Our verdict is Pathogenic. Variant got 16 ACMG points: 16P and 0B. PM2PM5PP3_StrongPP5_Very_Strong
The NM_000548.5(TSC2):c.3610G>A(p.Gly1204Arg) variant causes a missense, splice region change. The variant was absent in control chromosomes in GnomAD project. In-silico tool predicts a pathogenic outcome for this variant. 13/22 in silico tools predict a damaging outcome for this variant. 2/3 splice prediction tools predicting alterations to normal splicing. Variant has been reported in ClinVar as Likely pathogenic (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. G1204E) has been classified as Pathogenic.
TSC2 (HGNC:12363): (TSC complex subunit 2) This gene is a tumor suppressor gene that encodes the growth inhibitory protein tuberin. Tuberin interacts with hamartin to form the TSC protein complex which functions in the control of cell growth. This TSC protein complex negatively regulates mammalian target of rapamycin complex 1 (mTORC1) signaling which is a major regulator of anabolic cell growth. Mutations in this gene have been associated with tuberous sclerosis and lymphangioleiomyomatosis. [provided by RefSeq, May 2022]
Verdict is Pathogenic. Variant got 16 ACMG points.
PM2
Very rare variant in population databases, with high coverage;
PM5
Other missense variant is known to change same aminoacid residue: Variant chr16-2081595-G-A is described in Lovd as [Pathogenic].
PP3
Splicing scoreres supports a deletorius effect: Scorers claiming Pathogenic: dbscSNV1_ADA, dbscSNV1_RF. No scorers claiming Uncertain. Scorers claiming Benign: max_spliceai.
PP5
Variant 16-2080377-G-A is Pathogenic according to our data. Variant chr16-2080377-G-A is described in ClinVar as [Likely_pathogenic]. Clinvar id is 49527.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-2080377-G-A is described in Lovd as [Pathogenic]. Variant chr16-2080377-G-A is described in Lovd as [Pathogenic].
Center for Human Genetics, Inc, Center for Human Genetics, Inc
Significance: Likely pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing
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not provided Pathogenic:1
Apr 05, 2024
GeneDx
Significance: Likely pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing
mRNA functional studies show that c.3610G>A caused abnormal splicing and exon 29 skipping in approximately 50% of transcripts (PMID: 30236073); Not observed at significant frequency in large population cohorts (gnomAD); Deletions involving coding exons of this gene are a known mechanism of disease (HGMD); This variant is associated with the following publications: (PMID: 28643793, 29101226, 37522346, 35060563, 32917966, 30236073, 38149783, 17304050) -
Gain of MoRF binding (P = 0.0075);.;Gain of MoRF binding (P = 0.0075);.;.;.;.;Gain of MoRF binding (P = 0.0075);.;Gain of MoRF binding (P = 0.0075);.;.;.;.;.;