rs1554093487

Variant summary

Our verdict is Likely pathogenic. The variant received 6 ACMG points: 6P and 0B. PM1PM2PP3_Moderate

The NM_004387.4(NKX2-5):​c.491C>T​(p.Ser164Leu) variant causes a missense change involving the alteration of a conserved nucleotide. The variant was absent in control chromosomes in GnomAD project. In-silico tool predicts a pathogenic outcome for this variant. 14/22 in silico tools predict a damaging outcome for this variant. Variant has been reported in ClinVar as Uncertain significance (★★). Synonymous variant affecting the same amino acid position (i.e. S164S) has been classified as Likely benign.

Frequency

Genomes: not found (cov: 32)
Exomes 𝑓: 0.0 ( 0 hom. )
Failed GnomAD Quality Control

Consequence

NKX2-5
NM_004387.4 missense

Scores

17
1
1

Clinical Significance

Uncertain significance criteria provided, multiple submitters, no conflicts U:2

Conservation

PhyloP100: 9.97

Publications

0 publications found
Variant links:
Genes affected
NKX2-5 (HGNC:2488): (NK2 homeobox 5) This gene encodes a homeobox-containing transcription factor. This transcription factor functions in heart formation and development. Mutations in this gene cause atrial septal defect with atrioventricular conduction defect, and also tetralogy of Fallot, which are both heart malformation diseases. Mutations in this gene can also cause congenital hypothyroidism non-goitrous type 5, a non-autoimmune condition. Alternative splicing results in multiple transcript variants. [provided by RefSeq, Oct 2009]
NKX2-5 Gene-Disease associations (from GenCC):
  • atrial septal defect 7
    Inheritance: AD Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Genomics England PanelApp, G2P, Ambry Genetics, Labcorp Genetics (formerly Invitae), Laboratory for Molecular Medicine, Orphanet
  • hypothyroidism, congenital, nongoitrous, 5
    Inheritance: AD, Unknown Classification: DEFINITIVE, MODERATE, LIMITED Submitted by: G2P, Labcorp Genetics (formerly Invitae), Ambry Genetics
  • NKX2.5-related congenital, conduction and myopathic heart disease
    Inheritance: AD Classification: DEFINITIVE Submitted by: ClinGen
  • tetralogy of fallot
    Inheritance: AD Classification: DEFINITIVE Submitted by: G2P
  • conotruncal heart malformations
    Inheritance: SD, AD Classification: DEFINITIVE, STRONG Submitted by: Ambry Genetics, Labcorp Genetics (formerly Invitae)
  • athyreosis
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • familial atrial fibrillation
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • familial bicuspid aortic valve
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • familial isolated congenital asplenia
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • dilated cardiomyopathy
    Inheritance: AD Classification: LIMITED Submitted by: ClinGen

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Likely_pathogenic. The variant received 6 ACMG points.

PM1
In a hotspot region, there are 4 aminoacids with missense pathogenic changes in the window of +-8 aminoacids around while only 0 benign, 24 uncertain in NM_004387.4
PM2
Very rare variant in population databases, with high coverage;
PP3
MetaRNN computational evidence supports a deleterious effect, 0.933

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
NKX2-5NM_004387.4 linkc.491C>T p.Ser164Leu missense_variant Exon 2 of 2 ENST00000329198.5 NP_004378.1
NKX2-5NM_001166176.2 linkc.*290C>T 3_prime_UTR_variant Exon 2 of 2 NP_001159648.1
NKX2-5NM_001166175.2 linkc.*444C>T 3_prime_UTR_variant Exon 2 of 2 NP_001159647.1

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
NKX2-5ENST00000329198.5 linkc.491C>T p.Ser164Leu missense_variant Exon 2 of 2 1 NM_004387.4 ENSP00000327758.4
NKX2-5ENST00000424406.2 linkc.*444C>T 3_prime_UTR_variant Exon 2 of 2 1 ENSP00000395378.2
NKX2-5ENST00000521848.1 linkc.*290C>T 3_prime_UTR_variant Exon 2 of 2 2 ENSP00000427906.1

Frequencies

GnomAD3 genomes
Cov.:
32
GnomAD4 exome
Data not reliable, filtered out with message: AC0
AF:
0.00
AC:
0
AN:
1451902
Hom.:
0
Cov.:
35
AF XY:
0.00
AC XY:
0
AN XY:
721604
African (AFR)
AF:
0.00
AC:
0
AN:
33310
American (AMR)
AF:
0.00
AC:
0
AN:
43074
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
25946
East Asian (EAS)
AF:
0.00
AC:
0
AN:
39276
South Asian (SAS)
AF:
0.00
AC:
0
AN:
85178
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
51860
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
5366
European-Non Finnish (NFE)
AF:
0.00
AC:
0
AN:
1107908
Other (OTH)
AF:
0.00
AC:
0
AN:
59984
GnomAD4 genome
Cov.:
32

ClinVar

Significance: Uncertain significance
Submissions summary: Uncertain:2
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

not provided Uncertain:2
Jan 23, 2024
GeneDx
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

Has not been previously published as pathogenic or benign to our knowledge; Not observed at significant frequency in large population cohorts (gnomAD); In silico analysis supports that this missense variant has a deleterious effect on protein structure/function -

Sep 21, 2021
AiLife Diagnostics, AiLife Diagnostics
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
0.99
BayesDel_addAF
Pathogenic
0.53
D
BayesDel_noAF
Pathogenic
0.52
CADD
Pathogenic
34
DANN
Pathogenic
1.0
DEOGEN2
Pathogenic
0.98
D
Eigen
Pathogenic
0.87
Eigen_PC
Pathogenic
0.78
FATHMM_MKL
Pathogenic
0.99
D
LIST_S2
Uncertain
0.95
D
M_CAP
Pathogenic
0.64
D
MetaRNN
Pathogenic
0.93
D
MetaSVM
Pathogenic
1.1
D
MutationAssessor
Pathogenic
3.2
M
PhyloP100
10
PrimateAI
Pathogenic
0.89
D
PROVEAN
Pathogenic
-5.9
D
REVEL
Pathogenic
0.94
Sift
Pathogenic
0.0
D
Sift4G
Pathogenic
0.0
D
Polyphen
1.0
D
Vest4
0.91
MutPred
0.65
Loss of phosphorylation at S164 (P = 0.0258);
MVP
0.97
MPC
1.3
ClinPred
1.0
D
GERP RS
4.1
Varity_R
0.95
gMVP
0.72
Mutation Taster
=5/95
disease causing

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: rs1554093487; hg19: chr5-172660056; API