chr11-32391968-G-A
Variant names:
Variant summary
Our verdict is Pathogenic. Variant got 10 ACMG points: 10P and 0B. PM2PP5_Very_Strong
The NM_024426.6(WT1):c.1447+4C>T variant causes a splice region, intron change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.000000685 in 1,460,742 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a benign outcome for this variant. Variant has been reported in ClinVar as Likely pathogenic (★★).
Frequency
Genomes: not found (cov: 33)
Exomes 𝑓: 6.8e-7 ( 0 hom. )
Consequence
WT1
NM_024426.6 splice_region, intron
NM_024426.6 splice_region, intron
Scores
1
1
Clinical Significance
Conservation
PhyloP100: 8.05
Genes affected
WT1 (HGNC:12796): (WT1 transcription factor) This gene encodes a transcription factor that contains four zinc-finger motifs at the C-terminus and a proline/glutamine-rich DNA-binding domain at the N-terminus. It has an essential role in the normal development of the urogenital system, and it is mutated in a small subset of patients with Wilms tumor. This gene exhibits complex tissue-specific and polymorphic imprinting pattern, with biallelic, and monoallelic expression from the maternal and paternal alleles in different tissues. Multiple transcript variants have been described. In several variants, there is evidence for the use of a non-AUG (CUG) translation initiation codon upstream of, and in-frame with the first AUG. Authors of PMID:7926762 also provide evidence that WT1 mRNA undergoes RNA editing in human and rat, and that this process is tissue-restricted and developmentally regulated. [provided by RefSeq, Mar 2015]
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ACMG classification
Classification made for transcript
Verdict is Pathogenic. Variant got 10 ACMG points.
PM2
Very rare variant in population databases, with high coverage;
PP5
Variant 11-32391968-G-A is Pathogenic according to our data. Variant chr11-32391968-G-A is described in ClinVar as [Likely_pathogenic]. Clinvar id is 3500.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr11-32391968-G-A is described in Lovd as [Likely_pathogenic].
Transcripts
RefSeq
Ensembl
| Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | TSL | MANE | Protein | Appris | UniProt |
|---|---|---|---|---|---|---|---|---|---|---|
| WT1 | ENST00000452863.10 | c.1447+4C>T | splice_region_variant, intron_variant | Intron 9 of 9 | 1 | NM_024426.6 | ENSP00000415516.5 |
Frequencies
GnomAD3 genomes
GnomAD3 genomes
Cov.:
33
GnomAD4 exome AF: 6.85e-7 AC: 1AN: 1460742Hom.: 0 Cov.: 31 AF XY: 0.00 AC XY: 0AN XY: 726790
GnomAD4 exome
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31
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GnomAD4 genome
GnomAD4 genome
Cov.:
33
ClinVar
Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:16Other:1
Revision: criteria provided, multiple submitters, no conflicts
LINK: link
Submissions by phenotype
Frasier syndrome Pathogenic:5
| Pathogenic, no assertion criteria provided | literature only | OMIM | Jun 01, 2002 | - - |
| Pathogenic, no assertion criteria provided | literature only | Yale Center for Mendelian Genomics, Yale University | Jan 17, 2019 | - - |
| Pathogenic, criteria provided, single submitter | clinical testing | Institute of Human Genetics Munich, Klinikum Rechts Der Isar, TU München | Mar 31, 2020 | - - |
| Pathogenic, criteria provided, single submitter | clinical testing | Victorian Clinical Genetics Services, Murdoch Childrens Research Institute | Oct 09, 2024 | Based on the classification scheme VCGS_Germline_v1.3.4, this variant is classified as Pathogenic. Following criteria are met: 0103 - Dominant negative is a known mechanism of disease in this gene and is associated with Denys-Drash syndrome (MIM#194080); Frasier syndrome (MIM#136680); Meacham syndrome (MIM#608978) and Nephrotic syndrome, type 4 (MIM#256370) (PMID: 32352694). Loss of function is a known mechanism of disease in this gene and is associated with Wilms tumour, type 1 (MIM#194070). (I) 0107 - This gene is associated with autosomal dominant disease. (I) 0209 - Splice site variant proven to affect splicing of the transcript with uncertain effect on protein sequence. RT-PCR of total RNA obtained from patients' samples indicated an increase in KTS- transcripts. This is suggestive of an increased use of an alternative splice site, which results in the loss of three amino acids (PMID: 9398852, 12050205). (SP) 0251 - This variant is heterozygous. (I) 0301 - Variant is absent from gnomAD (both v2 and v3). (SP) 0505 - Abnormal splicing is predicted by in silico tools and affected nucleotide is highly conserved. (SP) 0801 - This variant has strong previous evidence of pathogenicity in unrelated individuals. This variant has been classified as likely pathogenic and pathogenic by multiple clinical laboratories in ClinVar. This variant has also been observed as a de novo or inherited variant in multiple individuals with Frasier syndrome (PMID: 9398852, 12050205, 30655312). (SP) 1208 - Inheritance information for this variant is not currently available in this individual. (I) Legend: (SP) - Supporting pathogenic, (I) - Information, (SB) - Supporting benign - |
| Pathogenic, criteria provided, single submitter | clinical testing | Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine | Aug 09, 2018 | The c.1432+4C>T variant in WT1 has been previously reported in >10 individuals with clinical features of Frasier syndrome, including in at 3 individuals with de novo occurrence (Barbaux 1997, Bastian 20115, Guaragna 2013, Hersmus 2012, Li 2010, Lispka 2013, Wang 2017) and segregated with disease in one affected family member. It was absent from large population studies and has been reported in ClinVar (Variation ID 3500). This variant is variant is located in the 5' splice region. Computational analyses and In vitro functional studies provide some evidence that the c.1432+4C>T variant may impact protein function (Barbaux 1997); however, these types of assays may not accurately represent biological function. In summary, this variant meets criteria to be classified as pathogenic for Frasier syndrome in an autosomal dominant manner based upon de novo occurences, presence in affected individuals, absence from controls and functional evidence. ACMG/AMP Criteria applied: PM6_Strong, PP1_strong, PM2, PS3_supporting (Richards 2015). - |
Nephrotic syndrome, type 4 Pathogenic:4
| Likely pathogenic, criteria provided, single submitter | clinical testing | Laboratorio de Genetica e Diagnostico Molecular, Hospital Israelita Albert Einstein | Feb 23, 2021 | ACMG classification criteria: PS3 supporting, PS4, PM2, PM6, PP1 - |
| Likely pathogenic, criteria provided, single submitter | clinical testing | Precision Medicine Center, Zhengzhou University | Dec 01, 2023 | PS2,PM2_p,PP3 - |
| Pathogenic, criteria provided, single submitter | clinical testing | Neuberg Centre For Genomic Medicine, NCGM | - | The splice site donor variant c.1447+4C>T in the WT1 gene has been observed in individuals with WT1-related disorders Gomes et al., 2018. Studies have shown that this variant results in the activation of a cryptic splice site in exon 9 Buratti et al., 2007. The variant is novel not in any individuals in gnomAD Exomes and 1000 Genomes. This splice variant in intron 9 affects the position of four nucleotides downstream of exon 9. It is submitted to ClinVar as Pathogenic multiple submissions. For these reasons, this variant has been classified as Pathogenic - |
| Pathogenic, no assertion criteria provided | literature only | OMIM | Jun 01, 2002 | - - |
Wilms tumor 1 Pathogenic:1Other:1
| not provided, no classification provided | literature only | GeneReviews | - | Common pathogenic variant; typical for 46,XY 46,XY complete gonadal dysgenesis - |
| Likely pathogenic, criteria provided, single submitter | clinical testing | All of Us Research Program, National Institutes of Health | Dec 18, 2023 | This variant substitutes a C nucleotide with a T nucleotide in the +4 position of the intron 9 splice donor site in the WT1 gene. This variant is also known as c.1447+4C>T and IVS9+4C>T in the literature. RNA studies have found that this variant results in the increased splicing at an alternative donor site in exon 9, resulting in the deletion of the last nine nucleotides of exon 9 and the in-frame deletion of lysine (K), threonine (T) and serine (S) located in between zinc fingers 3 and 4 in the WT1 protein (PMID: 10792605, 34622098). Altered ratio between the two WT1 isoforms with and without the KTS motif are associated with Frasier syndrome (PMID: 9499425, 10561752). This variant has been reported in over 60 individuals affected with Frasier syndromes (PMID: 9398852, 9499425, 10094551, 10505699, 10670748, 10792605, 11007843, 12050205, 22908070, 25623218, 29668062, 34622098, 35211794, 36980135) and related clinical features (PMID: 9529364, 20442690, 23515051, 24161391, 30655312) and three individuals affected with Denys-Drash syndrome (PMID: 9475094). Among individuals diagnosed with Frasier syndrome at least one was affected with Wilms tumor and 19 individuals were affected with gonadal tumors (PMID: 10094551, 22908070, 25623218, 34622098). This variant has not been identified in the general population by the Genome Aggregation Database (gnomAD). Based on the available evidence, this variant is classified as Likely Pathogenic. - |
Nephrotic range proteinuria Pathogenic:1
| Likely pathogenic, no assertion criteria provided | research | NIHR Bioresource Rare Diseases, University of Cambridge | - | - - |
11p partial monosomy syndrome;C0950121:Drash syndrome;C0950122:Frasier syndrome;CN033288:Wilms tumor 1 Pathogenic:1
| Pathogenic, criteria provided, single submitter | clinical testing | Labcorp Genetics (formerly Invitae), Labcorp | Sep 03, 2024 | This sequence change falls in intron 9 of the WT1 gene. It does not directly change the encoded amino acid sequence of the WT1 protein. RNA analysis indicates that this variant induces altered splicing and likely results in the loss of 3 amino acid residue(s), but is expected to preserve the integrity of the reading-frame. This variant is not present in population databases (gnomAD no frequency). This variant has been observed in individual(s) with WT1-related disorders (PMID: 9398852, 9499425, 29668062). In at least one individual the variant was observed to be de novo. This variant is also known as IVS9+4C>T. ClinVar contains an entry for this variant (Variation ID: 3500). Variants that disrupt the consensus splice site are a relatively common cause of aberrant splicing (PMID: 17576681, 9536098). Studies have shown that this variant results in the activation of a cryptic splice site in exon 9 (PMID: 9398852, 12050205). For these reasons, this variant has been classified as Pathogenic. - |
Mesothelioma, malignant;C0950121:Drash syndrome;C0950122:Frasier syndrome;C1837026:Meacham syndrome;C3151568:Nephrotic syndrome, type 4;CN033288:Wilms tumor 1 Pathogenic:1
| Pathogenic, criteria provided, single submitter | clinical testing | Fulgent Genetics, Fulgent Genetics | Feb 21, 2024 | - - |
Familial idiopathic steroid-resistant nephrotic syndrome Pathogenic:1
| Pathogenic, no assertion criteria provided | clinical testing | Blueprint Genetics | Nov 27, 2014 | - - |
not provided Pathogenic:1
| Pathogenic, criteria provided, single submitter | clinical testing | GeneDx | Dec 30, 2022 | Published functional studies demonstrate a damaging effect: abnormal gene splicing (Barbaux et al., 1997); Not observed in large population cohorts (gnomAD); In silico analysis supports a deleterious effect on splicing; This variant is associated with the following publications: (PMID: 1658787, 9398852, 22908070, 24856380, 17934764, 27300205, 34392242, 32838737, 31937884, 30348286, 24161391, 19484379, 21508141, 23515051, 20442690, 22815844, 9529364, 25905393, 10792605, 10670748, 9475094, 12050205, 25818337, 26668027, 16439601, 16780544, 10094551, 9499425, 25813279, 28204945, 28921387, 28476686, 29869118, 29668062, 30655312, 32581362, 32887937, 32381729, 32604935) - |
WT1-related disorder Pathogenic:1
| Pathogenic, criteria provided, single submitter | clinical testing | PreventionGenetics, part of Exact Sciences | Jan 13, 2023 | The WT1 c.1432+4C>T variant is predicted to interfere with splicing. This variant has been well documented to be pathogenic for Frasier syndrome and steroid-resistant nephrotic syndrome with FSGS (Barbaux et al. 1997. PubMed ID: 9398852; Melo et al. 2002. PubMed ID: 12050205; Li et al. 2010. PubMed ID: 20442690; Lipska et al. 2013. PubMed ID: 23515051). This variant has not been reported in a large population database (http://gnomad.broadinstitute.org), indicating this variant is rare. This variant is interpreted as pathogenic. - |
Computational scores
Source:
Name
Calibrated prediction
Score
Prediction
BayesDel_noAF
Benign
CADD
Benign
DANN
Uncertain
Splicing
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SpliceAI score (max)
Details are displayed if max score is > 0.2
DS_DL_spliceai
Position offset: 4
Find out detailed SpliceAI scores and Pangolin per-transcript scores at