Our verdict is Uncertain significance. Variant got 5 ACMG points: 5P and 0B. PVS1_ModeratePM2PP5
The NM_018062.4(FANCL):c.273+1G>C variant causes a splice donor change. The variant allele was found at a frequency of 0.0000137 in 1,611,174 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. 3/3 splice prediction tools predicting alterations to normal splicing. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars).
FANCL (HGNC:20748): (FA complementation group L) This gene encodes a ubiquitin ligase that is a member of the Fanconi anemia complementation group (FANC). Members of this group are related by their assembly into a common nuclear protein complex rather than by sequence similarity. This gene encodes the protein for complementation group L that mediates monoubiquitination of FANCD2 as well as FANCI. Fanconi anemia is a genetically heterogeneous recessive disorder characterized by cytogenetic instability, hypersensitivity to DNA crosslinking agents, increased chromosomal breakage, and defective DNA repair. Alternative splicing results in multiple transcript variants. [provided by RefSeq, May 2018]
Verdict is Uncertain_significance. Variant got 5 ACMG points.
PVS1
Splicing +-2 bp (donor or acceptor) variant, product NOT destroyed by NMD, known LOF gene, truncates exone, which is 0.04964539 fraction of the gene. No cryptic splice site detected. Exon removal is inframe change.
PM2
Very rare variant in population databases, with high coverage;
PP5
Variant 2-58226727-C-G is Pathogenic according to our data. Variant chr2-58226727-C-G is described in ClinVar as [Conflicting_classifications_of_pathogenicity]. Clinvar id is 1516268.We mark this variant Likely_pathogenic, oryginal submissions are: {Likely_pathogenic=2, Uncertain_significance=1}.
Fanconi anemia complementation group L Pathogenic:1Uncertain:1
Likely pathogenic, criteria provided, single submitter
clinical testing
Fulgent Genetics, Fulgent Genetics
Oct 15, 2021
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Uncertain significance, criteria provided, single submitter
clinical testing
Baylor Genetics
Nov 20, 2021
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Fanconi anemia Pathogenic:1
Likely pathogenic, criteria provided, single submitter
clinical testing
Labcorp Genetics (formerly Invitae), Labcorp
Sep 25, 2023
This variant is present in population databases (rs144729980, gnomAD 0.0009%). This sequence change affects a donor splice site in intron 4 of the FANCL gene. It is expected to disrupt RNA splicing. Variants that disrupt the donor or acceptor splice site typically lead to a loss of protein function (PMID: 16199547), and loss-of-function variants in FANCL are known to be pathogenic (PMID: 19405097, 23613520). This variant has not been reported in the literature in individuals affected with FANCL-related conditions. 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. ClinVar contains an entry for this variant (Variation ID: 1516268). -