chr9-133459038-C-CA

Variant summary

Our verdict is Pathogenic. Variant got 12 ACMG points: 12P and 0B. PVS1_ModeratePM2PP5_Very_Strong

The NM_139027.6(ADAMTS13):​c.3975dup​(p.Glu1326ArgfsTer6) variant causes a frameshift change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.0000515 in 1,613,066 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Pathogenic (★★).

Frequency

Genomes: 𝑓 0.000059 ( 0 hom., cov: 32)
Exomes 𝑓: 0.000051 ( 0 hom. )

Consequence

ADAMTS13
NM_139027.6 frameshift

Scores

Not classified

Clinical Significance

Pathogenic criteria provided, multiple submitters, no conflicts P:5

Conservation

PhyloP100: -2.03
Variant links:
Genes affected
ADAMTS13 (HGNC:1366): (ADAM metallopeptidase with thrombospondin type 1 motif 13) This gene encodes a member of a family of proteins containing several distinct regions, including a metalloproteinase domain, a disintegrin-like domain, and a thrombospondin type 1 (TS) motif. The enzyme encoded by this gene specifically cleaves von Willebrand Factor (vWF). Defects in this gene are associated with thrombotic thrombocytopenic purpura. Alternative splicing results in multiple transcript variants. [provided by RefSeq, Jul 2013]

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ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 12 ACMG points.

PVS1
Loss of function variant, product does not undergo nonsense mediated mRNA decay. Variant is located in the 3'-most exon, not predicted to undergo nonsense mediated mRNA decay. Fraction of 0.0345 CDS is truncated, and there are 0 pathogenic variants in the truncated region.
PM2
Very rare variant in population databases, with high coverage;
PP5
Variant 9-133459038-C-CA is Pathogenic according to our data. Variant chr9-133459038-C-CA is described in ClinVar as [Pathogenic]. Clinvar id is 5807.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE Protein UniProt
ADAMTS13NM_139027.6 linkuse as main transcriptc.3975dup p.Glu1326ArgfsTer6 frameshift_variant 29/29 ENST00000355699.7 NP_620596.2

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Protein Appris UniProt
ADAMTS13ENST00000355699.7 linkuse as main transcriptc.3975dup p.Glu1326ArgfsTer6 frameshift_variant 29/291 NM_139027.6 ENSP00000347927 A2Q76LX8-2

Frequencies

GnomAD3 genomes
AF:
0.0000591
AC:
9
AN:
152164
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.00
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00
Gnomad ASJ
AF:
0.00
Gnomad EAS
AF:
0.00
Gnomad SAS
AF:
0.00
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.000132
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.0000680
AC:
17
AN:
250006
Hom.:
0
AF XY:
0.0000516
AC XY:
7
AN XY:
135562
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.00
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad SAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.000151
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000507
AC:
74
AN:
1460902
Hom.:
0
Cov.:
30
AF XY:
0.0000495
AC XY:
36
AN XY:
726730
show subpopulations
Gnomad4 AFR exome
AF:
0.00
Gnomad4 AMR exome
AF:
0.00
Gnomad4 ASJ exome
AF:
0.00
Gnomad4 EAS exome
AF:
0.00
Gnomad4 SAS exome
AF:
0.00
Gnomad4 FIN exome
AF:
0.0000381
Gnomad4 NFE exome
AF:
0.0000621
Gnomad4 OTH exome
AF:
0.0000497
GnomAD4 genome
AF:
0.0000591
AC:
9
AN:
152164
Hom.:
0
Cov.:
32
AF XY:
0.0000404
AC XY:
3
AN XY:
74320
show subpopulations
Gnomad4 AFR
AF:
0.00
Gnomad4 AMR
AF:
0.00
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.00
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.000132
Gnomad4 OTH
AF:
0.00
Alfa
AF:
0.0000540
Hom.:
0
Bravo
AF:
0.0000680
EpiCase
AF:
0.000164
EpiControl
AF:
0.00

ClinVar

Significance: Pathogenic
Submissions summary: Pathogenic:5
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Upshaw-Schulman syndrome Pathogenic:3
Pathogenic, criteria provided, single submitterclinical testingFulgent Genetics, Fulgent GeneticsApr 27, 2022- -
Pathogenic, no assertion criteria providedliterature onlyOMIMNov 01, 2004- -
Pathogenic, criteria provided, single submitterclinical testingLaboratory for Molecular Medicine, Mass General Brigham Personalized MedicineMar 19, 2021The p.Glu1382ArgfsX6 variant in ADAMTS13 has been reported in the homozygous or compound heterozygous state in over 20 individuals with hereditary or congenital thrombotic thrombocytopenic purpura (cTTP; Kentouche 2002 PMID: 12434890, Pimanda 2004 PMID: 14512317, Hassenpflug 2018 PMID: 29554699; van Dorland 2019 PMID: 30792199). This variant represents the most common pathogenic variant associated with cTTP in European populations (van Dorland 2019 PMID: 30792199) and has been identified in 0.015% (19/128102) of European chromosomes by gnomAD (http://gnomad.broadinstitute.org). It has also been reported in ClinVar (Variation ID 5807). This variant is predicted to cause a frameshift, which alters the protein’s amino acid sequence beginning at position 1382 and leads to a premature termination codon 6 amino acids downstream. This alteration occurs within the last exon and is, therefore, likely to escape nonsense mediated decay (NMD) and result in a truncated protein. In vitro functional studies support that the truncation impacts protein secretion (Pimanda 2004 PMID: 14512317, Shang 2006 PMID: 16597588, Hassenpflug 2018 PMID: 29554699). In summary, this variant meets criteria to be classified as pathogenic for autosomal recessive cTTP. ACMG/AMP criteria applied: PM3_VeryStrong, PVS1_Moderate, PS3_Supporting. -
not provided Pathogenic:2
Pathogenic, criteria provided, single submitterclinical testingLabcorp Genetics (formerly Invitae), LabcorpJul 07, 2023For these reasons, this variant has been classified as Pathogenic. This sequence change creates a premature translational stop signal (p.Glu1382Argfs*6) in the ADAMTS13 gene. While this is not anticipated to result in nonsense mediated decay, it is expected to disrupt the last 46 amino acid(s) of the ADAMTS13 protein. This variant is present in population databases (rs781855393, gnomAD 0.02%). This premature translational stop signal has been observed in individual(s) with thrombotic thrombocytopenic purpura (PMID: 12434890, 22529288, 23346910, 29554699, 30792199). In at least one individual the data is consistent with being in trans (on the opposite chromosome) from a pathogenic variant. ClinVar contains an entry for this variant (Variation ID: 5807). -
Pathogenic, criteria provided, single submitterclinical testingGeneDxApr 12, 2024Observed multiple times with another ADAMTS13 variant in unrelated patients with thrombotic thrombocytopenic purpura in published literature, but it is not known whether the variants occurred on the same (in cis) or on different (in trans) chromosomes in some cases (PMID: 12434890, 22529288, 29554699); Frameshift variant predicted to result in abnormal protein length as the last 46 amino acids are replaced with 5 different amino acids, and other similar variants have been reported in HGMD; Published functional studies demonstrate a damaging effect: abnormal protein secretion and reduced enzyme activity (PMID: 29554699, 14512317, 18835837, 16597588); This variant is associated with the following publications: (PMID: 31589614, 34789164, 23346910, 26139087, 30792199, 29554699, 12393505, 16807643, 14512317, 16597588, 23700827, 18835837, 22529288, 12434890, 20118810) -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.010
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: rs387906343; hg19: chr9-136324160; API