hypoplasia type 6 (PCH6). Alternative splicing results in multiple transcript variants. [provided by RefSeq, Jan 2016]

RARS2 Gene-Disease associations (from GenCC):

mitochondrial disease
Inheritance: AR Classification: DEFINITIVE Submitted by: ClinGen
pontocerebellar hypoplasia type 6
Inheritance: AR Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Orphanet, Laboratory for Molecular Medicine, Labcorp Genetics (formerly Invitae), G2P, Ambry Genetics, PanelApp Australia
complex neurodevelopmental disorder
Inheritance: AD Classification: LIMITED Submitted by: Ambry Genetics

RARS2 links:

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Pathogenic. The variant received 10 ACMG points.

PM1

In a hotspot region, there are 4 aminoacids with missense pathogenic changes in the window of +-8 aminoacids around while only 0 benign, 8 uncertain in NM_020320.5

PP5

Variant 6-87548623-A-C is Pathogenic according to our data. Variant chr6-87548623-A-C is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 215055.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr6-87548623-A-C is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 215055.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr6-87548623-A-C is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 215055.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr6-87548623-A-C is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 215055.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr6-87548623-A-C is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 215055.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr6-87548623-A-C is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 215055.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr6-87548623-A-C is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 215055.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr6-87548623-A-C is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 215055.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr6-87548623-A-C is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 215055.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr6-87548623-A-C is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 215055.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr6-87548623-A-C is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 215055.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr6-87548623-A-C is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 215055.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr6-87548623-A-C is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 215055.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr6-87548623-A-C is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 215055.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr6-87548623-A-C is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 215055.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr6-87548623-A-C is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 215055.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr6-87548623-A-C is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 215055.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr6-87548623-A-C is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 215055.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr6-87548623-A-C is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 215055.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr6-87548623-A-C is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 215055.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr6-87548623-A-C is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 215055.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr6-87548623-A-C is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 215055.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr6-87548623-A-C is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 215055.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr6-87548623-A-C is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 215055.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr6-87548623-A-C is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 215055.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr6-87548623-A-C is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 215055.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr6-87548623-A-C is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 215055.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr6-87548623-A-C is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 215055.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr6-87548623-A-C is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 215055.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.

Transcripts

RefSeq

Gene	Transcript	HGVSc	HGVSp	Effect	Exon rank	MANE	Protein	UniProt
RARS2	NM_020320.5 link	c.419T>G	p.Phe140Cys	missense_variant	Exon 6 of 20	ENST00000369536.10	NP_064716.2	Q5T160

Ensembl

Gene	Transcript	HGVSc	HGVSp	Effect	Exon rank	TSL	MANE	Protein	Appris	UniProt
RARS2	ENST00000369536.10 link	c.419T>G	p.Phe140Cys	missense_variant	Exon 6 of 20	1	NM_020320.5	ENSP00000358549.5		Q5T160

Frequencies

GnomAD3 genomes

AF:

0.0000263

AC:

AN:

152234

Hom.:

Cov.:

show subpopulations

Gnomad AFR

AF:

0.00

Gnomad AMI

AF:

0.00

Gnomad AMR

AF:

0.000262

Gnomad ASJ

AF:

0.00

Gnomad EAS

AF:

0.00

Gnomad SAS

AF:

0.00

Gnomad FIN

AF:

0.00

Gnomad MID

AF:

0.00

Gnomad NFE

AF:

0.00

Gnomad OTH

AF:

0.00

GnomAD2 exomes

AF:

0.000220

AC:

AN:

250154

AF XY:

0.000177

show subpopulations

Gnomad AFR exome

AF:

0.00

Gnomad AMR exome

AF:

0.00157

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:

0.000164

GnomAD4 exome

AF:

0.0000411

AC:

AN:

1460946

Hom.:

Cov.:

AF XY:

0.0000358

AC XY:

AN XY:

726764

show subpopulations

African (AFR)

AF:

0.00

AC:

AN:

33450

American (AMR)

AF:

0.00132

AC:

AN:

44672

Ashkenazi Jewish (ASJ)

AF:

0.00

AC:

AN:

26092

East Asian (EAS)

AF:

0.00

AC:

AN:

39574

South Asian (SAS)

AF:

0.00

AC:

AN:

86198

European-Finnish (FIN)

AF:

0.00

AC:

AN:

53206

Middle Eastern (MID)

AF:

0.00

AC:

AN:

5752

European-Non Finnish (NFE)

AF:

0.00

AC:

AN:

1111644

Other (OTH)

AF:

0.0000166

AC:

AN:

60358

Allele Balance Distribution

Red line indicates average allele balance

Average allele balance: 0.430

Heterozygous variant carriers

0.00

0.20

0.40

0.60

0.80

0.95

Allele balance

Age Distribution

Exome Het

Variant carriers

<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:

0.0000263

AC:

AN:

152234

Hom.:

Cov.:

AF XY:

0.0000269

AC XY:

AN XY:

74378

show subpopulations

African (AFR)

AF:

0.00

AC:

AN:

41458

American (AMR)

AF:

0.000262

AC:

AN:

15284

Ashkenazi Jewish (ASJ)

AF:

0.00

AC:

AN:

3472

East Asian (EAS)

AF:

0.00

AC:

AN:

5202

South Asian (SAS)

AF:

0.00

AC:

AN:

4832

European-Finnish (FIN)

AF:

0.00

AC:

AN:

10628

Middle Eastern (MID)

AF:

0.00

AC:

AN:

316

European-Non Finnish (NFE)

AF:

0.00

AC:

AN:

68036

Other (OTH)

AF:

0.00

AC:

AN:

2094

Allele Balance Distribution

Red line indicates average allele balance

Average allele balance: 0.538

Heterozygous variant carriers

0.00

0.20

0.40

0.60

0.80

0.95

Allele balance

Age Distribution

Genome Het

Variant carriers

<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:

0.000172

Hom.:

Bravo

AF:

0.0000982

ExAC

AF:

0.000264

AC:

ClinVar

Significance: Pathogenic/Likely pathogenic

Submissions summary: Pathogenic:9

Revision: criteria provided, multiple submitters, no conflicts

LINK: link

Submissions by phenotype

Pontocerebellar hypoplasia type 6

Pathogenic:5

May 03, 2024

Rady Children's Institute for Genomic Medicine, Rady Children's Hospital San Diego

Significance:Pathogenic

Review Status:criteria provided, single submitter

Collection Method:clinical testing

The c.419T>G (p.Phe140Cys) variant affects a highly conserved amino acid and is predicted by multiple in silico tools to have a deleterious effect on protein function. This variant has been previously reported as a compound heterozygous change in individuals with pontocerebellar hypoplasia (PMID: 25356970, 26795593, 30921410, 31216405, 38438854). The c.419T>G (p.Phe140Cys) variant is present in the heterozygous state in the gnomAD v4 population database at a frequency of 0.004% (64/1613180), and is absent in the homozygous state, thus is presumed to be rare. Based on the available evidence, c.419T>G (p.Phe140Cys) is classified as Pathogenic. -

Mar 15, 2024

Baylor Genetics

Significance:Pathogenic

Review Status:criteria provided, single submitter

Collection Method:clinical testing

- -

Oct 07, 2016

Undiagnosed Diseases Network, NIH

Significance:Pathogenic

Review Status:criteria provided, single submitter

Collection Method:clinical testing

Compound heterozygous pathogenic variants, c.1612delA (p.T538fs) and c.419T>G (p.F140C), in the RARS2 gene were detected in this individual. The c.1612delA change predicts a translation reading frameshift at amino acid 538 (p.T538fs) with subsequent premature translation termination and therefore is classified as pathogenic. The c.419T>G (p.F140C) variant has been previously reported as disease causing [PMID 26795593, 25356970]. Whole exome sequencing and Sanger sequencing also showed that the mother is heterozygous for c.1612delA (p.T538fs) and the father is heterozygous for c.419T>G (p.F140C). Whole exome sequencing and Sanger sequencing also showed the affected sibling is heterozygous for both changes in RARS2. Our data indicate that the two changes in the RARS2 gene are in trans configuration (compound heterozygous) in this patient and the affected sibling. -

Jul 25, 2023

Revvity Omics, Revvity

Significance:Likely pathogenic

Review Status:criteria provided, single submitter

Collection Method:clinical testing

- -

Feb 22, 2024

Fulgent Genetics, Fulgent Genetics

Significance:Likely pathogenic

Review Status:criteria provided, single submitter

Collection Method:clinical testing

- -

not provided

Pathogenic:2

Dec 03, 2024

Labcorp Genetics (formerly Invitae), Labcorp

Significance:Pathogenic

Review Status:criteria provided, single submitter

Collection Method:clinical testing

This sequence change replaces phenylalanine, which is neutral and non-polar, with cysteine, which is neutral and slightly polar, at codon 140 of the RARS2 protein (p.Phe140Cys). This variant is present in population databases (rs772887102, gnomAD 0.2%). This missense change has been observed in individual(s) with clinical features of pontocerebellar hypoplasia and/or pontocerebellar hypoplasia (PMID: 26795593). In at least one individual the data is consistent with being in trans (on the opposite chromosome) from a pathogenic variant. ClinVar contains an entry for this variant (Variation ID: 215055). 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 RARS2 protein function with a positive predictive value of 95%. For these reasons, this variant has been classified as Pathogenic. -

Jul 24, 2025

GeneDx

Significance:Likely pathogenic

Review Status:criteria provided, single submitter

Collection Method:clinical testing

In silico analysis supports that this missense variant has a deleterious effect on protein structure/function; This variant is associated with the following publications: (PMID: 25356970, 26795593, 30921410, 31216405, 34717047, 31160820, 37334785, 38438854) -

Inborn genetic diseases

Pathogenic:1

Jul 01, 2013

Ambry Genetics

Significance:Likely pathogenic

Review Status:criteria provided, single submitter

Collection Method:clinical testing

- -

Pontoneocerebellar hypoplasia

Pathogenic:1

Apr 29, 2022

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

Significance:Likely pathogenic

Review Status:criteria provided, single submitter

Collection Method:clinical testing

Variant summary: RARS2 c.419T>G (p.Phe140Cys) results in a non-conservative amino acid change located in the Arginyl-tRNA synthetase, catalytic core domain (IPR035684) of the encoded protein sequence. Five of five in-silico tools predict a damaging effect of the variant on protein function. The variant allele was found at a frequency of 0.00022 in 250154 control chromosomes. This frequency is not significantly higher than estimated for a pathogenic variant in RARS2 causing Pontocerebellar Hypoplasia, Type 6 (0.00022 vs 0.0011), allowing no conclusion about variant significance. c.419T>G has been reported in the literature as a compound heterozygous genotype in individuals with features of RARS1-related disorders such as Pontocerebellar Hypoplasia, Type 6 and early-infantile (<12 weeks) developmental and epileptic encephalopathy undergoing Diagnostic Exome Sequencing (WES) analysis (example, Farwell_2015, Heiberg_2016, Liu_2019, de Valles-Ibanez_2022). These data indicate that the variant is likely to be associated with disease. To our knowledge, no experimental evidence demonstrating an impact on protein function has been reported. Three clinical diagnostic laboratories have submitted clinical-significance assessments for this variant to ClinVar after 2014 without evidence for independent evaluation. All laboratories classified the variant as pathogenic/likely pathogenic. Based on the evidence outlined above, the variant was classified as likely pathogenic. -

Computational scores

Source: dbNSFP v4.3

Name

Calibrated prediction

Score

Prediction

AlphaMissense

Pathogenic

0.81

BayesDel_addAF

Uncertain

0.070

BayesDel_noAF

Pathogenic

0.31

CADD

Pathogenic

(source)

DANN

Uncertain

0.99

DEOGEN2

Benign

0.36

Eigen

Pathogenic

0.73

Eigen_PC

Pathogenic

0.72

FATHMM_MKL

Pathogenic

0.98

LIST_S2

Uncertain

0.88

M_CAP

Uncertain

0.15

MetaRNN

Uncertain

0.74

MetaSVM

Uncertain

0.35

MutationAssessor

Pathogenic

3.9

PhyloP100

7.4

PrimateAI

Pathogenic

0.83

PROVEAN

Pathogenic

-7.8

REVEL

Pathogenic

0.81

Sift

Pathogenic

0.0

Sift4G

Pathogenic

0.0

Polyphen

1.0

Vest4

0.96

MutPred

0.90

Loss of stability (P = 0.0525);

MVP

0.89

MPC

0.64

ClinPred

0.99

GERP RS

5.6

Varity_R

0.96

gMVP

0.93

Mutation Taster

=41/59

disease causing (ClinVar)

(source)

Splicing

Name

Calibrated prediction

Score

Prediction

SpliceAI score (max)

0.010

Details are displayed if max score is > 0.2

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

Publications

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Variant summary

Frequency

Consequence

Scores

Clinical Significance

Conservation

Publications

ACMG classification

Transcripts

RefSeq

Ensembl

Frequencies

Age Distribution

Age Distribution

ClinVar

Submissions by phenotype

Computational scores

Splicing

Publications

Other links and lift over