rs199472876

Variant summary

Our verdict is Likely benign. Variant got -4 ACMG points: 0P and 4B. BS2

The NM_000238.4(KCNH2):​c.775G>A​(p.Asp259Asn) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.0000103 in 1,364,026 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Uncertain significance (★★).

Frequency

Genomes: 𝑓 0.0000066 ( 0 hom., cov: 33)
Exomes 𝑓: 0.000011 ( 0 hom. )

Consequence

KCNH2
NM_000238.4 missense

Scores

2
9
8

Clinical Significance

Uncertain significance criteria provided, multiple submitters, no conflicts U:4O:1

Conservation

PhyloP100: 2.17
Variant links:
Genes affected
KCNH2 (HGNC:6251): (potassium voltage-gated channel subfamily H member 2) This gene encodes a component of a voltage-activated potassium channel found in cardiac muscle, nerve cells, and microglia. Four copies of this protein interact with one copy of the KCNE2 protein to form a functional potassium channel. Mutations in this gene can cause long QT syndrome type 2 (LQT2). Transcript variants encoding distinct isoforms have been identified. [provided by RefSeq, May 2022]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Likely_benign. Variant got -4 ACMG points.

BS2
High AC in GnomAdExome4 at 13 AD,Digenic gene.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE Protein UniProt
KCNH2NM_000238.4 linkuse as main transcriptc.775G>A p.Asp259Asn missense_variant 4/15 ENST00000262186.10 NP_000229.1 Q12809-1Q15BH2A0A090N8Q0

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Protein Appris UniProt
KCNH2ENST00000262186.10 linkuse as main transcriptc.775G>A p.Asp259Asn missense_variant 4/151 NM_000238.4 ENSP00000262186.5 Q12809-1
KCNH2ENST00000532957.5 linkuse as main transcriptn.998G>A non_coding_transcript_exon_variant 4/92
KCNH2ENST00000684241.1 linkuse as main transcriptn.1608G>A non_coding_transcript_exon_variant 2/13

Frequencies

GnomAD3 genomes
AF:
0.00000659
AC:
1
AN:
151840
Hom.:
0
Cov.:
33
show subpopulations
Gnomad AFR
AF:
0.00
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00
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:
0.0000147
Gnomad OTH
AF:
0.00
GnomAD4 exome
AF:
0.0000107
AC:
13
AN:
1212186
Hom.:
0
Cov.:
31
AF XY:
0.00000847
AC XY:
5
AN XY:
590110
show subpopulations
Gnomad4 AFR exome
AF:
0.00
Gnomad4 AMR exome
AF:
0.00
Gnomad4 ASJ exome
AF:
0.00
Gnomad4 EAS exome
AF:
0.0000376
Gnomad4 SAS exome
AF:
0.0000388
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.00000806
Gnomad4 OTH exome
AF:
0.0000403
GnomAD4 genome
AF:
0.00000659
AC:
1
AN:
151840
Hom.:
0
Cov.:
33
AF XY:
0.00
AC XY:
0
AN XY:
74172
show subpopulations
Gnomad4 AFR
AF:
0.00
Gnomad4 AMR
AF:
0.00
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.00
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.0000147
Gnomad4 OTH
AF:
0.00
Bravo
AF:
0.0000151
ExAC
AF:
0.0000268
AC:
1

ClinVar

Significance: Uncertain significance
Submissions summary: Uncertain:4Other:1
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Long QT syndrome Uncertain:2
Uncertain significance, criteria provided, single submitterclinical testingLabcorp Genetics (formerly Invitae), LabcorpSep 01, 2022This sequence change replaces aspartic acid, which is acidic and polar, with asparagine, which is neutral and polar, at codon 259 of the KCNH2 protein (p.Asp259Asn). The frequency data for this variant in the population databases is considered unreliable, as metrics indicate poor data quality at this position in the gnomAD database. This missense change has been observed in individual(s) with clinical features of KCNH2-related conditions (PMID: 19716085, 32383558). ClinVar contains an entry for this variant (Variation ID: 67527). Algorithms developed to predict the effect of missense changes on protein structure and function (SIFT, PolyPhen-2, Align-GVGD) all suggest that this variant is likely to be tolerated. Experimental studies have shown that this missense change does not substantially affect KCNH2 function (PMID: 34002542). In summary, the available evidence is currently insufficient to determine the role of this variant in disease. Therefore, it has been classified as a Variant of Uncertain Significance. -
Uncertain significance, criteria provided, single submitterclinical testingClinical Genomics Laboratory, Washington University in St. LouisSep 12, 2023The KCNH2 c.775G>A (p.Asp259Asn) variant was identified in a heterozygous state. It has been reported in two individuals affected with long QT syndrome and one case of Sudden Unexpected Death in Epilepsy (SUDEP) (Westphal DS et al., PMID: 32383558; Kapplinger JD et al., PMID: 19716085; Soh MS et al.; PMID: 34002542). This variant has been reported the ClinVar database as a variant of uncertain significance by three submitters (ClinVar ID: 67527). It is only observed on 2/66574 alleles in the general population (gnomAD v.2.1.1), indicating it is not a common variant. Computational predictors are uncertain as to the impact of this variant on KCNH2 function. Due to limited information, and based on ACMG/AMP guidelines for variant interpretation (Richards S et al., PMID: 25741868), this variant is classified as being of uncertain significance at this time. -
not provided Uncertain:1
Uncertain significance, criteria provided, single submitterclinical testingGeneDxJul 11, 2024Identified in patients with LQTS in published literature (PMID: 32383558, 19716085); Not observed at significant frequency in large population cohorts (gnomAD); Published functional studies suggest that the p.(D259N) variant does not significantly affect KCNH2 function (PMID: 34002542, 38219013); In silico analysis indicates that this missense variant does not alter protein structure/function; This variant is associated with the following publications: (PMID: 19716085, 34002542, 32383558, 35932045, LiuY2024[Article], 38219013) -
Cardiovascular phenotype Uncertain:1
Uncertain significance, criteria provided, single submitterclinical testingAmbry GeneticsFeb 22, 2022The c.775G>A (p.D259N) alteration is located in exon 4 (coding exon 4) of the KCNH2 gene. This alteration results from a G to A substitution at nucleotide position 775, causing the aspartic acid (D) at amino acid position 259 to be replaced by an asparagine (N). Based on insufficient or conflicting evidence, the clinical significance of this alteration remains unclear. -
Congenital long QT syndrome Other:1
not provided, no classification providedliterature onlyCardiovascular Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust-This variant has been reported as associated with Long QT syndrome in the following publications (PMID:19716085). This is a literature report, and does not necessarily reflect the clinical interpretation of the Imperial College / Royal Brompton Cardiovascular Genetics laboratory. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.10
BayesDel_addAF
Uncertain
0.16
D
BayesDel_noAF
Uncertain
-0.010
CADD
Uncertain
23
DANN
Uncertain
0.99
DEOGEN2
Uncertain
0.47
T;T
Eigen
Benign
-0.44
Eigen_PC
Benign
-0.53
FATHMM_MKL
Benign
0.20
N
LIST_S2
Benign
0.78
T;T
M_CAP
Pathogenic
0.91
D
MetaRNN
Uncertain
0.45
T;T
MetaSVM
Uncertain
0.60
D
MutationAssessor
Benign
0.81
L;.
PrimateAI
Pathogenic
0.91
D
PROVEAN
Benign
-1.4
N;.
REVEL
Uncertain
0.49
Sift
Uncertain
0.0040
D;.
Sift4G
Uncertain
0.052
T;T
Polyphen
0.98
D;.
Vest4
0.30
MutPred
0.75
Gain of MoRF binding (P = 0.0365);.;
MVP
0.87
MPC
0.98
ClinPred
0.12
T
GERP RS
3.6
Varity_R
0.15
gMVP
0.50

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: rs199472876; hg19: chr7-150655288; API