rs144181978

Variant summary

Our verdict is Uncertain significance. The variant received 3 ACMG points: 3P and 0B. PP3_ModeratePP5

The NM_080916.3(DGUOK):​c.462T>A​(p.Asn154Lys) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.000269 in 1,614,200 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 Conflicting classifications of pathogenicity (no stars).

Frequency

Genomes: 𝑓 0.00020 ( 0 hom., cov: 32)
Exomes 𝑓: 0.00028 ( 0 hom. )

Consequence

DGUOK
NM_080916.3 missense

Scores

5
11
3

Clinical Significance

Conflicting classifications of pathogenicity criteria provided, conflicting classifications P:10U:1

Conservation

PhyloP100: 0.0930

Publications

6 publications found
Variant links:
Genes affected
DGUOK (HGNC:2858): (deoxyguanosine kinase) In mammalian cells, the phosphorylation of purine deoxyribonucleosides is mediated predominantly by two deoxyribonucleoside kinases, cytosolic deoxycytidine kinase and mitochondrial deoxyguanosine kinase. The protein encoded by this gene is responsible for phosphorylation of purine deoxyribonucleosides in the mitochondrial matrix. In addition, this protein phosphorylates several purine deoxyribonucleoside analogs used in the treatment of lymphoproliferative disorders, and this phosphorylation is critical for the effectiveness of the analogs. Alternative splice variants encoding different protein isoforms have been described for this gene. [provided by RefSeq, Jul 2008]
DGUOK-AS1 (HGNC:43441): (DGUOK antisense RNA 1)

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Uncertain_significance. The variant received 3 ACMG points.

PP3
MetaRNN computational evidence supports a deleterious effect, 0.899
PP5
Variant 2-73950603-T-A is Pathogenic according to our data. Variant chr2-73950603-T-A is described in ClinVar as Conflicting_classifications_of_pathogenicity. ClinVar VariationId is 214285.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
DGUOKNM_080916.3 linkc.462T>A p.Asn154Lys missense_variant Exon 4 of 7 ENST00000264093.9 NP_550438.1 Q16854-1E5KSL5

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
DGUOKENST00000264093.9 linkc.462T>A p.Asn154Lys missense_variant Exon 4 of 7 1 NM_080916.3 ENSP00000264093.4 Q16854-1

Frequencies

GnomAD3 genomes
AF:
0.000204
AC:
31
AN:
152190
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.0000483
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:
0.000426
Gnomad OTH
AF:
0.00
GnomAD2 exomes
AF:
0.000135
AC:
34
AN:
251492
AF XY:
0.000147
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.00
Gnomad ASJ exome
AF:
0.0000992
Gnomad EAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.000281
Gnomad OTH exome
AF:
0.000163
GnomAD4 exome
AF:
0.000276
AC:
404
AN:
1461892
Hom.:
0
Cov.:
32
AF XY:
0.000267
AC XY:
194
AN XY:
727246
show subpopulations
African (AFR)
AF:
0.0000299
AC:
1
AN:
33480
American (AMR)
AF:
0.00
AC:
0
AN:
44724
Ashkenazi Jewish (ASJ)
AF:
0.0000765
AC:
2
AN:
26136
East Asian (EAS)
AF:
0.00
AC:
0
AN:
39700
South Asian (SAS)
AF:
0.0000348
AC:
3
AN:
86258
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
53420
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
5768
European-Non Finnish (NFE)
AF:
0.000348
AC:
387
AN:
1112010
Other (OTH)
AF:
0.000182
AC:
11
AN:
60396
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.471
Heterozygous variant carriers
0
22
43
65
86
108
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome Het
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:
0.000204
AC:
31
AN:
152308
Hom.:
0
Cov.:
32
AF XY:
0.000175
AC XY:
13
AN XY:
74476
show subpopulations
African (AFR)
AF:
0.0000481
AC:
2
AN:
41562
American (AMR)
AF:
0.00
AC:
0
AN:
15306
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3470
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5182
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4828
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10622
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
294
European-Non Finnish (NFE)
AF:
0.000426
AC:
29
AN:
68018
Other (OTH)
AF:
0.00
AC:
0
AN:
2114
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.498
Heterozygous variant carriers
0
1
3
4
6
7
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:
0.000307
Hom.:
0
Bravo
AF:
0.000253
ESP6500AA
AF:
0.00
AC:
0
ESP6500EA
AF:
0.000581
AC:
5
ExAC
AF:
0.000115
AC:
14
EpiCase
AF:
0.000545
EpiControl
AF:
0.000178

ClinVar

Significance: Conflicting classifications of pathogenicity
Submissions summary: Pathogenic:10Uncertain:1
Revision: criteria provided, conflicting classifications
LINK: link

Submissions by phenotype

not provided Pathogenic:5Uncertain:1
Jan 26, 2025
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This sequence change replaces asparagine, which is neutral and polar, with lysine, which is basic and polar, at codon 154 of the DGUOK protein (p.Asn154Lys). This variant is present in population databases (rs144181978, gnomAD 0.03%). This missense change has been observed in individual(s) with DGUOK-related conditions (PMID: 23043144, 29228108, 30283818, 30956829, 31664448). In at least one individual the data is consistent with being in trans (on the opposite chromosome) from a pathogenic variant. ClinVar contains an entry for this variant (Variation ID: 214285). Invitae Evidence Modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) indicates that this missense variant is expected to disrupt DGUOK protein function with a positive predictive value of 95%. For these reasons, this variant has been classified as Pathogenic. -

Oct 29, 2024
GeneDx
Significance:Likely pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

In silico analysis supports that this missense variant has a deleterious effect on protein structure/function; This variant is associated with the following publications: (PMID: 23043144, 30956829, 29228108, 30283818, 30393377, 32308999, 33513296, 35114397, 31664448, 29137425) -

Apr 01, 2025
CeGaT Center for Human Genetics Tuebingen
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

DGUOK: PM3:Very Strong, PM2 -

Dec 21, 2021
Mayo Clinic Laboratories, Mayo Clinic
Significance:Likely pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

PP3, PP4, PM2, PM3, PS4_moderate -

Oct 12, 2017
Eurofins Ntd Llc (ga)
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Nov 30, 2021
Revvity Omics, Revvity
Significance:Likely pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Mitochondrial DNA depletion syndrome 3 (hepatocerebral type) Pathogenic:1
May 05, 2023
Women's Health and Genetics/Laboratory Corporation of America, LabCorp
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

Variant summary: DGUOK c.462T>A (p.Asn154Lys) results in a non-conservative amino acid change located in the deoxynucleoside kinase domain (IPR031314) of the encoded protein sequence. Four of five in-silico tools predict a damaging effect of the variant on protein function. The variant allele was found at a frequency of 0.00014 in 251492 control chromosomes (gnomAD). c.462T>A has been reported in the literature in the compound heterozygous state in at least six individuals with multiple mitochondrial DNA deletions and primarily presenting with progressive external ophthalmoplegia and myopathy (e.g. Ronchi_2012, Komal_2018, Caporali_2018, Montano_2019, Goudenege_2019). These data indicate that the variant is very likely to be associated with Mitochondrial DNA depletion syndrome 3. To our knowledge, no experimental evidence demonstrating an impact on protein function has been reported. The following publications have been ascertained in the context of this evaluation (PMID: 28902392, 30393377, 31664448, 30956829, 23043144, 30283818 , 29228108 ). Seven submitters have provided clinical-significance assessments for this variant to ClinVar after 2014 and classified the variant as either pathogenic (n=3)/likely pathogenic (n=3) or VUS (n=1). Based on the evidence outlined above, the variant was classified as pathogenic. -

Inborn genetic diseases Pathogenic:1
Oct 18, 2022
Ambry Genetics
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The c.462T>A (p.N154K) alteration is located in exon 4 (coding exon 4) of the DGUOK gene. This alteration results from a T to A substitution at nucleotide position 462, causing the asparagine (N) at amino acid position 154 to be replaced by a lysine (K). Based on data from gnomAD, the A allele has an overall frequency of 0.014% (40/282882) total alleles studied. The highest observed frequency was 0.029% (37/129192) of European (non-Finnish) alleles. This alteration has been reported with a second DGUOK variant in multiple individuals with progressive external ophthalmoplegia and other features of adult-onset mitochondrial DNA depletion syndrome (Ronchi, 2012; Caporali, 2018; Komal, 2018; Montano, 2019). This amino acid position is not well conserved in available vertebrate species. This alteration is predicted to be tolerated by in silico analysis. Based on the available evidence, this alteration is classified as pathogenic. -

Progressive external ophthalmoplegia with mitochondrial DNA deletions, autosomal recessive 4 Pathogenic:1
Aug 18, 2016
OMIM
Significance:Pathogenic
Review Status:no assertion criteria provided
Collection Method:literature only

- -

DGUOK-related disorder Pathogenic:1
Jun 17, 2024
PreventionGenetics, part of Exact Sciences
Significance:Pathogenic
Review Status:no assertion criteria provided
Collection Method:clinical testing

The DGUOK c.462T>A variant is predicted to result in the amino acid substitution p.Asn154Lys. This variant was reported in the compound heterozygous state in three unrelated individuals presenting with late-onset progressive external ophthalmoplegia (Patients 1 and 2 in Ronchi et al. 2012. PubMed ID: 23043144; Montano et al. 2019. PubMed ID: 30956829). Analysis of muscle tissues of the patients from Ronchi et al. showed a severe defect in DGUOK activity (Ronchi et al. 2012. PubMed ID: 23043144). This variant is reported in 0.029% of alleles in individuals of European (Non-Finnish) descent in gnomAD. This variant is interpreted as pathogenic. -

Progressive external ophthalmoplegia with mitochondrial DNA deletions, autosomal recessive 4;C5191055:Mitochondrial DNA depletion syndrome 3 (hepatocerebral type);CN305369:Portal hypertension, noncirrhotic, 1 Pathogenic:1
Jun 17, 2024
Fulgent Genetics, Fulgent Genetics
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
0.79
BayesDel_addAF
Benign
-0.070
T
BayesDel_noAF
Uncertain
-0.030
CADD
Benign
22
DANN
Uncertain
1.0
DEOGEN2
Pathogenic
0.93
D
Eigen
Uncertain
0.38
Eigen_PC
Uncertain
0.25
FATHMM_MKL
Uncertain
0.86
D
LIST_S2
Uncertain
0.89
D
M_CAP
Uncertain
0.22
D
MetaRNN
Pathogenic
0.90
D
MetaSVM
Uncertain
0.73
D
MutationAssessor
Pathogenic
3.0
M
PhyloP100
0.093
PrimateAI
Uncertain
0.61
T
PROVEAN
Uncertain
-4.2
D
REVEL
Pathogenic
0.76
Sift
Uncertain
0.0020
D
Sift4G
Benign
0.067
T
Polyphen
1.0
D
Vest4
0.78
MutPred
0.81
Gain of helix (P = 0.062);
MVP
0.99
MPC
0.58
ClinPred
0.97
D
GERP RS
0.50
Varity_R
0.91
gMVP
0.81
Mutation Taster
=58/42
disease causing (ClinVar)

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: rs144181978; hg19: chr2-74177730; API