rs121908865

Variant summary

Our verdict is Pathogenic. Variant got 10 ACMG points: 10P and 0B. PS1_ModeratePP5_Very_Strong

The NM_000369.5(TSHR):​c.326G>A​(p.Arg109Gln) variant causes a missense change. The variant allele was found at a frequency of 0.00000682 in 1,612,898 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Likely pathogenic (★★). Another nucleotide change resulting in same amino acid change has been previously reported as Likely pathogenicin UniProt.

Frequency

Genomes: 𝑓 0.000013 ( 0 hom., cov: 32)
Exomes 𝑓: 0.0000062 ( 0 hom. )

Consequence

TSHR
NM_000369.5 missense

Scores

1
10
8

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:3

Conservation

PhyloP100: 5.78
Variant links:
Genes affected
TSHR (HGNC:12373): (thyroid stimulating hormone receptor) The protein encoded by this gene is a membrane protein and a major controller of thyroid cell metabolism. The encoded protein is a receptor for thyrothropin and thyrostimulin, and its activity is mediated by adenylate cyclase. Defects in this gene are a cause of several types of hyperthyroidism. Three transcript variants encoding different isoforms have been found for this gene. [provided by RefSeq, Dec 2008]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 10 ACMG points.

PS1
Transcript NM_000369.5 (TSHR) is affected with MISSENSE_VARIANT having same AA change as one Pathogenic present in UniProt
PP5
Variant 14-81087962-G-A is Pathogenic according to our data. Variant chr14-81087962-G-A is described in ClinVar as [Likely_pathogenic]. Clinvar id is 6438.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-81087962-G-A is described in Lovd as [Likely_pathogenic].

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE Protein UniProt
TSHRNM_000369.5 linkuse as main transcriptc.326G>A p.Arg109Gln missense_variant 4/10 ENST00000298171.7 NP_000360.2
LOC101928462XR_001751022.2 linkuse as main transcriptn.882-310C>T intron_variant, non_coding_transcript_variant

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Protein Appris UniProt
TSHRENST00000298171.7 linkuse as main transcriptc.326G>A p.Arg109Gln missense_variant 4/101 NM_000369.5 ENSP00000298171 P1
ENST00000646052.2 linkuse as main transcriptn.905-310C>T intron_variant, non_coding_transcript_variant

Frequencies

GnomAD3 genomes
AF:
0.0000131
AC:
2
AN:
152106
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.00
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.0000655
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:
0.0000147
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.0000199
AC:
5
AN:
251390
Hom.:
0
AF XY:
0.0000294
AC XY:
4
AN XY:
135882
show subpopulations
Gnomad AFR exome
AF:
0.0000615
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:
0.0000352
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.00000616
AC:
9
AN:
1460674
Hom.:
0
Cov.:
29
AF XY:
0.00000826
AC XY:
6
AN XY:
726760
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:
0.00
Gnomad4 NFE exome
AF:
0.00000810
Gnomad4 OTH exome
AF:
0.00
GnomAD4 genome
AF:
0.0000131
AC:
2
AN:
152224
Hom.:
0
Cov.:
32
AF XY:
0.00
AC XY:
0
AN XY:
74442
show subpopulations
Gnomad4 AFR
AF:
0.00
Gnomad4 AMR
AF:
0.0000654
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.00
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.0000147
Gnomad4 OTH
AF:
0.00
Bravo
AF:
0.00000378
ESP6500AA
AF:
0.00
AC:
0
ESP6500EA
AF:
0.000116
AC:
1
ExAC
AF:
0.0000165
AC:
2
EpiCase
AF:
0.0000545
EpiControl
AF:
0.00

ClinVar

Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:3
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Hypothyroidism due to TSH receptor mutations Pathogenic:2
Pathogenic, criteria provided, single submitterclinical testingWomen's Health and Genetics/Laboratory Corporation of America, LabCorpJun 18, 2024Variant summary: TSHR c.326G>A (p.Arg109Gln) results in a conservative amino acid change in the encoded protein sequence. Three of five in-silico tools predict a benign effect of the variant on protein function. The variant allele was found at a frequency of 2e-05 in 251390 control chromosomes. c.326G>A has been reported in the literature in the homozygous and compound heterozygous state in multiple individuals affected with Hypothyroidism Due To TSH Receptor Mutations (e.g. deFilippis_2017, Sigisawa_2018, Clifton-Bligh_1997, Watanabe_2021, Kara_2023). These data indicate that the variant is very likely to be associated with disease. In vitro studies in HEK293 and COS-7 cells show that this variant results in decreased enzyme activity and reduced binding affinity (e.g. Sugisawa_2018, Clifton-Bligh_1997). The following publications have been ascertained in the context of this evaluation (PMID: 9100579, 36913313, 30083029, 34234053, 28444304). ClinVar contains an entry for this variant (Variation ID: 6438). Based on the evidence outlined above, the variant was classified as pathogenic. -
Pathogenic, no assertion criteria providedliterature onlyOMIMApr 01, 1997- -
not provided Pathogenic:1
Likely pathogenic, criteria provided, single submitterclinical testingLabcorp Genetics (formerly Invitae), LabcorpAug 18, 2023ClinVar contains an entry for this variant (Variation ID: 6438). This missense change has been observed in individual(s) with autosomal recessive hypothyroidism (PMID: 9100579, 27637299, 28444304, 30083029). 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 (rs121908865, gnomAD 0.007%). This sequence change replaces arginine, which is basic and polar, with glutamine, which is neutral and polar, at codon 109 of the TSHR protein (p.Arg109Gln). Advanced modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) performed at Invitae indicates that this missense variant is not expected to disrupt TSHR protein function. In summary, the currently available evidence indicates that the variant is pathogenic, but additional data are needed to prove that conclusively. Therefore, this variant has been classified as Likely Pathogenic. Algorithms developed to predict the effect of sequence changes on RNA splicing suggest that this variant may disrupt the consensus splice site. Experimental studies have shown that this missense change affects TSHR function (PMID: 9100579, 30083029). -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Uncertain
0.35
BayesDel_addAF
Uncertain
0.15
D
BayesDel_noAF
Pathogenic
0.16
CADD
Uncertain
25
DANN
Uncertain
1.0
DEOGEN2
Uncertain
0.47
.;.;.;T;.
Eigen
Uncertain
0.54
Eigen_PC
Uncertain
0.60
FATHMM_MKL
Uncertain
0.94
D
LIST_S2
Benign
0.78
.;T;T;T;T
M_CAP
Uncertain
0.11
D
MetaRNN
Uncertain
0.58
D;D;D;D;D
MetaSVM
Benign
-0.56
T
MutationAssessor
Benign
1.4
.;L;.;.;L
MutationTaster
Benign
1.0
A;A;A;A;A
PrimateAI
Benign
0.48
T
PROVEAN
Benign
-0.28
N;N;N;N;N
REVEL
Uncertain
0.55
Sift
Benign
0.77
T;T;T;T;T
Sift4G
Benign
0.76
T;T;T;T;T
Polyphen
1.0
.;D;.;.;.
Vest4
0.88
MVP
0.99
MPC
0.71
ClinPred
0.74
D
GERP RS
5.8
gMVP
0.84

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.25
Details are displayed if max score is > 0.2
DS_AL_spliceai
0.25
Position offset: -8

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: rs121908865; hg19: chr14-81554306; COSMIC: COSV53314267; API