rs193922343
Variant summary
Our verdict is Pathogenic. The variant received 18 ACMG points: 18P and 0B. PVS1PM2PP5_Very_Strong
The NM_000179.3(MSH6):c.3699_3702delAGAA(p.Lys1233AsnfsTer6) variant causes a frameshift change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.00000186 in 1,613,990 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Pathogenic (★★★). Synonymous variant affecting the same amino acid position (i.e. K1233K) has been classified as Likely benign. Variant results in nonsense mediated mRNA decay.
Frequency
Consequence
NM_000179.3 frameshift
Scores
Clinical Significance
Conservation
Publications
- intellectual developmental disorder with dysmorphic facies and behavioral abnormalitiesInheritance: AD Classification: DEFINITIVE, STRONG Submitted by: Labcorp Genetics (formerly Invitae), Ambry Genetics, G2P
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ACMG classification
Our verdict: Pathogenic. The variant received 18 ACMG points.
Transcripts
RefSeq
Ensembl
Frequencies
GnomAD3 genomes AF: 0.0000131 AC: 2AN: 152208Hom.: 0 Cov.: 33 show subpopulations
GnomAD2 exomes AF: 0.00000398 AC: 1AN: 251238 AF XY: 0.00000737 show subpopulations
GnomAD4 exome AF: 6.84e-7 AC: 1AN: 1461782Hom.: 0 AF XY: 0.00000138 AC XY: 1AN XY: 727190 show subpopulations
GnomAD4 genome AF: 0.0000131 AC: 2AN: 152208Hom.: 0 Cov.: 33 AF XY: 0.0000134 AC XY: 1AN XY: 74364 show subpopulations
ClinVar
Submissions by phenotype
Lynch syndrome 5 Pathogenic:4
This variant is considered pathogenic. This variant creates a frameshift predicted to result in premature protein truncation. -
This submission and the accompanying classification are no longer maintained by the submitter. For more information on current observations and classification, please contact variantquestions@myriad.com. -
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ACMG codes: PVS1, PS4M, PM2, PP5 -
not provided Pathogenic:3
This frameshift variant causes the premature termination of MSH6 protein synthesis. It has been reported in individuals with Lynch syndrome in the published literature (PMIDs: 25430799 (2015), 25980754 (2015), and 21642682 (2011)). Based on the available information, this variant is classified as pathogenic. -
Frameshift variant predicted to result in protein truncation or nonsense mediated decay in a gene for which loss-of-function is a known mechanism of disease; Not observed at significant frequency in large population cohorts (gnomAD); Truncating variants in this gene are considered pathogenic by a well-established clinical consortium and/or database; This variant is associated with the following publications: (PMID: 25980754, 25213678, 27443514, 21642682, 25430799, 28152038, 18389388, 30787465, 29922827, 32719484, 28888541, 35366121) -
PP4, PM2_moderate, PVS1 -
Lynch syndrome Pathogenic:2
Coding sequence variation resulting in a stop codon -
The c.3699_3702del variant in the MSH6 gene is located on the exon 8 and is predicted to shift the reading frame such that it introduces a premature translation termination codon (p.Lys1233Asnfs*6), resulting in an absent or disrupted protein product. This variant has been reported in multiple unrelated individuals with Lynch syndrome-related cancer (PMID: 25430799, 18389388, 28514183, 24933100, 25980754). Loss-of-function variants of MSH6 are known to be pathogenic (PMID: 30376427, 18269114, 29345684). The variant is reported in ClinVar as pathogenic (ID: 36593) and reviewed by the expert panel. The variant is rare in general population according to gnomAD (1/251238 chromosomes). Therefore, the c.3699_3702del (p.Lys1233Asnfs*6) variant in the MSH6 gene has been classified as pathogenic. -
Hereditary cancer-predisposing syndrome Pathogenic:2
This variant deletes 4 nucleotides in exon 8 of the MSH6 gene, creating a frameshift and premature translation stop signal. This variant is expected to result in an absent or non-functional protein product. This variant has been reported in individuals affected with Lynch syndrome-associated cancers (PMID: 18389388, 21642682, 24933100, 27443514). This variant has been identified in 1/251238 chromosomes in the general population by the Genome Aggregation Database (gnomAD). Loss of MSH6 function is a known mechanism of disease (clinicalgenome.org). Based on the available evidence, this variant is classified as Pathogenic. -
The c.3699_3702delAGAA pathogenic mutation, located in coding exon 8 of the MSH6 gene, results from a deletion of 4 nucleotides at nucleotide positions 3699 to 3702, causing a translational frameshift with a predicted alternate stop codon (p.K1233Nfs*6). This mutation has been reported in multiple families with hereditary non-polyposis colorectal cancer (HNPCC)/Lynch syndrome (Bonadona V et al. JAMA. 2011 Jun;305:2304-10). In addition to the clinical data presented in the literature, this alteration is expected to result in loss of function by premature protein truncation or nonsense-mediated mRNA decay. As such, this alteration is interpreted as a disease-causing mutation. -
Hereditary nonpolyposis colon cancer Pathogenic:1
Variant summary: MSH6 c.3699_3702delAGAA (p.Lys1233AsnfsX6) results in a premature termination codon, predicted to cause a truncation of the encoded protein or absence of the protein due to nonsense mediated decay, which are commonly known mechanisms for disease. Truncations downstream of this position have been classified as pathogenic by our laboratory. The variant allele was found at a frequency of 4e-06 in 251238 control chromosomes. c.3699_3702delAGAA has been reported in the literature in individuals affected with Hereditary Nonpolyposis Colorectal Cancer (Goldberg_2014, Bonadona_2011, Batte_2014, Raymond_2015). These data indicate that the variant is likely to be associated with disease. To our knowledge, no experimental evidence demonstrating an impact on protein function has been reported. Six clinical diagnostic laboratories have submitted clinical-significance assessments for this variant to ClinVar after 2014 without evidence for independent evaluation. All laboratories classified the variant as pathogenic. Based on the evidence outlined above, the variant was classified as pathogenic. -
MSH6-related disorder Pathogenic:1
The MSH6 c.3699_3702delAGAA variant is predicted to result in a frameshift and premature protein termination (p.Lys1233Asnfs*6). This variant was reported in individuals with Lynch syndrome (examples, eTable 1. Bonadona V et al 2011. PubMed ID: 21642682; Goldberg Y et al 2014. PubMed ID: 25430799). This variant is reported in 0.00088% of alleles in individuals of European (Non-Finnish) descent in gnomAD and is interpreted as pathogenic in ClinVar (https://www.ncbi.nlm.nih.gov/clinvar/variation/36593/). Frameshift variants in MSH6 are considered pathogenic. This variant is interpreted as pathogenic. -
Hereditary nonpolyposis colorectal neoplasms Pathogenic:1
This sequence change creates a premature translational stop signal (p.Lys1233Asnfs*6) in the MSH6 gene. It is expected to result in an absent or disrupted protein product. Loss-of-function variants in MSH6 are known to be pathogenic (PMID: 18269114, 24362816). This variant is present in population databases (rs267608115, gnomAD 0.0009%). This premature translational stop signal has been observed in individual(s) with Lynch syndrome (PMID: 18389388, 21642682). Invitae Evidence Modeling of clinical and family history, age, sex, and reported ancestry of multiple individuals with this MSH6 variant has been performed. This variant is expected to be pathogenic with a positive predictive value of at least 99%. This is a validated machine learning model that incorporates the clinical features of 1,370,736 individuals referred to our laboratory for MSH6 testing. This variant is also known as c.3697_3700delAAAG. ClinVar contains an entry for this variant (Variation ID: 36593). For these reasons, this variant has been classified as Pathogenic. -
Endometrial carcinoma Pathogenic:1
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Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at