NM_198576.4:c.3034G>C

Variant summary

Our verdict is Likely benign. The variant received -5 ACMG points: 0P and 5B. BP4_StrongBP6

The NM_198576.4(AGRN):​c.3034G>C​(p.Ala1012Pro) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.00000749 in 1,602,004 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a benign outcome for this variant. 17/21 in silico tools predict 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. A1012T) has been classified as Uncertain significance.

Frequency

Genomes: 𝑓 0.0000066 ( 0 hom., cov: 33)
Exomes 𝑓: 0.0000076 ( 0 hom. )

Consequence

AGRN
NM_198576.4 missense

Scores

17

Clinical Significance

Conflicting classifications of pathogenicity criteria provided, conflicting classifications U:1B:1

Conservation

PhyloP100: -0.105

Publications

1 publications found
Variant links:
Genes affected
AGRN (HGNC:329): (agrin) This gene encodes one of several proteins that are critical in the development of the neuromuscular junction (NMJ), as identified in mouse knock-out studies. The encoded protein contains several laminin G, Kazal type serine protease inhibitor, and epidermal growth factor domains. Additional post-translational modifications occur to add glycosaminoglycans and disulfide bonds. In one family with congenital myasthenic syndrome affecting limb-girdle muscles, a mutation in this gene was found. Alternative splicing results in multiple transcript variants encoding different isoforms. [provided by RefSeq, Mar 2015]
AGRN Gene-Disease associations (from GenCC):
  • congenital myasthenic syndrome 8
    Inheritance: AR Classification: STRONG Submitted by: PanelApp Australia, Labcorp Genetics (formerly Invitae), Genomics England PanelApp
  • presynaptic congenital myasthenic syndrome
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • postsynaptic congenital myasthenic syndrome
    Inheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Likely_benign. The variant received -5 ACMG points.

BP4
Computational evidence support a benign effect (MetaRNN=0.044953197).
BP6
Variant 1-1046519-G-C is Benign according to our data. Variant chr1-1046519-G-C is described in ClinVar as Conflicting_classifications_of_pathogenicity. ClinVar VariationId is 1950660.

Variant Effect in Transcripts

ACMG analysis was done for transcript: NM_198576.4. You can select a different transcript below to see updated ACMG assignments.

RefSeq Transcripts

Selected
GeneTranscriptTagsHGVScHGVSpEffectExon RankProteinUniProt
AGRN
NM_198576.4
MANE Select
c.3034G>Cp.Ala1012Pro
missense
Exon 18 of 36NP_940978.2
AGRN
NM_001305275.2
c.3034G>Cp.Ala1012Pro
missense
Exon 18 of 39NP_001292204.1
AGRN
NM_001364727.2
c.2719G>Cp.Ala907Pro
missense
Exon 17 of 36NP_001351656.1

Ensembl Transcripts

Selected
GeneTranscriptTagsHGVScHGVSpEffectExon RankProteinUniProt
AGRN
ENST00000379370.7
TSL:1 MANE Select
c.3034G>Cp.Ala1012Pro
missense
Exon 18 of 36ENSP00000368678.2
AGRN
ENST00000651234.1
c.2719G>Cp.Ala907Pro
missense
Exon 17 of 38ENSP00000499046.1
AGRN
ENST00000652369.2
c.2719G>Cp.Ala907Pro
missense
Exon 17 of 35ENSP00000498543.1

Frequencies

GnomAD3 genomes
AF:
0.00000662
AC:
1
AN:
151042
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:
0.00318
Gnomad NFE
AF:
0.00
Gnomad OTH
AF:
0.00
GnomAD2 exomes
AF:
0.00000817
AC:
2
AN:
244862
AF XY:
0.0000150
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:
0.00
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.00000758
AC:
11
AN:
1450840
Hom.:
0
Cov.:
54
AF XY:
0.00000831
AC XY:
6
AN XY:
722190
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
33246
American (AMR)
AF:
0.00
AC:
0
AN:
44450
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
25958
East Asian (EAS)
AF:
0.00
AC:
0
AN:
39490
South Asian (SAS)
AF:
0.0000582
AC:
5
AN:
85970
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
51598
Middle Eastern (MID)
AF:
0.000174
AC:
1
AN:
5740
European-Non Finnish (NFE)
AF:
9.05e-7
AC:
1
AN:
1104428
Other (OTH)
AF:
0.0000667
AC:
4
AN:
59960
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.452
Heterozygous variant carriers
0
1
2
2
3
4
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:
0.00000662
AC:
1
AN:
151164
Hom.:
0
Cov.:
33
AF XY:
0.00
AC XY:
0
AN XY:
73888
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
41196
American (AMR)
AF:
0.00
AC:
0
AN:
15252
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3466
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5118
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4770
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10312
Middle Eastern (MID)
AF:
0.00342
AC:
1
AN:
292
European-Non Finnish (NFE)
AF:
0.00
AC:
0
AN:
67758
Other (OTH)
AF:
0.00
AC:
0
AN:
2102
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.425
Heterozygous variant carriers
0
0
1
1
2
2
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance
Alfa
AF:
0.00
Hom.:
0
ExAC
AF:
0.00000827
AC:
1

ClinVar

Significance: Conflicting classifications of pathogenicity
Submissions summary: Uncertain:1Benign:1
Revision: criteria provided, conflicting classifications
LINK: link

Submissions by phenotype

Congenital myasthenic syndrome 8 Uncertain:1
Feb 03, 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. Algorithms developed to predict the effect of missense changes on protein structure and function output the following: SIFT: "Tolerated"; PolyPhen-2: "Possibly Damaging"; Align-GVGD: "Class C0". The proline amino acid residue is found in multiple mammalian species, which suggests that this missense change does not adversely affect protein function. This variant has not been reported in the literature in individuals affected with AGRN-related conditions. This variant is present in population databases (rs144781935, gnomAD 0.007%). This sequence change replaces alanine, which is neutral and non-polar, with proline, which is neutral and non-polar, at codon 1012 of the AGRN protein (p.Ala1012Pro).

Inborn genetic diseases Benign:1
Jun 19, 2025
Ambry Genetics
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This alteration is classified as likely benign based on a combination of the following: seen in unaffected individuals, population frequency, intact protein function, lack of segregation with disease, co-occurrence, RNA analysis, in silico models, amino acid conservation, lack of disease association in case-control studies, and/or the mechanism of disease or impacted region is inconsistent with a known cause of pathogenicity.

Computational scores

Source: dbNSFP v4.9

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.057
BayesDel_addAF
Benign
-0.42
T
BayesDel_noAF
Benign
-0.66
CADD
Benign
0.37
DANN
Benign
0.30
Eigen
Benign
-1.8
Eigen_PC
Benign
-1.8
FATHMM_MKL
Benign
0.0045
N
LIST_S2
Benign
0.48
T
M_CAP
Benign
0.037
D
MetaRNN
Benign
0.045
T
MetaSVM
Benign
-0.99
T
MutationAssessor
Benign
-1.4
N
PhyloP100
-0.10
PrimateAI
Benign
0.32
T
PROVEAN
Benign
0.14
N
REVEL
Benign
0.060
Sift
Benign
0.35
T
Sift4G
Benign
0.72
T
Vest4
0.066
MutPred
0.22
Gain of glycosylation at A1012 (P = 0.0155)
MVP
0.51
MPC
0.52
ClinPred
0.044
T
GERP RS
-5.1
gMVP
0.21
Mutation Taster
=98/2
polymorphism

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: rs144781935; hg19: chr1-981899; API