chr6-32038342-A-C

Variant summary

Our verdict is Benign. Variant got -9 ACMG points: 0P and 9B. BP4_StrongBS1_SupportingBS2

The ENST00000486063.5(CYP21A2):​n.3A>C variant causes a non coding transcript exon change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.0144 in 1,541,254 control chromosomes in the GnomAD database, including 276 homozygotes. In-silico tool predicts a benign outcome for this variant. Variant has been reported in ClinVar as Uncertain significance (no stars).

Frequency

Genomes: 𝑓 0.012 ( 31 hom., cov: 32)
Exomes 𝑓: 0.015 ( 245 hom. )

Consequence

CYP21A2
ENST00000486063.5 non_coding_transcript_exon

Scores

2

Clinical Significance

Uncertain significance no assertion criteria provided U:1

Conservation

PhyloP100: -0.191
Variant links:
Genes affected
CYP21A2 (HGNC:2600): (cytochrome P450 family 21 subfamily A member 2) This gene encodes a member of the cytochrome P450 superfamily of enzymes. The cytochrome P450 proteins are monooxygenases which catalyze many reactions involved in drug metabolism and synthesis of cholesterol, steroids and other lipids. This protein localizes to the endoplasmic reticulum and hydroxylates steroids at the 21 position. Its activity is required for the synthesis of steroid hormones including cortisol and aldosterone. Mutations in this gene cause congenital adrenal hyperplasia. A related pseudogene is located near this gene; gene conversion events involving the functional gene and the pseudogene are thought to account for many cases of steroid 21-hydroxylase deficiency. Two transcript variants encoding different isoforms have been found for this gene. [provided by RefSeq, Jul 2008]

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ACMG classification

Classification made for transcript

Verdict is Benign. Variant got -9 ACMG points.

BP4
Computational evidence support a benign effect (BayesDel_noAF=-0.92).
BS1
Variant frequency is greater than expected in population nfe. gnomad4 allele frequency = 0.0124 (1889/152228) while in subpopulation NFE AF= 0.0196 (1336/67996). AF 95% confidence interval is 0.0188. There are 31 homozygotes in gnomad4. There are 931 alleles in male gnomad4 subpopulation. Median coverage is 32. This position pass quality control queck. Existence of Clinvar submissions makes me limit the strength of this signal to Supporting
BS2
High Homozygotes in GnomAd4 at 31 AR gene

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE UniProt

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Appris UniProt
CYP21A2ENST00000486063.5 linkuse as main transcriptn.3A>C non_coding_transcript_exon_variant 1/83
CYP21A2ENST00000466779.5 linkuse as main transcriptc.-81A>C 5_prime_UTR_variant, NMD_transcript_variant 1/65
CYP21A2ENST00000478281.5 linkuse as main transcript upstream_gene_variant 4

Frequencies

GnomAD3 genomes
AF:
0.0124
AC:
1889
AN:
152110
Hom.:
31
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.00360
Gnomad AMI
AF:
0.0351
Gnomad AMR
AF:
0.00151
Gnomad ASJ
AF:
0.00230
Gnomad EAS
AF:
0.00
Gnomad SAS
AF:
0.00
Gnomad FIN
AF:
0.0311
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.0196
Gnomad OTH
AF:
0.00526
GnomAD4 exome
AF:
0.0146
AC:
20311
AN:
1389026
Hom.:
245
Cov.:
30
AF XY:
0.0140
AC XY:
9563
AN XY:
685394
show subpopulations
Gnomad4 AFR exome
AF:
0.00213
Gnomad4 AMR exome
AF:
0.00213
Gnomad4 ASJ exome
AF:
0.00123
Gnomad4 EAS exome
AF:
0.0000560
Gnomad4 SAS exome
AF:
0.0000379
Gnomad4 FIN exome
AF:
0.0281
Gnomad4 NFE exome
AF:
0.0171
Gnomad4 OTH exome
AF:
0.00973
GnomAD4 genome
AF:
0.0124
AC:
1889
AN:
152228
Hom.:
31
Cov.:
32
AF XY:
0.0125
AC XY:
931
AN XY:
74438
show subpopulations
Gnomad4 AFR
AF:
0.00359
Gnomad4 AMR
AF:
0.00150
Gnomad4 ASJ
AF:
0.00230
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.00
Gnomad4 FIN
AF:
0.0311
Gnomad4 NFE
AF:
0.0196
Gnomad4 OTH
AF:
0.00521
Alfa
AF:
0.00574
Hom.:
1
Bravo
AF:
0.0100

ClinVar

Significance: Uncertain significance
Submissions summary: Uncertain:1
Revision: no assertion criteria provided
LINK: link

Submissions by phenotype

CYP21A2-related disorder Uncertain:1
Uncertain significance, no assertion criteria providedclinical testingPreventionGenetics, part of Exact SciencesJan 22, 2024The CYP21A2 c.-81A>C variant is located in the 5' untranslated region. To our knowledge, this variant has not been reported in the literature. Its minor allele frequency is up to ~2.5% in a subpopulation of the gnomAD database. However, this population frequency data may not be reliable since the variant is located within a highly homologous sequence region, and current next-generation sequencing technology may not accurately assign sequencing reads from the gene and pseudogene (Mandelker et al. 2016. PubMed ID: 27228465). Due to limited functional and genetic evidence, the clinical significance of the c.-81A>C variant is currently uncertain. Of note, promoter variants in CYP21A2 have been reported to reduce transcriptional activities and therefore could be associated with mild disease (Zhang et al. 2009. PubMed ID: 18702679; Araújo et al. 2007. PubMed ID: 17666484). -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
BayesDel_noAF
Benign
-0.92
CADD
Benign
0.065
DANN
Benign
0.76

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.0
Details are displayed if max score is > 0.2

Find out detailed SpliceAI scores and Pangolin per-transcript scores at spliceailookup.broadinstitute.org

Publications

LitVar

Below is the list of publications found by LitVar. It may be empty.

Other links and lift over

dbSNP: rs554941446; hg19: chr6-32006119; COSMIC: COSV64473163; COSMIC: COSV64473163; API