chr16-31094645-C-A

Variant summary

Our verdict is Likely pathogenic. The variant received 7 ACMG points: 7P and 0B. PM2PP3_StrongPP5

The ENST00000394975.3(VKORC1):​c.85G>T​(p.Val29Leu) variant causes a missense change. The variant allele was found at a frequency of 0.00000249 in 1,607,036 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: 𝑓 0.000013 ( 0 hom., cov: 32)
Exomes 𝑓: 0.0000014 ( 0 hom. )

Consequence

VKORC1
ENST00000394975.3 missense

Scores

10
7
1

Clinical Significance

Pathogenic no assertion criteria provided P:1

Conservation

PhyloP100: 3.76

Publications

32 publications found
Variant links:
Genes affected
VKORC1 (HGNC:23663): (vitamin K epoxide reductase complex subunit 1) This gene encodes the catalytic subunit of the vitamin K epoxide reductase complex, which is responsible for the reduction of inactive vitamin K 2,3-epoxide to active vitamin K in the endoplasmic reticulum membrane. Vitamin K is a required co-factor for carboxylation of glutamic acid residues by vitamin K-dependent gamma-carboxylase in blood-clotting enzymes. Allelic variation in this gene is associated with vitamin k-dependent clotting factors combined deficiency of 2, and increased resistance or sensitivity to warfarin, an inhibitor of vitamin K epoxide reductase. Pseudogenes of this gene are located on chromosomes 1 and X. Alternative splicing results in multiple transcript variants. [provided by RefSeq, Aug 2015]
VKORC1 Gene-Disease associations (from GenCC):
  • vitamin K-dependent clotting factors, combined deficiency of, type 2
    Inheritance: Unknown, AR Classification: MODERATE, LIMITED Submitted by: Labcorp Genetics (formerly Invitae), ClinGen
  • vitamin K-dependent clotting factors, combined deficiency of, type 1
    Inheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Likely_pathogenic. The variant received 7 ACMG points.

PM2
Very rare variant in population databases, with high coverage;
PP3
MetaRNN computational evidence supports a deleterious effect, 0.982
PP5
Variant 16-31094645-C-A is Pathogenic according to our data. Variant chr16-31094645-C-A is described in ClinVar as Pathogenic. ClinVar VariationId is 2207.Status of the report is no_assertion_criteria_provided, 0 stars.

Variant Effect in Transcripts

ACMG analysis was done for transcript: ENST00000394975.3. You can select a different transcript below to see updated ACMG assignments.

RefSeq Transcripts

Selected
GeneTranscriptTagsHGVScHGVSpEffectExon RankProteinUniProt
VKORC1
NM_024006.6
MANE Select
c.85G>Tp.Val29Leu
missense
Exon 1 of 3NP_076869.1
VKORC1
NM_001311311.2
c.85G>Tp.Val29Leu
missense
Exon 1 of 4NP_001298240.1
VKORC1
NM_206824.3
c.85G>Tp.Val29Leu
missense
Exon 1 of 2NP_996560.1

Ensembl Transcripts

Selected
GeneTranscriptTagsHGVScHGVSpEffectExon RankProteinUniProt
VKORC1
ENST00000394975.3
TSL:1 MANE Select
c.85G>Tp.Val29Leu
missense
Exon 1 of 3ENSP00000378426.2
ENSG00000255439
ENST00000529564.1
TSL:4
c.85G>Tp.Val29Leu
missense
Exon 1 of 5ENSP00000431371.1
VKORC1
ENST00000319788.11
TSL:1
c.85G>Tp.Val29Leu
missense
Exon 1 of 4ENSP00000326135.7

Frequencies

GnomAD3 genomes
AF:
0.0000131
AC:
2
AN:
152266
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.00
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.0000654
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:
0.0000147
Gnomad OTH
AF:
0.00
GnomAD2 exomes
AF:
0.00000433
AC:
1
AN:
230844
AF XY:
0.00000786
show subpopulations
Gnomad AFR exome
AF:
0.0000723
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:
0.00000137
AC:
2
AN:
1454770
Hom.:
0
Cov.:
32
AF XY:
0.00000138
AC XY:
1
AN XY:
723766
show subpopulations
African (AFR)
AF:
0.0000299
AC:
1
AN:
33420
American (AMR)
AF:
0.00
AC:
0
AN:
44090
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
26018
East Asian (EAS)
AF:
0.00
AC:
0
AN:
39514
South Asian (SAS)
AF:
0.00
AC:
0
AN:
85820
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
49748
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
5754
European-Non Finnish (NFE)
AF:
9.01e-7
AC:
1
AN:
1110318
Other (OTH)
AF:
0.00
AC:
0
AN:
60088
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.450
Heterozygous variant carriers
0
0
1
1
2
2
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:
0.0000131
AC:
2
AN:
152266
Hom.:
0
Cov.:
32
AF XY:
0.00
AC XY:
0
AN XY:
74386
show subpopulations
⚠️ The allele balance in gnomAD version 4 Genomes is significantly skewed from the expected value of 0.5.
African (AFR)
AF:
0.00
AC:
0
AN:
41474
American (AMR)
AF:
0.0000654
AC:
1
AN:
15286
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3472
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5194
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4836
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10632
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
316
European-Non Finnish (NFE)
AF:
0.0000147
AC:
1
AN:
68050
Other (OTH)
AF:
0.00
AC:
0
AN:
2094
⚠️ The allele balance in gnomAD version 4 Genomes is significantly skewed from the expected value of 0.5. (p-value = 0.000203476), which strongly suggests a high chance of mosaicism in these individuals.
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.375
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:
0.000152
Hom.:
0
Bravo
AF:
0.0000227
ExAC
AF:
0.00000829
AC:
1

ClinVar

ClinVar submissions as Germline

Significance:Pathogenic
Revision:no assertion criteria provided
View on ClinVar
Pathogenic
VUS
Benign
Condition
1
-
-
Warfarin response (1)

Computational scores

Source: dbNSFP v4.9

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
0.83
BayesDel_addAF
Pathogenic
0.40
D
BayesDel_noAF
Pathogenic
0.33
CADD
Pathogenic
28
DANN
Uncertain
1.0
DEOGEN2
Pathogenic
0.85
D
Eigen
Uncertain
0.67
Eigen_PC
Uncertain
0.59
FATHMM_MKL
Uncertain
0.92
D
LIST_S2
Benign
0.79
T
M_CAP
Pathogenic
0.64
D
MetaRNN
Pathogenic
0.98
D
MetaSVM
Pathogenic
1.1
D
MutationAssessor
Uncertain
2.6
M
PhyloP100
3.8
PrimateAI
Pathogenic
0.81
D
PROVEAN
Uncertain
-2.5
D
REVEL
Pathogenic
0.86
Sift
Uncertain
0.019
D
Sift4G
Pathogenic
0.0
D
Polyphen
1.0
D
Vest4
0.67
MutPred
0.95
Loss of catalytic residue at V29 (P = 0.1021)
MVP
0.83
MPC
0.97
ClinPred
0.97
D
GERP RS
4.6
PromoterAI
-0.048
Neutral
RBP_binding_hub_radar
0.0
RBP_regulation_power_radar
1.1
Varity_R
0.86
gMVP
0.88
Mutation Taster
=4/96
disease causing (ClinVar)

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: rs104894539; hg19: chr16-31105966; API