rs121909383

Variant summary

Our verdict is Pathogenic. Variant got 18 ACMG points: 18P and 0B. PM1PM2PM5PP3_StrongPP5_Very_Strong

The NM_001126108.2(SLC12A3):​c.1046C>T​(p.Pro349Leu) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.0000514 in 1,614,136 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 Likely pathogenic (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. P349A) has been classified as Likely pathogenic.

Frequency

Genomes: 𝑓 0.000013 ( 0 hom., cov: 33)
Exomes 𝑓: 0.000055 ( 0 hom. )

Consequence

SLC12A3
NM_001126108.2 missense

Scores

14
4
1

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:4

Conservation

PhyloP100: 7.86
Variant links:
Genes affected
SLC12A3 (HGNC:10912): (solute carrier family 12 member 3) This gene encodes a renal thiazide-sensitive sodium-chloride cotransporter that is important for electrolyte homeostasis. This cotransporter mediates sodium and chloride reabsorption in the distal convoluted tubule. Mutations in this gene cause Gitelman syndrome, a disease similar to Bartter's syndrome, that is characterized by hypokalemic alkalosis combined with hypomagnesemia, low urinary calcium, and increased renin activity associated with normal blood pressure. This cotransporter is the target for thiazide diuretics that are used for treating high blood pressure. Multiple transcript variants encoding different isoforms have been found for this gene. [provided by RefSeq, Jul 2008]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 18 ACMG points.

PM1
In a transmembrane_region Helical (size 20) in uniprot entity S12A3_HUMAN there are 9 pathogenic changes around while only 0 benign (100%) in NM_001126108.2
PM2
Very rare variant in population databases, with high coverage;
PM5
Other missense variant is known to change same aminoacid residue: Variant chr16-56872736-C-T is described in ClinVar as [Pathogenic]. Clinvar id is 2733260.Status of the report is criteria_provided_single_submitter, 1 stars.
PP3
MetaRNN computational evidence supports a deleterious effect, 0.975
PP5
Variant 16-56872737-C-T is Pathogenic according to our data. Variant chr16-56872737-C-T is described in ClinVar as [Likely_pathogenic]. Clinvar id is 8592.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE UniProt
SLC12A3NM_001126108.2 linkuse as main transcriptc.1046C>T p.Pro349Leu missense_variant 8/26 ENST00000563236.6
SLC12A3NM_000339.3 linkuse as main transcriptc.1046C>T p.Pro349Leu missense_variant 8/26
SLC12A3NM_001126107.2 linkuse as main transcriptc.1043C>T p.Pro348Leu missense_variant 8/26
SLC12A3NM_001410896.1 linkuse as main transcriptc.1043C>T p.Pro348Leu missense_variant 8/26

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Appris UniProt
SLC12A3ENST00000563236.6 linkuse as main transcriptc.1046C>T p.Pro349Leu missense_variant 8/261 NM_001126108.2 A1P55017-1
SLC12A3ENST00000438926.6 linkuse as main transcriptc.1046C>T p.Pro349Leu missense_variant 8/261 A1P55017-2
SLC12A3ENST00000566786.5 linkuse as main transcriptc.1043C>T p.Pro348Leu missense_variant 8/261 P4P55017-3
SLC12A3ENST00000262502.5 linkuse as main transcriptc.1043C>T p.Pro348Leu missense_variant 8/265 A1

Frequencies

GnomAD3 genomes
AF:
0.0000131
AC:
2
AN:
152258
Hom.:
0
Cov.:
33
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:
0.00000398
AC:
1
AN:
251466
Hom.:
0
AF XY:
0.00000736
AC XY:
1
AN XY:
135912
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:
0.00
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000554
AC:
81
AN:
1461878
Hom.:
0
Cov.:
32
AF XY:
0.0000481
AC XY:
35
AN XY:
727240
show subpopulations
Gnomad4 AFR exome
AF:
0.0000896
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:
0.0000692
Gnomad4 OTH exome
AF:
0.0000166
GnomAD4 genome
AF:
0.0000131
AC:
2
AN:
152258
Hom.:
0
Cov.:
33
AF XY:
0.0000134
AC XY:
1
AN XY:
74390
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:
0.0000126
Hom.:
0
Bravo
AF:
0.0000113

ClinVar

Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:4
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Familial hypokalemia-hypomagnesemia Pathogenic:3
Pathogenic, no assertion criteria providedliterature onlyOMIMJan 01, 1996- -
Likely pathogenic, criteria provided, single submitterclinical testingFulgent Genetics, Fulgent GeneticsMay 06, 2022- -
Likely pathogenic, no assertion criteria providedclinical testingNatera, Inc.Mar 18, 2021- -
not provided Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingLabcorp Genetics (formerly Invitae), LabcorpJan 18, 2024This sequence change replaces proline, which is neutral and non-polar, with leucine, which is neutral and non-polar, at codon 349 of the SLC12A3 protein (p.Pro349Leu). This variant is present in population databases (rs121909383, gnomAD 0.007%). This missense change has been observed in individuals with Gitelman's syndrome (PMID: 8528245, 8900229, 21415153). It has also been observed to segregate with disease in related individuals. ClinVar contains an entry for this variant (Variation ID: 8592). 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 expected to disrupt SLC12A3 protein function with a positive predictive value of 95%. For these reasons, this variant has been classified as Pathogenic. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
0.96
BayesDel_addAF
Pathogenic
0.44
D
BayesDel_noAF
Pathogenic
0.57
CADD
Pathogenic
29
DANN
Uncertain
1.0
DEOGEN2
Pathogenic
0.96
.;.;D;D
Eigen
Pathogenic
1.0
Eigen_PC
Pathogenic
0.96
FATHMM_MKL
Pathogenic
0.99
D
LIST_S2
Pathogenic
0.99
D;D;D;D
M_CAP
Uncertain
0.20
D
MetaRNN
Pathogenic
0.97
D;D;D;D
MetaSVM
Uncertain
0.68
D
MutationAssessor
Pathogenic
4.4
.;H;H;.
MutationTaster
Benign
1.0
A;A;A;A
PrimateAI
Pathogenic
0.82
D
PROVEAN
Pathogenic
-9.2
D;D;D;D
REVEL
Pathogenic
0.94
Sift
Uncertain
0.0010
D;D;D;D
Sift4G
Pathogenic
0.0010
D;D;D;D
Polyphen
1.0
D;D;D;.
Vest4
0.98
MutPred
0.85
.;Loss of glycosylation at S350 (P = 0.1219);Loss of glycosylation at S350 (P = 0.1219);.;
MVP
0.99
MPC
0.48
ClinPred
1.0
D
GERP RS
5.7
Varity_R
0.95
gMVP
1.0

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.050
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: rs121909383; hg19: chr16-56906649; COSMIC: COSV99344704; API