NM_021098.3:c.4787G>A

Variant summary

Our verdict is Likely benign. The variant received -4 ACMG points: 0P and 4B. BS2

The NM_021098.3(CACNA1H):​c.4787G>A​(p.Arg1596His) variant causes a missense change. The variant allele was found at a frequency of 0.0000167 in 1,559,458 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Uncertain significance (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. R1596C) has been classified as Likely benign.

Frequency

Genomes: 𝑓 0.000033 ( 0 hom., cov: 33)
Exomes 𝑓: 0.000015 ( 0 hom. )

Consequence

CACNA1H
NM_021098.3 missense

Scores

3
11
4

Clinical Significance

Uncertain significance criteria provided, multiple submitters, no conflicts U:3

Conservation

PhyloP100: 4.74

Publications

0 publications found
Variant links:
Genes affected
CACNA1H (HGNC:1395): (calcium voltage-gated channel subunit alpha1 H) This gene encodes a T-type member of the alpha-1 subunit family, a protein in the voltage-dependent calcium channel complex. Calcium channels mediate the influx of calcium ions into the cell upon membrane polarization and consist of a complex of alpha-1, alpha-2/delta, beta, and gamma subunits in a 1:1:1:1 ratio. The alpha-1 subunit has 24 transmembrane segments and forms the pore through which ions pass into the cell. There are multiple isoforms of each of the proteins in the complex, either encoded by different genes or the result of alternative splicing of transcripts. Alternate transcriptional splice variants, encoding different isoforms, have been characterized for the gene described here. Studies suggest certain mutations in this gene lead to childhood absence epilepsy (CAE). [provided by RefSeq, Jul 2008]
CACNA1H Gene-Disease associations (from GenCC):
  • hyperaldosteronism, familial, type IV
    Inheritance: AD Classification: STRONG Submitted by: Labcorp Genetics (formerly Invitae)
  • childhood absence epilepsy
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • epilepsy, childhood absence, susceptibility to, 6
    Inheritance: AD Classification: LIMITED Submitted by: G2P, Labcorp Genetics (formerly Invitae)

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Likely_benign. The variant received -4 ACMG points.

BS2
High AC in GnomAd4 at 5 AD gene.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
CACNA1HNM_021098.3 linkc.4787G>A p.Arg1596His missense_variant Exon 27 of 35 ENST00000348261.11 NP_066921.2 O95180-1B3KQH9

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
CACNA1HENST00000348261.11 linkc.4787G>A p.Arg1596His missense_variant Exon 27 of 35 1 NM_021098.3 ENSP00000334198.7 O95180-1
CACNA1HENST00000569107.6 linkc.4802G>A p.Arg1601His missense_variant Exon 26 of 34 1 ENSP00000454990.2 H3BNT0
CACNA1HENST00000711493.1 linkc.4805G>A p.Arg1602His missense_variant Exon 26 of 34 ENSP00000518778.1
CACNA1HENST00000565831.7 linkc.4769G>A p.Arg1590His missense_variant Exon 26 of 34 1 ENSP00000455840.1 O95180-2
CACNA1HENST00000711450.1 linkc.4802G>A p.Arg1601His missense_variant Exon 27 of 35 ENSP00000518762.1
CACNA1HENST00000564231.6 linkc.4787G>A p.Arg1596His missense_variant Exon 27 of 35 1 ENSP00000457555.2 H3BUA8
CACNA1HENST00000638323.1 linkc.4748G>A p.Arg1583His missense_variant Exon 27 of 35 5 ENSP00000492267.1 A0A1W2PR14
CACNA1HENST00000562079.6 linkc.4769G>A p.Arg1590His missense_variant Exon 26 of 34 1 ENSP00000454581.2 H3BMW6
CACNA1HENST00000711438.1 linkc.4730G>A p.Arg1577His missense_variant Exon 26 of 34 ENSP00000518754.1
CACNA1HENST00000711482.1 linkc.4787G>A p.Arg1596His missense_variant Exon 27 of 36 ENSP00000518771.1
CACNA1HENST00000711485.1 linkc.4769G>A p.Arg1590His missense_variant Exon 26 of 35 ENSP00000518774.1
CACNA1HENST00000711455.1 linkc.4787G>A p.Arg1596His missense_variant Exon 27 of 36 ENSP00000518768.1
CACNA1HENST00000711483.1 linkc.4787G>A p.Arg1596His missense_variant Exon 27 of 35 ENSP00000518772.1
CACNA1HENST00000711456.1 linkc.4787G>A p.Arg1596His missense_variant Exon 27 of 34 ENSP00000518769.1
CACNA1HENST00000621827.2 linkn.4787G>A non_coding_transcript_exon_variant Exon 27 of 37 6 ENSP00000518766.1
CACNA1HENST00000637236.3 linkn.*739G>A non_coding_transcript_exon_variant Exon 26 of 34 5 ENSP00000492650.2 A0A1W2PS38
CACNA1HENST00000639478.1 linkn.4725G>A non_coding_transcript_exon_variant Exon 27 of 35 5 ENSP00000491945.1 A0A1W2PQW2
CACNA1HENST00000640028.1 linkn.*2638G>A non_coding_transcript_exon_variant Exon 27 of 35 5 ENSP00000491488.1 A0A1W2PQ19
CACNA1HENST00000711442.1 linkn.*4231G>A non_coding_transcript_exon_variant Exon 25 of 34 ENSP00000518758.1
CACNA1HENST00000711448.1 linkn.4769G>A non_coding_transcript_exon_variant Exon 26 of 36 ENSP00000518760.1
CACNA1HENST00000711449.1 linkn.4769G>A non_coding_transcript_exon_variant Exon 26 of 35 ENSP00000518761.1
CACNA1HENST00000711451.1 linkn.4864G>A non_coding_transcript_exon_variant Exon 27 of 36 ENSP00000518763.1
CACNA1HENST00000711452.1 linkn.4787G>A non_coding_transcript_exon_variant Exon 27 of 36 ENSP00000518764.1
CACNA1HENST00000711453.1 linkn.4787G>A non_coding_transcript_exon_variant Exon 27 of 36 ENSP00000518765.1
CACNA1HENST00000711484.1 linkn.4769G>A non_coding_transcript_exon_variant Exon 26 of 35 ENSP00000518773.1
CACNA1HENST00000711486.1 linkn.4787G>A non_coding_transcript_exon_variant Exon 27 of 37 ENSP00000518775.1
CACNA1HENST00000711487.1 linkn.4787G>A non_coding_transcript_exon_variant Exon 27 of 36 ENSP00000518776.1
CACNA1HENST00000711488.1 linkn.4846G>A non_coding_transcript_exon_variant Exon 26 of 35 ENSP00000518777.1
CACNA1HENST00000637236.3 linkn.*739G>A 3_prime_UTR_variant Exon 26 of 34 5 ENSP00000492650.2 A0A1W2PS38
CACNA1HENST00000640028.1 linkn.*2638G>A 3_prime_UTR_variant Exon 27 of 35 5 ENSP00000491488.1 A0A1W2PQ19
CACNA1HENST00000711442.1 linkn.*4231G>A 3_prime_UTR_variant Exon 25 of 34 ENSP00000518758.1

Frequencies

GnomAD3 genomes
AF:
0.0000329
AC:
5
AN:
151930
Hom.:
0
Cov.:
33
show subpopulations
Gnomad AFR
AF:
0.00
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00
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:
0.0000736
Gnomad OTH
AF:
0.00
GnomAD2 exomes
AF:
0.00000595
AC:
1
AN:
167942
AF XY:
0.00
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.00
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.0000143
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000149
AC:
21
AN:
1407528
Hom.:
0
Cov.:
31
AF XY:
0.0000129
AC XY:
9
AN XY:
695762
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
32234
American (AMR)
AF:
0.00
AC:
0
AN:
36800
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
25338
East Asian (EAS)
AF:
0.00
AC:
0
AN:
36824
South Asian (SAS)
AF:
0.0000124
AC:
1
AN:
80490
European-Finnish (FIN)
AF:
0.0000224
AC:
1
AN:
44716
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
5660
European-Non Finnish (NFE)
AF:
0.0000166
AC:
18
AN:
1086892
Other (OTH)
AF:
0.0000171
AC:
1
AN:
58574
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.513
Heterozygous variant carriers
0
2
4
5
7
9
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:
0.0000329
AC:
5
AN:
151930
Hom.:
0
Cov.:
33
AF XY:
0.0000404
AC XY:
3
AN XY:
74214
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
41370
American (AMR)
AF:
0.00
AC:
0
AN:
15280
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3466
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5136
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4822
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10590
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
316
European-Non Finnish (NFE)
AF:
0.0000736
AC:
5
AN:
67950
Other (OTH)
AF:
0.00
AC:
0
AN:
2092
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.535
Heterozygous variant carriers
0
1
1
2
2
3
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:
0.00
Hom.:
0
Bravo
AF:
0.0000227

ClinVar

Significance: Uncertain significance
Submissions summary: Uncertain:3
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Epilepsy, childhood absence, susceptibility to, 6;C4310756:Hyperaldosteronism, familial, type IV Uncertain:1
Feb 03, 2022
Fulgent Genetics, Fulgent Genetics
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Inborn genetic diseases Uncertain:1
Sep 22, 2022
Ambry Genetics
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The c.4787G>A (p.R1596H) alteration is located in exon 27 (coding exon 26) of the CACNA1H gene. This alteration results from a G to A substitution at nucleotide position 4787, causing the arginine (R) at amino acid position 1596 to be replaced by a histidine (H). Based on insufficient or conflicting evidence, the clinical significance of this alteration remains unclear. -

Idiopathic generalized epilepsy;C4310756:Hyperaldosteronism, familial, type IV Uncertain:1
Jul 05, 2022
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

In summary, the available evidence is currently insufficient to determine the role of this variant in disease. Therefore, it has been classified as a Variant of Uncertain Significance. This sequence change replaces arginine, which is basic and polar, with histidine, which is basic and polar, at codon 1596 of the CACNA1H protein (p.Arg1596His). The frequency data for this variant in the population databases is considered unreliable, as metrics indicate poor data quality at this position in the gnomAD database. This variant has not been reported in the literature in individuals affected with CACNA1H-related conditions. ClinVar contains an entry for this variant (Variation ID: 529578). Advanced modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) performed at Invitae indicates that this missense variant is not expected to disrupt CACNA1H protein function. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.16
BayesDel_addAF
Pathogenic
0.18
D
BayesDel_noAF
Uncertain
0.020
CADD
Pathogenic
29
DANN
Uncertain
1.0
DEOGEN2
Uncertain
0.55
D;.;.;.
Eigen
Uncertain
0.29
Eigen_PC
Uncertain
0.30
FATHMM_MKL
Uncertain
0.83
D
LIST_S2
Pathogenic
0.98
D;D;D;.
M_CAP
Uncertain
0.27
D
MetaRNN
Uncertain
0.46
T;T;T;T
MetaSVM
Pathogenic
1.0
D
PhyloP100
4.7
PrimateAI
Uncertain
0.66
T
PROVEAN
Uncertain
-2.5
N;.;N;N
REVEL
Uncertain
0.51
Sift
Benign
0.35
T;.;T;T
Sift4G
Benign
0.12
T;.;T;T
Polyphen
1.0
D;.;D;D
Vest4
0.57
MutPred
0.41
Loss of solvent accessibility (P = 0.0128);.;.;.;
MVP
0.85
ClinPred
0.90
D
GERP RS
3.9
Varity_R
0.19
gMVP
0.52
Mutation Taster
=87/13
polymorphism

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.030
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: rs1458781875; hg19: chr16-1263789; COSMIC: COSV108192879; COSMIC: COSV108192879; API