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X-25013543-GCGGCCGCGGCTGCCGCGGCGGCCC-GCGGCCGCGGCTGCCGCGGCGGCCCCGGCCGCGGCTGCCGCGGCGGCCC

Variant summary

Our verdict is Likely benign. Variant got -1 ACMG points: 3P and 4B. PM4PP5BS2

The NM_139058.3(ARX):​c.451_452insGGGCCGCCGCGGCAGCCGCGGCCG​(p.Gly143_Ala150dup) variant causes a inframe insertion change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.0000189 in 794,926 control chromosomes in the GnomAD database, with no homozygous occurrence. There are 2 hemizygotes in GnomAD. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars). Synonymous variant affecting the same amino acid position (i.e. A151A) has been classified as Likely benign.

Frequency

Genomes: 𝑓 0.000077 ( 0 hom., 0 hem., cov: 21)
Exomes 𝑓: 0.000010 ( 0 hom. 2 hem. )

Consequence

ARX
NM_139058.3 inframe_insertion

Scores

Not classified

Clinical Significance

Conflicting classifications of pathogenicity criteria provided, conflicting classifications P:4U:1

Conservation

PhyloP100: 0.378
Variant links:
Genes affected
ARX (HGNC:18060): (aristaless related homeobox) This gene is a homeobox-containing gene expressed during development. The expressed protein contains two conserved domains, a C-peptide (or aristaless domain) and the prd-like class homeobox domain. It is a member of the group-II aristaless-related protein family whose members are expressed primarily in the central and/or peripheral nervous system. This gene is thought to be involved in CNS development. Expansion of a polyalanine tract and other mutations in this gene cause X-linked cognitive disability and epilepsy. [provided by RefSeq, Jul 2016]

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ACMG classification

Classification made for transcript

Verdict is Likely_benign. Variant got -1 ACMG points.

PM4
Nonframeshift variant in NON repetitive region in NM_139058.3.
PP5
Variant X-25013543-G-GCGGCCGCGGCTGCCGCGGCGGCCC is Pathogenic according to our data. Variant chrX-25013543-G-GCGGCCGCGGCTGCCGCGGCGGCCC is described in ClinVar as [Conflicting_classifications_of_pathogenicity]. Clinvar id is 11187.We mark this variant Likely_pathogenic, oryginal submissions are: {Pathogenic=1, Uncertain_significance=1}.
BS2
High Hemizygotes in GnomAdExome4 at 2 XL gene

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE UniProt
ARXNM_139058.3 linkuse as main transcriptc.451_452insGGGCCGCCGCGGCAGCCGCGGCCG p.Gly143_Ala150dup inframe_insertion 2/5 ENST00000379044.5

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Appris UniProt
ARXENST00000379044.5 linkuse as main transcriptc.451_452insGGGCCGCCGCGGCAGCCGCGGCCG p.Gly143_Ala150dup inframe_insertion 2/51 NM_139058.3 P1

Frequencies

GnomAD3 genomes
AF:
0.0000767
AC:
8
AN:
104289
Hom.:
0
Cov.:
21
AF XY:
0.00
AC XY:
0
AN XY:
29767
show subpopulations
Gnomad AFR
AF:
0.000237
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:
0.0000200
Gnomad OTH
AF:
0.00
GnomAD4 exome
AF:
0.0000101
AC:
7
AN:
690637
Hom.:
0
Cov.:
30
AF XY:
0.00000954
AC XY:
2
AN XY:
209747
show subpopulations
Gnomad4 AFR exome
AF:
0.000226
Gnomad4 AMR exome
AF:
0.00
Gnomad4 ASJ exome
AF:
0.00
Gnomad4 EAS exome
AF:
0.00
Gnomad4 SAS exome
AF:
0.0000664
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.00000484
Gnomad4 OTH exome
AF:
0.00
GnomAD4 genome
AF:
0.0000767
AC:
8
AN:
104289
Hom.:
0
Cov.:
21
AF XY:
0.00
AC XY:
0
AN XY:
29767
show subpopulations
Gnomad4 AFR
AF:
0.000237
Gnomad4 AMR
AF:
0.00
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.00
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.0000200
Gnomad4 OTH
AF:
0.00

ClinVar

Significance: Conflicting classifications of pathogenicity
Submissions summary: Pathogenic:4Uncertain:1
Revision: criteria provided, conflicting classifications
LINK: link

Submissions by phenotype

Developmental and epileptic encephalopathy, 1 Pathogenic:1
Pathogenic, no assertion criteria providedliterature onlyOMIMMay 04, 2007- -
Intellectual disability, X-linked, with or without seizures, arx-related Pathogenic:1
Pathogenic, no assertion criteria providedliterature onlyOMIMMay 04, 2007- -
Intellectual disability, X-linked, with or without seizures, arx-related;C3463992:Developmental and epileptic encephalopathy, 1 Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingInvitaeJan 18, 2024This variant, c.428_451dup, results in the insertion of 8 amino acid(s) of the ARX protein (p.Gly143_Ala150dup), but otherwise preserves the integrity of the reading frame. This variant is present in population databases (rs387906493, gnomAD 0.02%). This variant has been observed in individual(s) with ARX-related conditions (PMID: 16235064, 20506206, 21204215, 26029707). It has also been observed to segregate with disease in related individuals. This variant is also known as c.441_464 and dup24. ClinVar contains an entry for this variant (Variation ID: 11187). Studies have shown that this variant alters ARX gene expression (PMID: 17331656). For these reasons, this variant has been classified as Pathogenic. -
Partington syndrome Pathogenic:1
Pathogenic, no assertion criteria providedliterature onlyOMIMMay 04, 2007- -
not provided Uncertain:1
Uncertain significance, criteria provided, single submitterclinical testingGeneDxAug 28, 2018The c.428_451dup24 variant in the ARX gene has been reported multiple times previously in association with ARX-related disorders (Strømme et al., 2002; Stepp et al., 2005; Laperuta et al., 2007). The c.428_451dup24 variant results in an in-frame addition of 8 Alanine residues in the second polyalanine tract of ARX, leading to a protein with 20 Alanine repeats instead of the normal 12 repeats. Therefore, based on the currently available information, it is unclear whether this variant is a pathogenic variant or a rare benign variant. We consider it to be a variant of uncertain significance. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction

Splicing

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

Publications

LitVar

Below is the list of publications found by LitVar. It may be empty.

Other links and lift over

dbSNP: rs387906493; hg19: chrX-25031660; API