rs118204020

Variant summary

Our verdict is Pathogenic. Variant got 11 ACMG points: 11P and 0B. PM2PP3PP5_Very_Strong

The NM_024884.3(L2HGDH):​c.905C>T​(p.Pro302Leu) variant causes a missense, splice region change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.000014 in 1,572,704 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. 13/23 in silico tools predict a damaging outcome for this variant. 2/3 splice prediction tools predicting alterations to normal splicing. Variant has been reported in ClinVar as Likely pathogenic (★★).

Frequency

Genomes: 𝑓 0.000013 ( 0 hom., cov: 32)
Exomes 𝑓: 0.000014 ( 0 hom. )

Consequence

L2HGDH
NM_024884.3 missense, splice_region

Scores

14
4
1
Splicing: ADA: 0.9987
2

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:6

Conservation

PhyloP100: 9.67
Variant links:
Genes affected
L2HGDH (HGNC:20499): (L-2-hydroxyglutarate dehydrogenase) This gene encodes L-2-hydroxyglutarate dehydrogenase, a FAD-dependent enzyme that oxidizes L-2-hydroxyglutarate to alpha-ketoglutarate in a variety of mammalian tissues. Mutations in this gene cause L-2-hydroxyglutaric aciduria, a rare autosomal recessive neurometabolic disorder resulting in moderate to severe cognitive disability. [provided by RefSeq, Jul 2008]

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ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 11 ACMG points.

PM2
Very rare variant in population databases, with high coverage;
PP3
Splicing scoreres supports a deletorius effect: Scorers claiming Pathogenic: dbscSNV1_ADA, dbscSNV1_RF. No scorers claiming Uncertain. Scorers claiming Benign: max_spliceai.
PP5
Variant 14-50269164-G-A is Pathogenic according to our data. Variant chr14-50269164-G-A is described in ClinVar as [Likely_pathogenic]. Clinvar id is 1607.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-50269164-G-A is described in Lovd as [Likely_pathogenic].

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
L2HGDHNM_024884.3 linkc.905C>T p.Pro302Leu missense_variant, splice_region_variant Exon 7 of 10 ENST00000267436.9 NP_079160.1 Q9H9P8-1

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
L2HGDHENST00000267436.9 linkc.905C>T p.Pro302Leu missense_variant, splice_region_variant Exon 7 of 10 1 NM_024884.3 ENSP00000267436.4 Q9H9P8-1
L2HGDHENST00000261699.8 linkc.905C>T p.Pro302Leu missense_variant, splice_region_variant Exon 7 of 10 1 ENSP00000261699.4 C9JVN9
L2HGDHENST00000421284.7 linkc.905C>T p.Pro302Leu missense_variant, splice_region_variant Exon 7 of 11 2 ENSP00000405559.3 Q9H9P8-1

Frequencies

GnomAD3 genomes
AF:
0.0000132
AC:
2
AN:
151162
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:
0.0000295
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.0000119
AC:
3
AN:
251328
Hom.:
0
AF XY:
0.0000147
AC XY:
2
AN XY:
135832
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:
0.0000327
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.0000176
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000141
AC:
20
AN:
1421542
Hom.:
0
Cov.:
33
AF XY:
0.0000170
AC XY:
12
AN XY:
706628
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:
0.0000350
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.0000148
Gnomad4 OTH exome
AF:
0.0000173
GnomAD4 genome
AF:
0.0000132
AC:
2
AN:
151162
Hom.:
0
Cov.:
32
AF XY:
0.0000136
AC XY:
1
AN XY:
73768
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:
0.0000295
Gnomad4 OTH
AF:
0.00
Bravo
AF:
0.00000378
EpiCase
AF:
0.00
EpiControl
AF:
0.000119

ClinVar

Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:6
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

L-2-hydroxyglutaric aciduria Pathogenic:5
Sep 25, 2023
Clinical Genetics Laboratory, University Hospital Schleswig-Holstein
Significance: Likely pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing

- -

Nov 15, 2004
OMIM
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: literature only

- -

Jul 25, 2023
Labcorp Genetics (formerly Invitae), Labcorp
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

An algorithm developed to predict the effect of missense changes on protein structure and function (PolyPhen-2) suggests that this variant is likely to be disruptive. ClinVar contains an entry for this variant (Variation ID: 1607). This missense change has been observed in individual(s) with clinical features of L-2-hydroxyglutaric aciduria (PMID: 15385440, 16134148, 18415700; Invitae). In at least one individual the data is consistent with being in trans (on the opposite chromosome) from a pathogenic variant. This variant is present in population databases (rs118204020, gnomAD 0.003%). This sequence change replaces proline, which is neutral and non-polar, with leucine, which is neutral and non-polar, at codon 302 of the L2HGDH protein (p.Pro302Leu). For these reasons, this variant has been classified as Pathogenic. -

Mar 15, 2021
Institute of Human Genetics, University of Leipzig Medical Center
Significance: Likely pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

This variant was identified as homozygous. -

May 09, 2022
MGZ Medical Genetics Center
Significance: Likely pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

not provided Pathogenic:1
Jun 01, 2022
CeGaT Center for Human Genetics Tuebingen
Significance: Likely pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

L2HGDH: PM2, PM3, PP4:Moderate, PP1, PP3 -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
0.83
BayesDel_addAF
Pathogenic
0.39
D
BayesDel_noAF
Pathogenic
0.43
CADD
Pathogenic
35
DANN
Uncertain
1.0
DEOGEN2
Uncertain
0.47
T;D;D
Eigen
Pathogenic
1.2
Eigen_PC
Pathogenic
1.1
FATHMM_MKL
Pathogenic
1.0
D
LIST_S2
Uncertain
0.97
D;.;D
M_CAP
Uncertain
0.23
D
MetaRNN
Pathogenic
0.92
D;D;D
MetaSVM
Pathogenic
0.97
D
MutationAssessor
Pathogenic
4.4
.;H;H
PrimateAI
Pathogenic
0.80
T
PROVEAN
Pathogenic
-9.7
D;D;D
REVEL
Pathogenic
0.93
Sift
Pathogenic
0.0
D;D;D
Sift4G
Pathogenic
0.0
D;D;D
Polyphen
1.0
D;D;D
Vest4
0.77
MutPred
0.80
Gain of catalytic residue at I300 (P = 5e-04);Gain of catalytic residue at I300 (P = 5e-04);Gain of catalytic residue at I300 (P = 5e-04);
MVP
0.95
MPC
0.81
ClinPred
1.0
D
GERP RS
5.6
Varity_R
0.98
gMVP
0.96

Splicing

Name
Calibrated prediction
Score
Prediction
dbscSNV1_ADA
Pathogenic
1.0
dbscSNV1_RF
Pathogenic
0.93
SpliceAI score (max)
0.030
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: rs118204020; hg19: chr14-50735882; COSMIC: COSV55556333; API