chr4-1004391-T-G
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Variant summary
Our verdict is Likely pathogenic. Variant got 6 ACMG points: 6P and 0B. PM2PM4PP5_Moderate
The NM_000203.5(IDUA):c.1960T>G(p.Ter654Glyext*?) variant causes a stop lost change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.000000686 in 1,457,954 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 Pathogenic (★).
Frequency
Genomes: not found (cov: 32)
Exomes 𝑓: 6.9e-7 ( 0 hom. )
Consequence
IDUA
NM_000203.5 stop_lost
NM_000203.5 stop_lost
Scores
7
Clinical Significance
Conservation
PhyloP100: 0.123
Genes affected
IDUA (HGNC:5391): (alpha-L-iduronidase) This gene encodes an enzyme that hydrolyzes the terminal alpha-L-iduronic acid residues of two glycosaminoglycans, dermatan sulfate and heparan sulfate. This hydrolysis is required for the lysosomal degradation of these glycosaminoglycans. Mutations in this gene that result in enzymatic deficiency lead to the autosomal recessive disease mucopolysaccharidosis type I (MPS I). [provided by RefSeq, Jul 2008]
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ACMG classification
Classification made for transcript
Verdict is Likely_pathogenic. Variant got 6 ACMG points.
PM2
Very rare variant in population databases, with high coverage;
PM4
Stoplost variant in NM_000203.5 Downstream stopcodon found after 666 codons.
PP5
Variant 4-1004391-T-G is Pathogenic according to our data. Variant chr4-1004391-T-G is described in ClinVar as [Pathogenic]. Clinvar id is 11920.Status of the report is criteria_provided_single_submitter, 1 stars.
Transcripts
RefSeq
Gene | Transcript | HGVSc | HGVSp | Effect | #exon/exons | MANE | Protein | UniProt |
---|---|---|---|---|---|---|---|---|
IDUA | NM_000203.5 | c.1960T>G | p.Ter654Glyext*? | stop_lost | 14/14 | ENST00000514224.2 | NP_000194.2 |
Ensembl
Gene | Transcript | HGVSc | HGVSp | Effect | #exon/exons | TSL | MANE | Protein | Appris | UniProt |
---|---|---|---|---|---|---|---|---|---|---|
IDUA | ENST00000514224.2 | c.1960T>G | p.Ter654Glyext*? | stop_lost | 14/14 | 2 | NM_000203.5 | ENSP00000425081.2 | ||
IDUA | ENST00000247933.9 | c.1960T>G | p.Ter654Glyext*? | stop_lost | 14/14 | 1 | ENSP00000247933.4 | |||
IDUA | ENST00000514698.5 | n.2071T>G | non_coding_transcript_exon_variant | 11/11 | 5 | |||||
IDUA | ENST00000652070.1 | n.2016T>G | non_coding_transcript_exon_variant | 13/13 |
Frequencies
GnomAD3 genomes Cov.: 32
GnomAD3 genomes
Cov.:
32
GnomAD4 exome AF: 6.86e-7 AC: 1AN: 1457954Hom.: 0 Cov.: 32 AF XY: 0.00000138 AC XY: 1AN XY: 725374
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GnomAD4 genome Cov.: 32
GnomAD4 genome
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32
ClinVar
Significance: Likely pathogenic
Submissions summary: Pathogenic:3Other:1
Revision: reviewed by expert panel
LINK: link
Submissions by phenotype
Mucopolysaccharidosis type 1 Pathogenic:2Other:1
Likely pathogenic, reviewed by expert panel | curation | ClinGen Lysosomal Storage Disorder Variant Curation Expert Panel | Dec 06, 2024 | The NM_000203.5:c.1960T>G in IDUA is a stop-loss variant, predicted to alter the stop codon (p.Ter654Gly), resulting in an increase in the length of the protein (PM1). One patient with "Hurler-Scheie" syndrome, who is compound heterozygous for the variant and another variant in IDUA that has been classified as pathogenic by the ClinGen Lysosomal Diseases VCEP, c.208C>T (p.Gln70Ter) (ClinVar Variation ID: 11909), has been reported. The variants were confirmed to be in trans (PMID: 7550232) (PM3; insufficient evidence to apply PP4). The highest population minor allele frequency in gnomAD v4.1.0 is 8.475e-7 (1/1179958 alleles) in the European non-Finnish population, which is lower than the ClinGen Lysosomal Diseases VCEP’s threshold for PM2_Supporting (<0.00025), meeting this criterion (PM2_Supporting). When the variant was expressed in COS cells, the intracellular activity of IDUA was low (negative control 1.3 (U/mg cell protein, wild type 14.5 (U/mg cell protein, variant 2.5 (U/mg cell protein), approximately 10% wild type ( PMID: 7550232). This is higher than the LD VCEP's threshold for IDUA activity for PS3_Supporting (<2%), therefore, PS3 was not applied. Other IDUA stop loss variants have been reported in patients with MPS1. One of these variants, c.1960T>C (p.Ter654Arg) (Bertola et al, PMID: 21394825; Ngiwsara et al, PMID: 29282708), has been classified as likely pathogenic by the ClinGen LD VCEP (PM5_Supporting). The other variants are c.1961A>T (p.Ter654Cys) ((Bach et al, 1993, PMID: 8328452) and c.1960T>A (p.Ter654Arg) (Thomas et al, PMID: 33301762). In summary, this variant meets the criteria to be classified as likely pathogenic for mucopolysaccharidosis type 1. IDUA-specific ACMG/AMP criteria applied, as specified by the ClinGen Lysosomal Diseases Variant Curation Expert Panel (Specifications Version 1.0.0): PM4, PM3, PM2_Supporting, PM5_Supporting. (Classification approved by the ClinGen Lysosomal Diseases Variant Curation Expert Panel on December 6, 2024) - |
not provided, no classification provided | literature only | GeneReviews | - | Variant causes attenuated MPS I; predict extension of α-L-iduronidase at the carboxyl end that may change conformation and/or stability of enzyme. - |
Pathogenic, criteria provided, single submitter | clinical testing | Labcorp Genetics (formerly Invitae), Labcorp | Aug 11, 2020 | This variant results in an extension of the IDUA protein. Other variant(s) that result in a similarly extended protein product (p.*654Argext*) have been determined to be pathogenic (PMID: 29282708, 21394825). This suggests that these extensions are likely to be causative of disease. For these reasons, this variant has been classified as Pathogenic. Algorithms developed to predict the effect of sequence changes on RNA splicing suggest that this variant may create or strengthen a splice site, but this prediction has not been confirmed by published transcriptional studies. This sequence change disrupts the translational stop signal of the IDUA mRNA. It is expected to extend the length of the IDUA protein by 55 additional amino acid residues. This variant is not present in population databases (ExAC no frequency). This variant has been observed in individual(s) with IDUA-related conditions (PMID: 7550232). In at least one individual the data is consistent with the variant being in trans (on the opposite chromosome) from a pathogenic variant. ClinVar contains an entry for this variant (Variation ID: 11920). This variant has been reported to affect IDUA protein function (PMID: 7550232). - |
Mucopolysaccharidosis, MPS-I-H/S Pathogenic:1
Pathogenic, no assertion criteria provided | literature only | OMIM | Jan 01, 1995 | - - |
Computational scores
Source:
Name
Calibrated prediction
Score
Prediction
BayesDel_addAF
Benign
T
BayesDel_noAF
Benign
CADD
Benign
DANN
Benign
Eigen
Benign
Eigen_PC
Benign
FATHMM_MKL
Benign
N
Vest4
GERP RS
Splicing
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SpliceAI score (max)
Details are displayed if max score is > 0.2
Find out detailed SpliceAI scores and Pangolin per-transcript scores at