chr3-38603840-GGAGGGC-G
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Variant summary
Our verdict is Uncertain significance. Variant got 4 ACMG points: 4P and 0B. PM2PM4
The NM_001099404.2(SCN5A):c.1756_1761del(p.Ala586_Leu587del) variant causes a inframe deletion change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.0000738 in 1,612,764 control chromosomes in the GnomAD database, including 1 homozygotes. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars).
Frequency
Genomes: 𝑓 0.000026 ( 0 hom., cov: 32)
Exomes 𝑓: 0.000079 ( 1 hom. )
Consequence
SCN5A
NM_001099404.2 inframe_deletion
NM_001099404.2 inframe_deletion
Scores
Not classified
Clinical Significance
Conservation
PhyloP100: 2.43
Genes affected
SCN5A (HGNC:10593): (sodium voltage-gated channel alpha subunit 5) The protein encoded by this gene is an integral membrane protein and tetrodotoxin-resistant voltage-gated sodium channel subunit. This protein is found primarily in cardiac muscle and is responsible for the initial upstroke of the action potential in an electrocardiogram. Defects in this gene have been associated with long QT syndrome type 3 (LQT3), atrial fibrillation, cardiomyopathy, and Brugada syndrome 1, all autosomal dominant cardiac diseases. Alternative splicing results in several transcript variants encoding different isoforms. [provided by RefSeq, May 2022]
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ACMG classification
Classification made for transcript
Verdict is Uncertain_significance. Variant got 4 ACMG points.
PM2
Very rare variant in population databases, with high coverage;
PM4
Nonframeshift variant in NON repetitive region in NM_001099404.2.
Transcripts
RefSeq
Gene | Transcript | HGVSc | HGVSp | Effect | #exon/exons | MANE | Protein | UniProt |
---|---|---|---|---|---|---|---|---|
SCN5A | NM_000335.5 | c.1756_1761del | p.Ala586_Leu587del | inframe_deletion | 12/28 | ENST00000423572.7 | NP_000326.2 | |
SCN5A | NM_001099404.2 | c.1756_1761del | p.Ala586_Leu587del | inframe_deletion | 12/28 | ENST00000413689.6 | NP_001092874.1 |
Ensembl
Gene | Transcript | HGVSc | HGVSp | Effect | #exon/exons | TSL | MANE | Protein | Appris | UniProt |
---|---|---|---|---|---|---|---|---|---|---|
SCN5A | ENST00000413689.6 | c.1756_1761del | p.Ala586_Leu587del | inframe_deletion | 12/28 | 5 | NM_001099404.2 | ENSP00000410257 | P4 | |
SCN5A | ENST00000423572.7 | c.1756_1761del | p.Ala586_Leu587del | inframe_deletion | 12/28 | 1 | NM_000335.5 | ENSP00000398266 | A1 |
Frequencies
GnomAD3 genomes AF: 0.0000263 AC: 4AN: 152178Hom.: 0 Cov.: 32
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GnomAD3 exomes AF: 0.000149 AC: 37AN: 248138Hom.: 1 AF XY: 0.000216 AC XY: 29AN XY: 134538
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GnomAD4 exome AF: 0.0000787 AC: 115AN: 1460468Hom.: 1 AF XY: 0.000124 AC XY: 90AN XY: 726418
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GnomAD4 genome AF: 0.0000263 AC: 4AN: 152296Hom.: 0 Cov.: 32 AF XY: 0.0000403 AC XY: 3AN XY: 74474
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ClinVar
Significance: Conflicting classifications of pathogenicity
Submissions summary: Uncertain:4Benign:3
Revision: criteria provided, conflicting classifications
LINK: link
Submissions by phenotype
not provided Uncertain:1Benign:2
Uncertain significance, criteria provided, single submitter | clinical testing | Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine | Jun 30, 2022 | The p.Ala586_Leu587del variant in SCN5A has been reported in a case of SIDS and was absent from 364 controls (Amestad 2007). It has also been identified in 0.08% (4/4828) of South Asian chromosomes by gnomAD v. 3 (http://gnomad.broadinstitute.org). This variant results in the deletion of an alanine (Ala) and a leucine (Leu) at position 586 and 587, but does not alter the amino acid reading frame. It is unclear how this deletion may impact the protein. In vitro functional studies showed that the variant did not exhibit a LongQT phenotype, however did have functional disturbances such as greater peak sodium densitites and changes in recovery from inactivation (Wang 2007 PMID: 17210841); however, these types of assays may not accurately represent biological function. In summary, the clinical significance of this variant is uncertain. ACMG/AMP Criteria applied: BS1. - |
Likely benign, criteria provided, single submitter | clinical testing | Labcorp Genetics (formerly Invitae), Labcorp | Jan 08, 2024 | - - |
Likely benign, criteria provided, single submitter | clinical testing | GeneDx | Oct 22, 2018 | This variant is associated with the following publications: (PMID: 28316956, 17210841, 17210839, 21215473, 27332903, 21167004, 25923670, 31043699) - |
Brugada syndrome 1 Uncertain:1
Uncertain significance, criteria provided, single submitter | clinical testing | Mendelics | May 28, 2019 | - - |
Cardiovascular phenotype Uncertain:1
Uncertain significance, criteria provided, single submitter | clinical testing | Ambry Genetics | Oct 12, 2020 | The c.1756_1761delGCCCTC variant (also known as p.A586_L587del) is located in coding exon 11 of the SCN5A gene. This variant results from an in-frame GCCCTC deletion at nucleotide positions 1756 to 1761. This results in the in-frame deletion of the alanine and leucine residues at codons 586 and 587. This alteration has been reported in a sudden infant death syndrome (SIDS) case, a sudden cardiac death (SCD) case, and in a long QT syndrome (LQTS) cohort (Arnestad M et al. Circulation. 2007;115:361-7; Kapplinger JD et al. Heart Rhythm. 2009;6:1297-303; Bagnall RD et al. N Engl J Med. 2016 Jun;374:2441-52). One functional study demonstrated a small effect of the deletion on peak sodium current density; however, the authors deemed the change insufficient to provoke pathological behavior (Wang DW et al. Circulation, 2007;115:368-76). This amino acid region is poorly conserved in available vertebrate species. Since supporting evidence is limited at this time, the clinical significance of this alteration remains unclear. - |
Cardiac arrhythmia Uncertain:1
Uncertain significance, criteria provided, single submitter | clinical testing | Color Diagnostics, LLC DBA Color Health | Apr 15, 2021 | This variant deletes two amino acids from the linker region between transmembrane domains DI and DII of the SCN5A protein. Computational splicing tools suggest that this variant may not impact RNA splicing. To our knowledge, functional assays have not been performed for this variant. This variant has been reported in an individual affected with sudden cardiac death (PMID: 27332903). This variant has also been identified in 36/245052 chromosomes (35/30726 South Asian chromosomes) in the general population by the Genome Aggregation Database (gnomAD). The relatively high frequency of this variant in the general population suggests that this variant is unlikely to be disease-causing. However, additional studies are necessary to determine the role of this variant in disease conclusively. - |
Sudden unexplained death Benign:1
Likely benign, criteria provided, single submitter | research | Agnes Ginges Centre for Molecular Cardiology, Centenary Institute | Nov 18, 2016 | The SCN5A Ala586_Leu587del has been previously reported in a case of Sudden Infant Death Syndrome (Arnestad et al, 2007). We identified this variant in a patient presenting with sudden unexplained death at 27yo. The allele frequency is 0.00015 in the Exome Aggregation Consortium (http://exac.broadinstitute.org/), which is higher than expected. Based on the relative rarity of arrhythmia syndromes causing unexplained SCD, we believe this variant could not cause disease. As a result we have classified this variant as 'likely benign'. - |
Computational scores
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Find out detailed SpliceAI scores and Pangolin per-transcript scores at