rs104893904

Variant summary

Our verdict is Benign. The variant received -10 ACMG points: 3P and 13B. PM1PP3BP4_StrongBP6BS1BS2

The NM_004387.4(NKX2-5):​c.61G>C​(p.Glu21Gln) variant causes a missense change. The variant allele was found at a frequency of 0.000587 in 1,612,066 control chromosomes in the GnomAD database, including 7 homozygotes. In-silico tool predicts a benign outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars). Synonymous variant affecting the same amino acid position (i.e. E21E) has been classified as Benign.

Frequency

Genomes: 𝑓 0.00070 ( 0 hom., cov: 30)
Exomes 𝑓: 0.00057 ( 7 hom. )

Consequence

NKX2-5
NM_004387.4 missense

Scores

7
9
3

Clinical Significance

Conflicting classifications of pathogenicity criteria provided, conflicting classifications U:2B:8

Conservation

PhyloP100: 5.69

Publications

17 publications found
Variant links:
Genes affected
NKX2-5 (HGNC:2488): (NK2 homeobox 5) This gene encodes a homeobox-containing transcription factor. This transcription factor functions in heart formation and development. Mutations in this gene cause atrial septal defect with atrioventricular conduction defect, and also tetralogy of Fallot, which are both heart malformation diseases. Mutations in this gene can also cause congenital hypothyroidism non-goitrous type 5, a non-autoimmune condition. Alternative splicing results in multiple transcript variants. [provided by RefSeq, Oct 2009]
NKX2-5 Gene-Disease associations (from GenCC):
  • atrial septal defect 7
    Inheritance: AD Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Genomics England PanelApp, G2P, Ambry Genetics, Labcorp Genetics (formerly Invitae), Laboratory for Molecular Medicine, Orphanet
  • hypothyroidism, congenital, nongoitrous, 5
    Inheritance: AD, Unknown Classification: DEFINITIVE, MODERATE, LIMITED Submitted by: G2P, Labcorp Genetics (formerly Invitae), Ambry Genetics
  • NKX2.5-related congenital, conduction and myopathic heart disease
    Inheritance: AD Classification: DEFINITIVE Submitted by: ClinGen
  • tetralogy of fallot
    Inheritance: AD Classification: DEFINITIVE Submitted by: G2P
  • conotruncal heart malformations
    Inheritance: SD, AD Classification: DEFINITIVE, STRONG Submitted by: Ambry Genetics, Labcorp Genetics (formerly Invitae)
  • athyreosis
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • familial atrial fibrillation
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • familial bicuspid aortic valve
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • familial isolated congenital asplenia
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • dilated cardiomyopathy
    Inheritance: AD Classification: LIMITED Submitted by: ClinGen

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Benign. The variant received -10 ACMG points.

PM1
In a hotspot region, there are 2 aminoacids with missense pathogenic changes in the window of +-8 aminoacids around while only 1 benign, 11 uncertain in NM_004387.4
PP3
Multiple lines of computational evidence support a deleterious effect 6: BayesDel_noAF, Cadd, M_CAP, PrimateAI, REVEL, REVEL [when max_spliceai, FATHMM_MKL, MetaRNN, MutationTaster was below the threshold]
BP4
Computational evidence support a benign effect (MetaRNN=0.009920806).
BP6
Variant 5-173235023-C-G is Benign according to our data. Variant chr5-173235023-C-G is described in ClinVar as Conflicting_classifications_of_pathogenicity. ClinVar VariationId is 9009.
BS1
Variant frequency is greater than expected in population mid. GnomAdExome4 allele frequency = 0.000575 (839/1459768) while in subpopulation MID AF = 0.00122 (7/5722). AF 95% confidence interval is 0.000574. There are 7 homozygotes in GnomAdExome4. There are 443 alleles in the male GnomAdExome4 subpopulation. Median coverage is 33. This position passed quality control check.
BS2
High AC in GnomAd4 at 107 AD,Unknown,SD gene.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
NKX2-5NM_004387.4 linkc.61G>C p.Glu21Gln missense_variant Exon 1 of 2 ENST00000329198.5 NP_004378.1 P52952-1A0A0S2Z383
NKX2-5NM_001166176.2 linkc.61G>C p.Glu21Gln missense_variant Exon 1 of 2 NP_001159648.1 P52952-2
NKX2-5NM_001166175.2 linkc.61G>C p.Glu21Gln missense_variant Exon 1 of 2 NP_001159647.1 P52952-3A0A0S2Z3K2
NKX2-5XM_017009071.3 linkc.61G>C p.Glu21Gln missense_variant Exon 1 of 2 XP_016864560.1 E5RH49

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
NKX2-5ENST00000329198.5 linkc.61G>C p.Glu21Gln missense_variant Exon 1 of 2 1 NM_004387.4 ENSP00000327758.4 P52952-1
NKX2-5ENST00000424406.2 linkc.61G>C p.Glu21Gln missense_variant Exon 1 of 2 1 ENSP00000395378.2 P52952-3
NKX2-5ENST00000521848.1 linkc.61G>C p.Glu21Gln missense_variant Exon 1 of 2 2 ENSP00000427906.1 P52952-2
NKX2-5ENST00000517440.1 linkc.61G>C p.Glu21Gln missense_variant Exon 1 of 2 4 ENSP00000429905.1 E5RH49

Frequencies

GnomAD3 genomes
AF:
0.000703
AC:
107
AN:
152180
Hom.:
0
Cov.:
30
show subpopulations
Gnomad AFR
AF:
0.00
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.0000654
Gnomad ASJ
AF:
0.0236
Gnomad EAS
AF:
0.00
Gnomad SAS
AF:
0.00
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00316
Gnomad NFE
AF:
0.000294
Gnomad OTH
AF:
0.00144
GnomAD2 exomes
AF:
0.00110
AC:
267
AN:
242910
AF XY:
0.000977
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.000203
Gnomad ASJ exome
AF:
0.0224
Gnomad EAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.000223
Gnomad OTH exome
AF:
0.00167
GnomAD4 exome
AF:
0.000575
AC:
839
AN:
1459768
Hom.:
7
Cov.:
33
AF XY:
0.000610
AC XY:
443
AN XY:
726232
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
33288
American (AMR)
AF:
0.000246
AC:
11
AN:
44686
Ashkenazi Jewish (ASJ)
AF:
0.0219
AC:
571
AN:
26070
East Asian (EAS)
AF:
0.00
AC:
0
AN:
39646
South Asian (SAS)
AF:
0.000128
AC:
11
AN:
86186
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
52296
Middle Eastern (MID)
AF:
0.00122
AC:
7
AN:
5722
European-Non Finnish (NFE)
AF:
0.000139
AC:
154
AN:
1111558
Other (OTH)
AF:
0.00141
AC:
85
AN:
60316
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.483
Heterozygous variant carriers
0
49
99
148
198
247
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome Het
Exome Hom
Variant carriers
0
20
40
60
80
100
<30
30-35
35-40
40-45
45-50
50-55
55-60
60-65
65-70
70-75
75-80
>80
Age
GnomAD4 genome
AF:
0.000703
AC:
107
AN:
152298
Hom.:
0
Cov.:
30
AF XY:
0.000765
AC XY:
57
AN XY:
74462
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
41570
American (AMR)
AF:
0.0000653
AC:
1
AN:
15308
Ashkenazi Jewish (ASJ)
AF:
0.0236
AC:
82
AN:
3472
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5160
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4832
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10614
Middle Eastern (MID)
AF:
0.00340
AC:
1
AN:
294
European-Non Finnish (NFE)
AF:
0.000294
AC:
20
AN:
68026
Other (OTH)
AF:
0.00142
AC:
3
AN:
2112
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.513
Heterozygous variant carriers
0
6
12
18
24
30
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Genome Het
Variant carriers
0
2
4
6
8
10
<30
30-35
35-40
40-45
45-50
50-55
55-60
60-65
65-70
70-75
75-80
>80
Age
Alfa
AF:
0.00176
Hom.:
2
Bravo
AF:
0.000748
ESP6500AA
AF:
0.000230
AC:
1
ESP6500EA
AF:
0.000822
AC:
7
ExAC
AF:
0.000778
AC:
94
Asia WGS
AF:
0.000289
AC:
2
AN:
3476
EpiCase
AF:
0.000654
EpiControl
AF:
0.000593

ClinVar

Significance: Conflicting classifications of pathogenicity
Submissions summary: Uncertain:2Benign:8
Revision: criteria provided, conflicting classifications
LINK: link

Submissions by phenotype

not provided Uncertain:1Benign:3
May 31, 2017
Center for Pediatric Genomic Medicine, Children's Mercy Hospital and Clinics
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

May 11, 2021
GeneDx
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant is associated with the following publications: (PMID: 11714651, 17891434, 20725931, 16930004, 25274754, 25524324, 24782644, 12798584, 25333069, 25713730, 15810002, 21165553, 21110066, 20456451, 18375573, 17544441, 26805889, 27152669, 20497191, 20462343, 25944381, 14607454, 31256874, 28549997) -

Feb 01, 2024
CeGaT Center for Human Genetics Tuebingen
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

NKX2-5: PP3, BS1 -

Nov 21, 2024
ARUP Laboratories, Molecular Genetics and Genomics, ARUP Laboratories
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Atrial septal defect 7 Benign:2
May 28, 2019
Mendelics
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Jan 31, 2025
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Tetralogy of Fallot Uncertain:1
Nov 20, 2001
OMIM
Significance:Uncertain significance
Review Status:no assertion criteria provided
Collection Method:literature only

- -

not specified Benign:1
-
PreventionGenetics, part of Exact Sciences
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Congenital heart disease Benign:1
Oct 02, 2015
Women's Health and Genetics/Laboratory Corporation of America, LabCorp
Significance:Likely benign
Review Status:no assertion criteria provided
Collection Method:clinical testing

- -

Cardiovascular phenotype Benign:1
Oct 13, 2017
Ambry Genetics
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This alteration is classified as benign based on a combination of the following: seen in unaffected individuals, population frequency, intact protein function, lack of segregation with disease, co-occurrence, RNA analysis, in silico models, amino acid conservation, lack of disease association in case-control studies, and/or the mechanism of disease or impacted region is inconsistent with a known cause of pathogenicity. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Uncertain
0.48
BayesDel_addAF
Uncertain
0.10
D
BayesDel_noAF
Pathogenic
0.19
CADD
Pathogenic
27
DANN
Uncertain
1.0
DEOGEN2
Uncertain
0.54
D;.;.;T
Eigen
Uncertain
0.65
Eigen_PC
Uncertain
0.61
FATHMM_MKL
Pathogenic
0.97
D
LIST_S2
Uncertain
0.92
D;D;D;D
M_CAP
Pathogenic
0.66
D
MetaRNN
Benign
0.0099
T;T;T;T
MetaSVM
Pathogenic
0.94
D
MutationAssessor
Uncertain
2.1
M;M;M;.
PhyloP100
5.7
PrimateAI
Pathogenic
0.82
D
PROVEAN
Benign
-1.9
N;D;D;D
REVEL
Pathogenic
0.78
Sift
Uncertain
0.0030
D;D;D;D
Sift4G
Pathogenic
0.0
D;D;D;.
Polyphen
0.95
P;.;.;D
Vest4
0.34
MVP
0.82
MPC
1.3
ClinPred
0.053
T
GERP RS
4.8
PromoterAI
0.010
Neutral
Varity_R
0.33
gMVP
0.78
Mutation Taster
=89/11
polymorphism

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

Other links and lift over

dbSNP: rs104893904; hg19: chr5-172662026; COSMIC: COSV61298729; API