chr2-28783934-A-C
Variant summary
Our verdict is Pathogenic. Variant got 6 ACMG points: 7P and 1B. PP2PS2BP4PM2_SupportingPS4_Supporting
This summary comes from the ClinGen Evidence Repository: The c.548A>C (p.Glu183Ala) variant in PPP1CB is a missense variant predicted to cause substitution of glutamate by alanine at amino acid 183. This variant is absent from gnomAD v2 (PM2_Supporting). PPP1CB, in which the variant was identified, is defined by the ClinGen RASopathy VCEP as a gene that has a low rate of benign missense variation and where pathogenic missense variants are a common mechanism of disease. The missense Z-score is 4.33 which is above the threshold set by the Rasopathy VCEP (PP3). The computational predictor REVEL gives a score of 0.283, which is below the threshold of 0.3, does not predict a damaging effect on PPP1CB function (BP4). This variant was observed in a proband with a phenotype consistent with RASopathy (PS4_Supporting; PMID:30236064). This variant has also been identified as a de novo occurrence with confirmed parental relationships in 2 individuals with features of RASopathy (PS2_VeryStrong; PMIDs: 30236064, 27681385). Based on ACMG/AMP criteria, this variant has enough supporting evidence to be classified as uncertain significance; however, the RASopathy VCEP has upgraded this classification to pathogenic based on ClinGen policy. In summary, this variant currently meets the criteria to be classified as pathogenic for autosomal dominant RASopathy based on the ACMG/AMP criteria applied, as specified by the ClinGen RASopathy VCEP: PS2_VeryStrong, PS4_Supporting, PM2_Supporting, PP2, BP4. (RASopathy VCEP specifications version 1.3; 12/3/2024) LINK:https://erepo.genome.network/evrepo/ui/classification/CA10586683/MONDO:0021060/128
Frequency
Consequence
NM_002709.3 missense
Scores
Clinical Significance
Conservation
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ACMG classification
Verdict is Pathogenic. Variant got 6 ACMG points.
Transcripts
RefSeq
Ensembl
Frequencies
GnomAD3 genomes Cov.: 32
GnomAD4 exome Cov.: 29
GnomAD4 genome Cov.: 32
ClinVar
Submissions by phenotype
not provided Pathogenic:2
This sequence change replaces glutamic acid, which is acidic and polar, with alanine, which is neutral and non-polar, at codon 183 of the PPP1CB protein (p.Glu183Ala). This variant is not present in population databases (gnomAD no frequency). This missense change has been observed in individual(s) with clinical features of Noonan syndrome (PMID: 27681385, 30236064). In at least one individual the variant was observed to be de novo. ClinVar contains an entry for this variant (Variation ID: 254652). Advanced modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) performed at Invitae indicates that this missense variant is not expected to disrupt PPP1CB protein function with a negative predictive value of 80%. For these reasons, this variant has been classified as Pathogenic. -
Not observed in large population cohorts (Lek et al., 2016); In silico analysis, which includes protein predictors and evolutionary conservation, supports a deleterious effect; This variant is associated with the following publications: (PMID: 27681385, 30236064) -
Noonan syndrome-like disorder with loose anagen hair 2 Pathogenic:1
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Cardiovascular phenotype Pathogenic:1
The c.548A>C (p.E183A) alteration is located in exon 5 (coding exon 5) of the PPP1CB gene. This alteration results from an A to C substitution at nucleotide position 548, causing the glutamic acid (E) at amino acid position 183 to be replaced by an alanine (A). Based on data from the Genome Aggregation Database (gnomAD), the PPP1CB c.548A>C alteration was not observed, with coverage at this position. This alteration has been previously reported in multiple patients with various phenotypes suggestive of Noonan syndrome including global developmental delay, macrocephaly, seizures, congenital heart defects, and dysmorphic features (Ma, 2016; Lin, 2018; Hong 2020). In addition, another alteration affecting the same amino acid, p.E183V, was reported in a patient with a similar neurodevelopmental disorder (Ma, 2016). The p.E183 amino acid is conserved in available vertebrate species. This missense alteration is located in a region that has a low rate of benign missense variation (Lek, 2016; Firth, 2009). The p.E183A alteration is predicted to be tolerated by in silico analysis. Based on the available evidence, this alteration is classified as pathogenic. -
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at