chr19-19194133-G-A

Variant summary

Our verdict is Uncertain significance. The variant received 4 ACMG points: 4P and 0B. PP3_Strong

The NM_003721.4(RFXANK):​c.187G>A​(p.Ala63Thr) variant causes a missense, splice region change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.000142 in 1,614,088 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a benign outcome for this variant. 13/23 in silico tools predict a benign outcome for this variant. 2/3 splice prediction tools predicting alterations to normal splicing. Variant has been reported in ClinVar as Uncertain significance (★★).

Frequency

Genomes: 𝑓 0.00011 ( 0 hom., cov: 32)
Exomes 𝑓: 0.00015 ( 0 hom. )

Consequence

RFXANK
NM_003721.4 missense, splice_region

Scores

2
15
Splicing: ADA: 1.000
2

Clinical Significance

Uncertain significance criteria provided, multiple submitters, no conflicts U:5

Conservation

PhyloP100: 2.72

Publications

2 publications found
Variant links:
Genes affected
RFXANK (HGNC:9987): (regulatory factor X associated ankyrin containing protein) Major histocompatibility (MHC) class II molecules are transmembrane proteins that have a central role in development and control of the immune system. The protein encoded by this gene, along with regulatory factor X-associated protein and regulatory factor-5, forms a complex that binds to the X box motif of certain MHC class II gene promoters and activates their transcription. Once bound to the promoter, this complex associates with the non-DNA-binding factor MHC class II transactivator, which controls the cell type specificity and inducibility of MHC class II gene expression. This protein contains ankyrin repeats involved in protein-protein interactions. Mutations in this gene have been linked to bare lymphocyte syndrome type II, complementation group B. Multiple alternatively spliced transcript variants encoding different isoforms have been described for this gene. [provided by RefSeq, Jul 2013]
RFXANK Gene-Disease associations (from GenCC):
  • MHC class II deficiency
    Inheritance: AR Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Labcorp Genetics (formerly Invitae), ClinGen, Laboratory for Molecular Medicine, Orphanet

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Uncertain_significance. The variant received 4 ACMG points.

PP3
Splicing predictors support a deleterious effect. Scorers claiming Pathogenic: dbscSNV1_ADA, dbscSNV1_RF. No scorers claiming Uncertain. Scorers claiming Benign: max_spliceai.

Variant Effect in Transcripts

ACMG analysis was done for transcript: NM_003721.4. You can select a different transcript below to see updated ACMG assignments.

RefSeq Transcripts

Sel.
GeneTranscriptTagsHGVScHGVSpEffectExon RankProteinUniProt
RFXANK
NM_003721.4
MANE Select
c.187G>Ap.Ala63Thr
missense splice_region
Exon 3 of 10NP_003712.1O14593-1
RFXANK
NM_001370238.1
c.187G>Ap.Ala63Thr
missense splice_region
Exon 2 of 10NP_001357167.1
RFXANK
NM_001370237.1
c.187G>Ap.Gly63Ser
missense splice_region
Exon 2 of 10NP_001357166.1

Ensembl Transcripts

Sel.
GeneTranscriptTagsHGVScHGVSpEffectExon RankProteinUniProt
RFXANK
ENST00000303088.9
TSL:1 MANE Select
c.187G>Ap.Ala63Thr
missense splice_region
Exon 3 of 10ENSP00000305071.2O14593-1
RFXANK
ENST00000407360.7
TSL:1
c.187G>Ap.Ala63Thr
missense splice_region
Exon 2 of 9ENSP00000384572.3O14593-1
RFXANK
ENST00000456252.7
TSL:1
c.187G>Ap.Ala63Thr
missense splice_region
Exon 3 of 9ENSP00000409138.2O14593-3

Frequencies

GnomAD3 genomes
AF:
0.000105
AC:
16
AN:
152170
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.000193
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.000131
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:
0.0000882
Gnomad OTH
AF:
0.00
GnomAD2 exomes
AF:
0.0000756
AC:
19
AN:
251466
AF XY:
0.0000736
show subpopulations
Gnomad AFR exome
AF:
0.000308
Gnomad AMR exome
AF:
0.000145
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.0000703
Gnomad OTH exome
AF:
0.000163
GnomAD4 exome
AF:
0.000146
AC:
214
AN:
1461800
Hom.:
0
Cov.:
32
AF XY:
0.000143
AC XY:
104
AN XY:
727204
show subpopulations
African (AFR)
AF:
0.000239
AC:
8
AN:
33480
American (AMR)
AF:
0.000201
AC:
9
AN:
44724
Ashkenazi Jewish (ASJ)
AF:
0.0000383
AC:
1
AN:
26136
East Asian (EAS)
AF:
0.00
AC:
0
AN:
39700
South Asian (SAS)
AF:
0.00
AC:
0
AN:
86254
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
53406
Middle Eastern (MID)
AF:
0.000173
AC:
1
AN:
5766
European-Non Finnish (NFE)
AF:
0.000165
AC:
183
AN:
1111944
Other (OTH)
AF:
0.000199
AC:
12
AN:
60390
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.475
Heterozygous variant carriers
0
11
23
34
46
57
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome Het
Variant carriers
0
10
20
30
40
50
<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:
0.000105
AC:
16
AN:
152288
Hom.:
0
Cov.:
32
AF XY:
0.000121
AC XY:
9
AN XY:
74462
show subpopulations
African (AFR)
AF:
0.000193
AC:
8
AN:
41554
American (AMR)
AF:
0.000131
AC:
2
AN:
15282
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3472
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5188
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4830
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10618
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
294
European-Non Finnish (NFE)
AF:
0.0000882
AC:
6
AN:
68024
Other (OTH)
AF:
0.00
AC:
0
AN:
2114
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.463
Heterozygous variant carriers
0
1
3
4
6
7
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Genome 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
Alfa
AF:
0.000117
Hom.:
0
Bravo
AF:
0.000140
TwinsUK
AF:
0.00
AC:
0
ALSPAC
AF:
0.000259
AC:
1
ESP6500AA
AF:
0.000227
AC:
1
ESP6500EA
AF:
0.00
AC:
0
ExAC
AF:
0.0000741
AC:
9
EpiCase
AF:
0.000436
EpiControl
AF:
0.000237

ClinVar

ClinVar submissions
Significance:Uncertain significance
Revision:criteria provided, multiple submitters, no conflicts
View on ClinVar
Pathogenic
VUS
Benign
Condition
-
3
-
not provided (3)
-
1
-
MHC class II deficiency (1)
-
1
-
MHC class II deficiency 1 (1)

Computational scores

Source: dbNSFP v4.9

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.069
BayesDel_addAF
Benign
-0.31
T
BayesDel_noAF
Benign
-0.36
CADD
Uncertain
24
DANN
Uncertain
0.99
DEOGEN2
Benign
0.023
T
Eigen
Benign
-0.26
Eigen_PC
Benign
-0.29
FATHMM_MKL
Benign
0.47
N
LIST_S2
Benign
0.64
T
M_CAP
Benign
0.010
T
MetaRNN
Benign
0.096
T
MetaSVM
Benign
-1.1
T
PhyloP100
2.7
PrimateAI
Benign
0.42
T
PROVEAN
Benign
-1.8
N
REVEL
Benign
0.078
Sift
Uncertain
0.010
D
Sift4G
Benign
0.33
T
Polyphen
0.0010
B
Vest4
0.29
MVP
0.57
MPC
0.24
ClinPred
0.023
T
GERP RS
1.7
PromoterAI
-0.027
Neutral
RBP_binding_hub_radar
0.0
RBP_regulation_power_radar
1.8
Varity_R
0.037
gMVP
0.11
Mutation Taster
=79/21
polymorphism

Splicing

Name
Calibrated prediction
Score
Prediction
dbscSNV1_ADA
Pathogenic
1.0
dbscSNV1_RF
Pathogenic
0.98
SpliceAI score (max)
0.050
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: rs150525759; hg19: chr19-19304942; API