chr1-23804441-C-T
Variant names: 
Variant summary
Our verdict is Likely pathogenic. The variant received 8 ACMG points: 8P and 0B. PM2PP2PP3_StrongPP5
The NM_000191.3(HMGCL):c.835G>A(p.Glu279Lys) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.00000137 in 1,461,876 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Pathogenic (no stars).
Frequency
 Genomes: not found (cov: 32) 
 Exomes 𝑓:  0.0000014   (  0   hom.  ) 
Consequence
 HMGCL
NM_000191.3 missense
NM_000191.3 missense
Scores
 15
 3
 1
Clinical Significance
Conservation
 PhyloP100:  7.85  
Publications
4 publications found 
Genes affected
 HMGCL  (HGNC:5005):  (3-hydroxy-3-methylglutaryl-CoA lyase) The protein encoded by this gene belongs to the HMG-CoA lyase family. It is a mitochondrial enzyme that catalyzes the final step of leucine degradation and plays a key role in ketone body formation. Mutations in this gene are associated with HMG-CoA lyase deficiency. Alternatively spliced transcript variants encoding different isoforms have been found for this gene. [provided by RefSeq, Oct 2009] 
HMGCL Gene-Disease associations (from GenCC):
- 3-hydroxy-3-methylglutaric aciduriaInheritance: AR Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: PanelApp Australia, Labcorp Genetics (formerly Invitae), G2P, Orphanet, Myriad Women’s Health, ClinGen
 
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ACMG classification
Classification was made for transcript
Our verdict: Likely_pathogenic. The variant received 8 ACMG points.
PM2
Very rare variant in population databases, with high coverage; 
PP2
Missense variant in the gene, where a lot of missense mutations are associated with disease in ClinVar. The gene has 11 curated pathogenic missense variants (we use a threshold of 10). The gene has 2 curated benign missense variants. Gene score misZ: 0.46042 (below the threshold of 3.09). Trascript score misZ: 0.32928 (below the threshold of 3.09). GenCC associations: The gene is linked to 3-hydroxy-3-methylglutaric aciduria. 
PP3
MetaRNN computational evidence supports a deleterious effect, 0.994
PP5
Variant 1-23804441-C-T is Pathogenic according to our data. Variant chr1-23804441-C-T is described in ClinVar as Pathogenic. ClinVar VariationId is 11958.Status of the report is no_assertion_criteria_provided, 0 stars. 
Transcripts
RefSeq
Ensembl
Frequencies
GnomAD3 genomes  Cov.: 32 
GnomAD3 genomes 
Cov.: 
32
GnomAD4 exome  AF:  0.00000137  AC: 2AN: 1461876Hom.:  0  Cov.: 31 AF XY:  0.00000138  AC XY: 1AN XY: 727238 show subpopulations 
GnomAD4 exome 
 AF: 
AC: 
2
AN: 
1461876
Hom.: 
Cov.: 
31
 AF XY: 
AC XY: 
1
AN XY: 
727238
show subpopulations 
African (AFR) 
 AF: 
AC: 
0
AN: 
33480
American (AMR) 
 AF: 
AC: 
0
AN: 
44724
Ashkenazi Jewish (ASJ) 
 AF: 
AC: 
0
AN: 
26134
East Asian (EAS) 
 AF: 
AC: 
2
AN: 
39700
South Asian (SAS) 
 AF: 
AC: 
0
AN: 
86258
European-Finnish (FIN) 
 AF: 
AC: 
0
AN: 
53408
Middle Eastern (MID) 
 AF: 
AC: 
0
AN: 
5768
European-Non Finnish (NFE) 
 AF: 
AC: 
0
AN: 
1112010
Other (OTH) 
 AF: 
AC: 
0
AN: 
60394
 Allele Balance Distribution 
 Red line indicates average allele balance 
 Average allele balance: 0.550 
Heterozygous variant carriers
 0 
 0 
 1 
 1 
 2 
 2 
 0.00 
 0.20 
 0.40 
 0.60 
 0.80 
 0.95 
Allele balance
GnomAD4 genome  Cov.: 32 
GnomAD4 genome 
Cov.: 
32
Alfa 
 AF: 
Hom.: 
ClinVar
Significance: Pathogenic 
Submissions summary: Pathogenic:1 
Revision: no assertion criteria provided
LINK: link 
Submissions by phenotype
Deficiency of hydroxymethylglutaryl-CoA lyase    Pathogenic:1 
Oct 01, 2000
OMIM
Significance:Pathogenic
Review Status:no assertion criteria provided
Collection Method:literature only
- -
Computational scores
Source: 
Name
Calibrated prediction
Score
Prediction
 AlphaMissense 
 Pathogenic 
 BayesDel_addAF 
 Pathogenic 
D 
 BayesDel_noAF 
 Pathogenic 
 DANN 
 Pathogenic 
 DEOGEN2 
 Pathogenic 
D;. 
 Eigen 
 Pathogenic 
 Eigen_PC 
 Pathogenic 
 FATHMM_MKL 
 Uncertain 
D 
 LIST_S2 
 Pathogenic 
D;D 
 M_CAP 
 Pathogenic 
D 
 MetaRNN 
 Pathogenic 
D;D 
 MetaSVM 
 Pathogenic 
D 
 MutationAssessor 
 Pathogenic 
H;. 
 PhyloP100 
 PrimateAI 
 Uncertain 
T 
 PROVEAN 
 Uncertain 
D;D 
 REVEL 
 Pathogenic 
 Sift 
 Pathogenic 
D;D 
 Sift4G 
 Pathogenic 
D;D 
 Polyphen 
D;. 
 Vest4 
 MutPred 
Gain of ubiquitination at E279 (P = 0.0276);.;
 MVP 
 MPC 
 ClinPred 
D 
 GERP RS 
 Varity_R 
 gMVP 
Splicing
Name
Calibrated prediction
Score
Prediction
 SpliceAI score (max) 
Details are displayed if max score is > 0.2
 Find out detailed SpliceAI scores and Pangolin per-transcript scores at 
Publications
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