Our verdict is Pathogenic. Variant got 16 ACMG points: 16P and 0B. PM1PM2PP3_StrongPP5_Very_Strong
The NM_000116.5(TAFAZZIN):c.238G>C(p.Gly80Arg) variant causes a missense, splice region change involving the alteration of a conserved nucleotide. The variant was absent in control chromosomes in GnomAD project. In-silico tool predicts a pathogenic outcome for this variant. 15/26 in silico tools predict a damaging outcome for this variant. 3/3 splice prediction tools predicting alterations to normal splicing. Variant has been reported in ClinVar as Likely pathogenic (★★).
TAFAZZIN (HGNC:11577): (tafazzin, phospholipid-lysophospholipid transacylase) This gene encodes a protein that is expressed at high levels in cardiac and skeletal muscle. Mutations in this gene have been associated with a number of clinical disorders including Barth syndrome, dilated cardiomyopathy (DCM), hypertrophic DCM, endocardial fibroelastosis, and left ventricular noncompaction (LVNC). Multiple transcript variants encoding different isoforms have been described. A long form and a short form of each of these isoforms is produced; the short form lacks a hydrophobic leader sequence and may exist as a cytoplasmic protein rather than being membrane-bound. Other alternatively spliced transcripts have been described but the full-length nature of all these transcripts is not known. [provided by RefSeq, Jul 2008]
DNASE1L1 (HGNC:2957): (deoxyribonuclease 1 like 1) This gene encodes a deoxyribonuclease protein that shows high sequence similarity to DNase I. The encoded protein is localized to the endoplasmic reticulum and modified by N-linked glycosylation. Alternate transcriptional splice variants encoding the same protein have been observed. [provided by RefSeq, Jan 2015]
Verdict is Pathogenic. Variant got 16 ACMG points.
PM1
In a chain Tafazzin (size 261) in uniprot entity TAZ_HUMAN there are 6 pathogenic changes around while only 0 benign (100%) in NM_000116.5
PM2
Very rare variant in population databases, with high coverage;
PP3
Splicing scoreres supports a deletorius effect: Scorers claiming Pathogenic: dbscSNV1_ADA, dbscSNV1_RF, max_spliceai. No scorers claiming Uncertain. No scorers claiming Benign.
PP5
Variant X-154412214-G-C is Pathogenic according to our data. Variant chrX-154412214-G-C is described in ClinVar as [Likely_pathogenic]. Clinvar id is 807698.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chrX-154412214-G-C is described in Lovd as [Pathogenic].
Kids Neuroscience Centre, Sydney Children's Hospitals Network
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing
Use of Intron-2 cryptic 5’ splice-site abnormally includes 36 nt of intron-2 into the TAZ pre-mRNA, encoding 12 ectopic amino acids into the tafazzin protein. Exon-2 skipping abnormally removes 129 nucleotides from the TAZ pre-mRNA. This event is in frame, deleting 43 (highly conserved) amino acids from the encoded tafazzin protein. Our RT-PCR results infer splicing outcomes consistent with a damaging effect for the encoded tafazzin protein. -
Oct 29, 2018
Institute of Human Genetics Munich, Klinikum Rechts Der Isar, TU München
Significance: Likely pathogenic
Review Status: criteria provided, single submitter