rs121907986

Variant summary

Our verdict is Pathogenic. Variant got 18 ACMG points: 18P and 0B. PVS1PM2PP5_Very_Strong

The NM_000521.4(HEXB):​c.850C>T​(p.Arg284Ter) variant causes a stop gained change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.0000372 in 1,613,086 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Pathogenic (★★). Variant results in nonsense mediated mRNA decay.

Frequency

Genomes: 𝑓 0.000013 ( 0 hom., cov: 32)
Exomes 𝑓: 0.000040 ( 0 hom. )

Consequence

HEXB
NM_000521.4 stop_gained

Scores

2
4
1

Clinical Significance

Pathogenic criteria provided, multiple submitters, no conflicts P:13

Conservation

PhyloP100: 2.14
Variant links:
Genes affected
HEXB (HGNC:4879): (hexosaminidase subunit beta) Hexosaminidase B is the beta subunit of the lysosomal enzyme beta-hexosaminidase that, together with the cofactor GM2 activator protein, catalyzes the degradation of the ganglioside GM2, and other molecules containing terminal N-acetyl hexosamines. Beta-hexosaminidase is composed of two subunits, alpha and beta, which are encoded by separate genes. Both beta-hexosaminidase alpha and beta subunits are members of family 20 of glycosyl hydrolases. Mutations in the alpha or beta subunit genes lead to an accumulation of GM2 ganglioside in neurons and neurodegenerative disorders termed the GM2 gangliosidoses. Beta subunit gene mutations lead to Sandhoff disease (GM2-gangliosidosis type II). Alternatively spliced transcript variants encoding different isoforms have been found for this gene. [provided by RefSeq, May 2014]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 18 ACMG points.

PVS1
Loss of function variant, product undergoes nonsense mediated mRNA decay. LoF is a known mechanism of disease.
PM2
Very rare variant in population databases, with high coverage;
PP5
Variant 5-74713584-C-T is Pathogenic according to our data. Variant chr5-74713584-C-T is described in ClinVar as [Pathogenic]. Clinvar id is 3887.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-74713584-C-T is described in Lovd as [Pathogenic].

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE Protein UniProt
HEXBNM_000521.4 linkuse as main transcriptc.850C>T p.Arg284Ter stop_gained 7/14 ENST00000261416.12 NP_000512.2
HEXBNM_001292004.2 linkuse as main transcriptc.175C>T p.Arg59Ter stop_gained 7/14 NP_001278933.1

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Protein Appris UniProt
HEXBENST00000261416.12 linkuse as main transcriptc.850C>T p.Arg284Ter stop_gained 7/141 NM_000521.4 ENSP00000261416 P1
HEXBENST00000511181.5 linkuse as main transcriptc.175C>T p.Arg59Ter stop_gained 7/141 ENSP00000426285
HEXBENST00000504459.5 linkuse as main transcriptn.47C>T non_coding_transcript_exon_variant 1/73

Frequencies

GnomAD3 genomes
AF:
0.0000131
AC:
2
AN:
152138
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:
0.0000294
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.0000278
AC:
7
AN:
251468
Hom.:
0
AF XY:
0.0000441
AC XY:
6
AN XY:
135914
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:
0.000229
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.00
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000397
AC:
58
AN:
1460948
Hom.:
0
Cov.:
30
AF XY:
0.0000509
AC XY:
37
AN XY:
726844
show subpopulations
Gnomad4 AFR exome
AF:
0.00
Gnomad4 AMR exome
AF:
0.00
Gnomad4 ASJ exome
AF:
0.00
Gnomad4 EAS exome
AF:
0.0000252
Gnomad4 SAS exome
AF:
0.000220
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.0000333
Gnomad4 OTH exome
AF:
0.0000166
GnomAD4 genome
AF:
0.0000131
AC:
2
AN:
152138
Hom.:
0
Cov.:
32
AF XY:
0.00
AC XY:
0
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:
0.0000294
Gnomad4 OTH
AF:
0.00
Alfa
AF:
0.0000268
Hom.:
0
Bravo
AF:
0.0000227
ExAC
AF:
0.0000247
AC:
3

ClinVar

Significance: Pathogenic
Submissions summary: Pathogenic:13
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Sandhoff disease Pathogenic:11
Pathogenic, criteria provided, single submitterclinical testingRevvity Omics, RevvityJan 15, 2021- -
Pathogenic, criteria provided, single submitterclinical testing3billionMar 22, 2022Stop-gained (nonsense): predicted to result in a loss or disruption of normal protein function through nonsense-mediated decay (NMD) or protein truncation. Multiple pathogenic variants are reported downstream of the variant. The variant has been reported at least twice as pathogenic/likely pathogenic with clinical assertions and evidence for the classification (ClinVar ID: VCV000003887, PMID:8162015). It is observed at an extremely low frequency in the gnomAD v2.1.1 dataset (total allele frequency:0.0000278). Therefore, this variant is classified as pathogenic according to the recommendation of ACMG/AMP guideline. -
Pathogenic, criteria provided, single submitterclinical testingLabcorp Genetics (formerly Invitae), LabcorpDec 19, 2023This sequence change creates a premature translational stop signal (p.Arg284*) in the HEXB gene. It is expected to result in an absent or disrupted protein product. Loss-of-function variants in HEXB are known to be pathogenic (PMID: 7550345, 18758829). This variant is present in population databases (rs121907986, gnomAD 0.02%). This premature translational stop signal has been observed in individuals with Sandhoff disease (PMID: 8162015, 18758829, 23046579, 24613245, 26582265, 29448188). ClinVar contains an entry for this variant (Variation ID: 3887). For these reasons, this variant has been classified as Pathogenic. -
Pathogenic, criteria provided, single submitterclinical testingWomen's Health and Genetics/Laboratory Corporation of America, LabCorpJan 18, 2018Variant summary: The HEXB c.850C>T (p.Arg284X) variant results in a premature termination codon, predicted to cause a truncated or absent HEXB protein due to nonsense mediated decay, which are commonly known mechanisms for disease. This variant was found in 8/277214 control chromosomes at a frequency of 0.0000289, which does not exceed the estimated maximal expected allele frequency of a pathogenic HEXB variant (0.001479). The variant has been identified in numerous patients as both a homozygous and compound heterozygous allele. Functional studies suggest that HEXB enzyme activity is severely affected, though these studies are complicated by the fact that the variant causes HEXB to be heat-sensitive, which is the major method of separating HEXA and HEXB activity. In addition, multiple clinical diagnostic laboratories/reputable databases classified this variant as pathogenic. Taken together, this variant is classified as pathogenic. -
Pathogenic, criteria provided, single submitterclinical testingCentogene AG - the Rare Disease Company-- -
Pathogenic, criteria provided, single submitterclinical testingFoundation for Research in Genetics and Endocrinology, FRIGE's Institute of Human GeneticsDec 26, 2022A compound heterozygous status for the variant c.850C>T (p.Arg284Ter) in Exon 7 of the HEXB gene was detected. The variants have not been reported in the 1000 genomes database and has a MAF of 0.003% in the gnomAD database. The in-silico prediction is disease causing by Mutation Taster and DANN. In summary, the variant meets our criteria to be classified as pathogenic. -
Pathogenic, no assertion criteria providedclinical testingNatera, Inc.Sep 16, 2020- -
Pathogenic, criteria provided, single submitterclinical testingLifecell International Pvt. Ltd-A Homozygote Nonsense variant c.850C>T in Exon 7 of the HEXB gene that results in the amino acid substitution p.Arg284* was identified. The observed variant has a minor allele frequency of 0.00003% in gnomAD exomes. The severity of the impact of this variant on the protein is high, based on the effect of the protein and REVEL score . Rare Exome Variant Ensemble Learner (REVEL) is an ensembl method for predicting the pathogenicity of missense variants based on a combination of scores from 13 individual tools: MutPred, FATHMM v2.3, VEST 3.0, PolyPhen-2, SIFT, PROVEAN, MutationAssessor, MutationTaster, LRT, GERP++, SiPhy, phyloP, and phastCons. The REVEL score for an individual missense variant can range from 0 to 1, with higher scores reflecting greater likelihood that the variant is disease-causing. ClinVar has also classified this variant as Pathogenic(Vaiant ID 3887).This variant has been previously reported in Zhang Z-X et al., 1994. Based on the above evidence this variant has been classified as Pathogenic according to the ACMG guidelines. -
Pathogenic, criteria provided, single submitterclinical testingCourtagen Diagnostics Laboratory, Courtagen Life SciencesMar 04, 2015- -
Pathogenic, no assertion criteria providedclinical testingCounsylMay 09, 2018- -
Pathogenic, criteria provided, single submitterclinical testingNeuberg Centre For Genomic Medicine, NCGM-The stop gained p.R284* in HEXB (NM_000521.4) has been reported previously in multipel affected patients with Sandhoff disease including patients of Indian origin (Mahdieh N et al,Tamhankar PM et al). It has been submitted to ClinVar as Pathogenic. The p.R284* variant is observed in 7/30,616 (0.0229%) alleles from individuals of South Asian background in gnomAD Exomes and is novel (not in any individuals) in 1000 Genomes. This variant is predicted to cause loss of normal protein function through protein truncation. For these reasons, this variant has been classified as Pathogenic. -
not provided Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingGeneDxMar 04, 2021Observed in multiple unrelated individuals with Sandhoff disease (PMID: 8162015, 24613245, 23046579); Reported both with a second pathogenic variant on the opposite allele (in trans) and in the apparently homozygous state in affected individuals, and not observed in homozygous state in controls (PMID: 8162015, 24613245, 23046579); Nonsense variant predicted to result in protein truncation or nonsense mediated decay in a gene for which loss-of-function is a known mechanism of disease; This variant is associated with the following publications: (PMID: 26020229, 21483992, 24613245, 23046579, 1532910, 25525159, 19282776, 23430803, 18758829, 29448188, 30075786, 33083013, 34554397, 8162015) -
Sandhoff disease, infantile form Pathogenic:1
Pathogenic, no assertion criteria providedliterature onlyOMIMFeb 01, 2009- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
BayesDel_addAF
Pathogenic
0.37
D
BayesDel_noAF
Pathogenic
0.59
CADD
Pathogenic
37
DANN
Uncertain
1.0
Eigen
Uncertain
0.65
Eigen_PC
Uncertain
0.51
FATHMM_MKL
Uncertain
0.90
D
MutationTaster
Benign
1.0
A;A
Vest4
0.85
GERP RS
3.5
RBP_binding_hub_radar
0.0
RBP_regulation_power_radar
1.7

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: rs121907986; hg19: chr5-74009409; COSMIC: COSV54668906; COSMIC: COSV54668906; API