Our verdict is Uncertain significance. Variant got 2 ACMG points: 2P and 0B. PM2
The NM_001177306.2(PAM):c.690T>A(p.His230Gln) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant was absent in control chromosomes in GnomAD project. Variant has been reported in ClinVar as Uncertain significance (★).
PAM (HGNC:8596): (peptidylglycine alpha-amidating monooxygenase) This gene encodes a multifunctional protein. The encoded preproprotein is proteolytically processed to generate the mature enzyme. This enzyme includes two domains with distinct catalytic activities, a peptidylglycine alpha-hydroxylating monooxygenase (PHM) domain and a peptidyl-alpha-hydroxyglycine alpha-amidating lyase (PAL) domain. These catalytic domains work sequentially to catalyze the conversion of neuroendocrine peptides to active alpha-amidated products. Alternative splicing results in multiple transcript variants, at least one of which encodes an isoform that is proteolytically processed. [provided by RefSeq, Jan 2016]
Review Status: criteria provided, single submitter
Collection Method: clinical testing
The c.690T>A (p.H230Q) alteration is located in exon 9 (coding exon 9) of the PAM gene. This alteration results from a T to A substitution at nucleotide position 690, causing the histidine (H) at amino acid position 230 to be replaced by a glutamine (Q). Based on insufficient or conflicting evidence, the clinical significance of this alteration remains unclear. -
Gain of catalytic residue at H230 (P = 0.0803);Gain of catalytic residue at H230 (P = 0.0803);Gain of catalytic residue at H230 (P = 0.0803);Gain of catalytic residue at H230 (P = 0.0803);Gain of catalytic residue at H230 (P = 0.0803);