rs146243145

Variant summary

Our verdict is Benign. The variant received -9 ACMG points: 0P and 9B. BP4_StrongBP6BS2

The NM_198576.4(AGRN):​c.2501G>A​(p.Arg834Gln) variant causes a missense change. The variant allele was found at a frequency of 0.00132 in 1,612,966 control chromosomes in the GnomAD database, including 3 homozygotes. In-silico tool predicts a benign outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. R834G) has been classified as Uncertain significance.

Frequency

Genomes: 𝑓 0.00096 ( 0 hom., cov: 34)
Exomes 𝑓: 0.0014 ( 3 hom. )

Consequence

AGRN
NM_198576.4 missense

Scores

1
9
8

Clinical Significance

Conflicting classifications of pathogenicity criteria provided, conflicting classifications U:1B:2

Conservation

PhyloP100: 6.31

Publications

3 publications found
Variant links:
Genes affected
AGRN (HGNC:329): (agrin) This gene encodes one of several proteins that are critical in the development of the neuromuscular junction (NMJ), as identified in mouse knock-out studies. The encoded protein contains several laminin G, Kazal type serine protease inhibitor, and epidermal growth factor domains. Additional post-translational modifications occur to add glycosaminoglycans and disulfide bonds. In one family with congenital myasthenic syndrome affecting limb-girdle muscles, a mutation in this gene was found. Alternative splicing results in multiple transcript variants encoding different isoforms. [provided by RefSeq, Mar 2015]
AGRN Gene-Disease associations (from GenCC):
  • congenital myasthenic syndrome 8
    Inheritance: AR Classification: STRONG Submitted by: PanelApp Australia, Labcorp Genetics (formerly Invitae), Genomics England PanelApp
  • presynaptic congenital myasthenic syndrome
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • postsynaptic congenital myasthenic syndrome
    Inheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Benign. The variant received -9 ACMG points.

BP4
Computational evidence support a benign effect (MetaRNN=0.056515425).
BP6
Variant 1-1045488-G-A is Benign according to our data. Variant chr1-1045488-G-A is described in ClinVar as Conflicting_classifications_of_pathogenicity. ClinVar VariationId is 387869.
BS2
High Homozygotes in GnomAdExome4 at 3 AR,AD gene

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
AGRNNM_198576.4 linkc.2501G>A p.Arg834Gln missense_variant Exon 14 of 36 ENST00000379370.7 NP_940978.2

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
AGRNENST00000379370.7 linkc.2501G>A p.Arg834Gln missense_variant Exon 14 of 36 1 NM_198576.4 ENSP00000368678.2

Frequencies

GnomAD3 genomes
AF:
0.000966
AC:
147
AN:
152222
Hom.:
0
Cov.:
34
show subpopulations
Gnomad AFR
AF:
0.000507
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.0000654
Gnomad ASJ
AF:
0.00
Gnomad EAS
AF:
0.00
Gnomad SAS
AF:
0.00145
Gnomad FIN
AF:
0.000471
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.00163
Gnomad OTH
AF:
0.000955
GnomAD2 exomes
AF:
0.00116
AC:
289
AN:
250056
AF XY:
0.00131
show subpopulations
Gnomad AFR exome
AF:
0.000495
Gnomad AMR exome
AF:
0.000116
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.000464
Gnomad NFE exome
AF:
0.00179
Gnomad OTH exome
AF:
0.000819
GnomAD4 exome
AF:
0.00136
AC:
1982
AN:
1460626
Hom.:
3
Cov.:
34
AF XY:
0.00135
AC XY:
983
AN XY:
726600
show subpopulations
African (AFR)
AF:
0.000388
AC:
13
AN:
33478
American (AMR)
AF:
0.000157
AC:
7
AN:
44712
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
26130
East Asian (EAS)
AF:
0.00
AC:
0
AN:
39694
South Asian (SAS)
AF:
0.00152
AC:
131
AN:
86256
European-Finnish (FIN)
AF:
0.000555
AC:
29
AN:
52284
Middle Eastern (MID)
AF:
0.000173
AC:
1
AN:
5768
European-Non Finnish (NFE)
AF:
0.00156
AC:
1737
AN:
1111932
Other (OTH)
AF:
0.00106
AC:
64
AN:
60372
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.480
Heterozygous variant carriers
0
137
274
412
549
686
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome Het
Exome Hom
Variant carriers
0
64
128
192
256
320
<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:
0.000965
AC:
147
AN:
152340
Hom.:
0
Cov.:
34
AF XY:
0.000953
AC XY:
71
AN XY:
74496
show subpopulations
African (AFR)
AF:
0.000505
AC:
21
AN:
41574
American (AMR)
AF:
0.0000653
AC:
1
AN:
15308
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3472
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5186
South Asian (SAS)
AF:
0.00145
AC:
7
AN:
4826
European-Finnish (FIN)
AF:
0.000471
AC:
5
AN:
10622
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
294
European-Non Finnish (NFE)
AF:
0.00163
AC:
111
AN:
68030
Other (OTH)
AF:
0.000945
AC:
2
AN:
2116
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.488
Heterozygous variant carriers
0
8
16
24
32
40
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Genome Het
Variant carriers
0
4
8
12
16
20
<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:
0.00149
Hom.:
0
Bravo
AF:
0.000952
TwinsUK
AF:
0.000539
AC:
2
ALSPAC
AF:
0.00234
AC:
9
ESP6500AA
AF:
0.000227
AC:
1
ESP6500EA
AF:
0.00140
AC:
12
ExAC
AF:
0.00129
AC:
156
Asia WGS
AF:
0.000289
AC:
1
AN:
3478
EpiCase
AF:
0.00169
EpiControl
AF:
0.00136

ClinVar

Significance: Conflicting classifications of pathogenicity
Submissions summary: Uncertain:1Benign:2
Revision: criteria provided, conflicting classifications
LINK: link

Submissions by phenotype

not provided Uncertain:1
Mar 28, 2025
GeneDx
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

Reported in a patient with congenital myasthenic syndrome in the published literature who also had a variant in another gene that may have been responsible for the phenotype (PMID: 27397848); 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: 27397848) -

AGRN-related disorder Benign:1
Sep 06, 2023
PreventionGenetics, part of Exact Sciences
Significance:Likely benign
Review Status:no assertion criteria provided
Collection Method:clinical testing

This variant is classified as likely benign based on ACMG/AMP sequence variant interpretation guidelines (Richards et al. 2015 PMID: 25741868, with internal and published modifications). -

Congenital myasthenic syndrome 8 Benign:1
Jan 30, 2025
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.25
BayesDel_addAF
Benign
-0.22
T
BayesDel_noAF
Benign
-0.090
CADD
Pathogenic
27
DANN
Pathogenic
1.0
Eigen
Uncertain
0.57
Eigen_PC
Uncertain
0.58
FATHMM_MKL
Uncertain
0.95
D
LIST_S2
Uncertain
0.95
D;D
M_CAP
Uncertain
0.097
D
MetaRNN
Benign
0.057
T;T
MetaSVM
Benign
-0.61
T
MutationAssessor
Benign
1.2
L;.
PhyloP100
6.3
PrimateAI
Uncertain
0.60
T
PROVEAN
Uncertain
-2.6
D;.
REVEL
Uncertain
0.33
Sift
Benign
0.14
T;.
Sift4G
Uncertain
0.0090
D;D
Vest4
0.61
MVP
0.79
MPC
0.36
ClinPred
0.052
T
GERP RS
5.4
gMVP
0.44
Mutation Taster
=53/47
polymorphism

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.010
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: rs146243145; hg19: chr1-980868; API