rs148032587

Variant summary

Our verdict is Pathogenic. Variant got 16 ACMG points: 16P and 0B. PM1PM2PP3_StrongPP5_Very_Strong

The NM_000303.3(PMM2):​c.442G>A​(p.Asp148Asn) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.000565 in 1,544,316 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 (★★).

Frequency

Genomes: 𝑓 0.00013 ( 0 hom., cov: 34)
Exomes 𝑓: 0.00061 ( 0 hom. )

Consequence

PMM2
NM_000303.3 missense

Scores

12
4
3

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:12

Conservation

PhyloP100: 9.73
Variant links:
Genes affected
PMM2 (HGNC:9115): (phosphomannomutase 2) The protein encoded by this gene catalyzes the isomerization of mannose 6-phosphate to mannose 1-phosphate, which is a precursor to GDP-mannose necessary for the synthesis of dolichol-P-oligosaccharides. Mutations in this gene have been shown to cause defects in glycoprotein biosynthesis, which manifests as carbohydrate-deficient glycoprotein syndrome type I. [provided by RefSeq, Jul 2008]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 16 ACMG points.

PM1
In a chain Phosphomannomutase 2 (size 244) in uniprot entity PMM2_HUMAN there are 79 pathogenic changes around while only 2 benign (98%) in NM_000303.3
PM2
Very rare variant in population databases, with high coverage;
PP3
MetaRNN computational evidence supports a deleterious effect, 0.962
PP5
Variant 16-8811173-G-A is Pathogenic according to our data. Variant chr16-8811173-G-A is described in ClinVar as [Likely_pathogenic]. Clinvar id is 197659.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-8811173-G-A is described in Lovd as [Pathogenic].

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE Protein UniProt
PMM2NM_000303.3 linkuse as main transcriptc.442G>A p.Asp148Asn missense_variant 5/8 ENST00000268261.9 NP_000294.1
PMM2XM_047434215.1 linkuse as main transcriptc.193G>A p.Asp65Asn missense_variant 3/6 XP_047290171.1

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Protein Appris UniProt
PMM2ENST00000268261.9 linkuse as main transcriptc.442G>A p.Asp148Asn missense_variant 5/81 NM_000303.3 ENSP00000268261 P1O15305-1

Frequencies

GnomAD3 genomes
AF:
0.000131
AC:
20
AN:
152172
Hom.:
0
Cov.:
34
show subpopulations
Gnomad AFR
AF:
0.000217
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:
0.000147
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.000159
AC:
28
AN:
176372
Hom.:
0
AF XY:
0.000171
AC XY:
16
AN XY:
93724
show subpopulations
Gnomad AFR exome
AF:
0.0000936
Gnomad AMR exome
AF:
0.00
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad SAS exome
AF:
0.0000826
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.000354
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.000613
AC:
853
AN:
1392144
Hom.:
0
Cov.:
28
AF XY:
0.000582
AC XY:
401
AN XY:
689580
show subpopulations
Gnomad4 AFR exome
AF:
0.000126
Gnomad4 AMR exome
AF:
0.00
Gnomad4 ASJ exome
AF:
0.00
Gnomad4 EAS exome
AF:
0.00
Gnomad4 SAS exome
AF:
0.0000373
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.000782
Gnomad4 OTH exome
AF:
0.000225
GnomAD4 genome
AF:
0.000131
AC:
20
AN:
152172
Hom.:
0
Cov.:
34
AF XY:
0.000108
AC XY:
8
AN XY:
74336
show subpopulations
Gnomad4 AFR
AF:
0.000217
Gnomad4 AMR
AF:
0.0000655
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.00
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.000147
Gnomad4 OTH
AF:
0.00
Alfa
AF:
0.000297
Hom.:
0
Bravo
AF:
0.000162
TwinsUK
AF:
0.00162
AC:
6
ALSPAC
AF:
0.00104
AC:
4
ESP6500AA
AF:
0.000228
AC:
1
ESP6500EA
AF:
0.000583
AC:
5
ExAC
AF:
0.000124
AC:
14

ClinVar

Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:12
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

PMM2-congenital disorder of glycosylation Pathogenic:5
Pathogenic, criteria provided, single submitterclinical testingLabcorp Genetics (formerly Invitae), LabcorpJan 29, 2024This sequence change replaces aspartic acid, which is acidic and polar, with asparagine, which is neutral and polar, at codon 148 of the PMM2 protein (p.Asp148Asn). This variant is present in population databases (rs148032587, gnomAD 0.03%). This missense change has been observed in individual(s) with PMM2-CDG (CDG-Ia) (PMID: 10801058, 11715002, 18203160). 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: 197659). 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 PMM2 protein function with a positive predictive value of 95%. Experimental studies have shown that this missense change affects PMM2 function (PMID: 11715002). For these reasons, this variant has been classified as Pathogenic. -
Pathogenic, criteria provided, single submitterclinical testingBaylor GeneticsMar 20, 2024- -
Likely pathogenic, criteria provided, single submitterclinical testingMyriad Genetics, Inc.Nov 09, 2021NM_000303.2(PMM2):c.442G>A(D148N) is a missense variant classified as likely pathogenic in the context of congenital disorder of glycosylation type Ia. D148N has been observed in cases with relevant disease (PMID: 18203160, 11715002, 10801058, 33413482, 32635232). Functional assessments of this variant are available in the literature (PMID: 11715002). D148N has been observed in population frequency databases (gnomAD: NFE 0.04%). In summary, NM_000303.2(PMM2):c.442G>A(D148N) is a missense variant that has been observed more frequently in cases with the relevant disease than in healthy populations. Please note: this variant was assessed in the context of healthy population screening. -
Pathogenic, criteria provided, single submitterclinical testingWomen's Health and Genetics/Laboratory Corporation of America, LabCorpJul 28, 2022Variant summary: PMM2 c.442G>A (p.Asp148Asn) results in a conservative amino acid change in 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 0.00016 in 176372 control chromosomes (gnomAD). This frequency is not significantly higher than expected for a pathogenic variant in PMM2 causing Congenital Disorder Of Glycosylation Type 1a (0.00016 vs 0.0056), allowing no conclusion about variant significance. c.442G>A has been reported in the literature in compound heterozygous individuals affected with Congenital Disorder Of Glycosylation Type 1a (Imtiaz_2000, Matthijs_2000, Westphal_2001, Franscisco_2020). These data indicate that the variant is likely to be associated with disease. At least one functional study reports the variant results in reducing enzyme activity (Westphal_2001). Eight Three ClinVar submitters (evaluation after 2014) cite the variant as pathogenic (n=6) and likely pathogenic (n=2). Based on the evidence outlined above, the variant was classified as pathogenic. -
Pathogenic, no assertion criteria providedclinical testingNatera, Inc.Sep 16, 2020- -
not provided Pathogenic:5
Pathogenic, criteria provided, single submitterclinical testingCenter for Pediatric Genomic Medicine, Children's Mercy Hospital and ClinicsSep 05, 2017- -
Pathogenic, criteria provided, single submitterclinical testingEurofins Ntd Llc (ga)Jun 04, 2014- -
Likely pathogenic, criteria provided, single submitterclinical testingGenetic Services Laboratory, University of ChicagoMay 29, 2018- -
Pathogenic, no assertion criteria providedclinical testingDepartment of Pathology and Laboratory Medicine, Sinai Health System-The PMM2 p.D148N variant was identified in 2 of 36 proband chromosomes (frequency: 0.056) from families with congenital disorders of glycosylation (CDG) type 1A (Imtiaz_2000_PMID:10801058; Westphal_2001_PMID:11715002). The variant was identified in dbSNP (ID: rs148032587), ClinVar (classified as likely pathogenic by Counsyl and as pathogenic by Invitae, Ambry Genetics, EGL Genetics and the Center for Pediatric Genomic Medicine at Children's Mercy Hospital and Clinics) and LOVD 3.0 (classified as pathogenic). The variant was also identified in control databases in 32 of 207784 chromosomes at a frequency of 0.000154 (Genome Aggregation Database Feb 27, 2017). The variant was observed in the following populations: European (non-Finnish) in 26 of 86006 chromosomes (freq: 0.000302), African in 4 of 19396 chromosomes (freq: 0.000206) and South Asian in 2 of 24218 chromosomes (freq: 0.000083), but was not observed in the Latino, Ashkenazi Jewish, East Asian, European (Finnish) or Other populations. The variant occurs outside of the splicing consensus sequence and in silico or computational prediction software programs (SpliceSiteFinder, MaxEntScan, NNSPLICE, GeneSplicer) do not predict a difference in splicing. Although computational analyses (PolyPhen-2, SIFT, AlignGVGD, BLOSUM, MutationTaster) provide inconsistent predictions regarding the impact to the protein, the p.D148 residue is highly conserved in mammals and other organisms. Further, expression of a vector carrying the p.D148N variant showed decreased PMM activity compared to wildtype (Westphal_2001_PMID:11715002). In summary, based on the above information this variant meets our laboratory’s criteria to be classified as pathogenic. -
Pathogenic, criteria provided, single submitterclinical testingGeneDxFeb 25, 2022Published functional studies demonstrate a damaging effect (Westphal et al., 2001); 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: 26014514, 28425223, 18203160, 11715002, 25525159, 9140401, 10527672, 10602363, 10854097, 15844218, 21949237, 24498599, 26488408, 26805780, 28373276, 28492532, 11058895, 21811164, 11343337, 10801058, 32874916, 19176971, 31589614, 33413482, 32841164, 32635232) -
Inborn genetic diseases Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingAmbry GeneticsSep 16, 2016- -
PMM2-related disorder Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingPreventionGenetics, part of Exact SciencesDec 01, 2022The PMM2 c.442G>A variant is predicted to result in the amino acid substitution p.Asp148Asn. This variant has been reported in patients with congenital disorder of glycosylation 1a (see, for example, Imtiaz et al. 2000. PubMed ID: 10801058; Westphal et al. 2001. PubMed ID: 11715002; Starosta et al. 2021. PubMed ID: 33413482; Francisco et al. 2020. PubMed ID: 32635232). This variant was also described, along with a second potentially causative variant, in an individual with abnormal transferrin isoforms (Schon et al. 2021. PubMed ID: 34732400, supplementary data), and in vitro functional data suggest that this variant results in a thermolabile enzyme (Westphal et al. 2001. PubMed ID: 11715002). This variant was also described in the compound heterozygous state, along with a promoter variant, in a patient with polycystic kidney disease and hyperinsulinemic hypoglycemia, an allelic disorder to classic CDG type 1a (Moreno Macian et al. 2020. PubMed ID: 32841164). This variant is reported in 0.030% of alleles in individuals of European (Non-Finnish) descent in gnomAD (http://gnomad.broadinstitute.org/variant/16-8905030-G-A). This variant is interpreted as pathogenic. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
0.93
BayesDel_addAF
Benign
-0.033
T
BayesDel_noAF
Pathogenic
0.16
CADD
Pathogenic
27
DANN
Pathogenic
1.0
DEOGEN2
Pathogenic
0.93
D;D
Eigen
Pathogenic
0.73
Eigen_PC
Uncertain
0.63
FATHMM_MKL
Pathogenic
0.97
D
LIST_S2
Uncertain
0.89
D;D
M_CAP
Pathogenic
0.37
D
MetaRNN
Pathogenic
0.96
D;D
MetaSVM
Pathogenic
1.1
D
MutationAssessor
Pathogenic
3.4
.;M
MutationTaster
Benign
1.0
D;D;D;D;D
PrimateAI
Uncertain
0.60
T
PROVEAN
Pathogenic
-4.6
D;D
REVEL
Pathogenic
0.85
Sift
Benign
0.034
D;D
Sift4G
Uncertain
0.048
D;D
Polyphen
1.0
.;D
Vest4
0.95
MVP
0.98
MPC
0.016
ClinPred
0.79
D
GERP RS
5.3
Varity_R
0.79
gMVP
0.88

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

LitVar

Below is the list of publications found by LitVar. It may be empty.

Other links and lift over

dbSNP: rs148032587; hg19: chr16-8905030; API