rs199573929

Variant summary

Our verdict is Benign. The variant received -13 ACMG points: 0P and 13B. BP4_StrongBP6BS1BS2

The NM_001378454.1(ALMS1):​c.2036A>G​(p.Tyr679Cys) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.00241 in 1,613,872 control chromosomes in the GnomAD database, including 7 homozygotes. In-silico tool predicts a benign outcome for this variant. 12/18 in silico tools predict a benign outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars).

Frequency

Genomes: 𝑓 0.0015 ( 0 hom., cov: 32)
Exomes 𝑓: 0.0025 ( 7 hom. )

Consequence

ALMS1
NM_001378454.1 missense

Scores

1
14

Clinical Significance

Conflicting classifications of pathogenicity criteria provided, conflicting classifications U:9B:7

Conservation

PhyloP100: -0.105

Publications

4 publications found
Variant links:
Genes affected
ALMS1 (HGNC:428): (ALMS1 centrosome and basal body associated protein) This gene encodes a protein containing a large tandem-repeat domain as well as additional low complexity regions. The encoded protein functions in microtubule organization, particularly in the formation and maintanance of cilia. Mutations in this gene cause Alstrom syndrome. There is a pseudogene for this gene located adjacent in the same region of chromosome 2. Alternative splice variants have been described but their full length nature has not been determined. [provided by RefSeq, Apr 2014]
ALMS1 Gene-Disease associations (from GenCC):
  • Alstrom syndrome
    Inheritance: AR Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Labcorp Genetics (formerly Invitae), ClinGen, PanelApp Australia, G2P, Orphanet, Genomics England PanelApp

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Benign. The variant received -13 ACMG points.

BP4
Computational evidence support a benign effect (MetaRNN=0.015712231).
BP6
Variant 2-73448563-A-G is Benign according to our data. Variant chr2-73448563-A-G is described in ClinVar as Conflicting_classifications_of_pathogenicity. ClinVar VariationId is 210126.
BS1
Variant frequency is greater than expected in population sas. GnomAd4 allele frequency = 0.00149 (227/152150) while in subpopulation SAS AF = 0.00269 (13/4826). AF 95% confidence interval is 0.00222. There are 0 homozygotes in GnomAd4. There are 102 alleles in the male GnomAd4 subpopulation. Median coverage is 32. This position passed quality control check.
BS2
High Homozygotes in GnomAdExome4 at 7 AR gene

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
ALMS1NM_001378454.1 linkc.2036A>G p.Tyr679Cys missense_variant Exon 8 of 23 ENST00000613296.6 NP_001365383.1
ALMS1NM_015120.4 linkc.2036A>G p.Tyr679Cys missense_variant Exon 8 of 23 NP_055935.4 Q8TCU4

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
ALMS1ENST00000613296.6 linkc.2036A>G p.Tyr679Cys missense_variant Exon 8 of 23 1 NM_001378454.1 ENSP00000482968.1 Q8TCU4-1

Frequencies

GnomAD3 genomes
AF:
0.00149
AC:
227
AN:
152032
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.000556
Gnomad AMI
AF:
0.00329
Gnomad AMR
AF:
0.000655
Gnomad ASJ
AF:
0.00
Gnomad EAS
AF:
0.00
Gnomad SAS
AF:
0.00269
Gnomad FIN
AF:
0.000377
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.00253
Gnomad OTH
AF:
0.000956
GnomAD2 exomes
AF:
0.00157
AC:
390
AN:
248830
AF XY:
0.00173
show subpopulations
Gnomad AFR exome
AF:
0.000388
Gnomad AMR exome
AF:
0.000348
Gnomad ASJ exome
AF:
0.0000995
Gnomad EAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.000835
Gnomad NFE exome
AF:
0.00240
Gnomad OTH exome
AF:
0.00116
GnomAD4 exome
AF:
0.00251
AC:
3669
AN:
1461722
Hom.:
7
Cov.:
82
AF XY:
0.00253
AC XY:
1839
AN XY:
727170
show subpopulations
African (AFR)
AF:
0.000448
AC:
15
AN:
33464
American (AMR)
AF:
0.000380
AC:
17
AN:
44708
Ashkenazi Jewish (ASJ)
AF:
0.0000383
AC:
1
AN:
26126
East Asian (EAS)
AF:
0.0000252
AC:
1
AN:
39688
South Asian (SAS)
AF:
0.00284
AC:
245
AN:
86256
European-Finnish (FIN)
AF:
0.000636
AC:
34
AN:
53418
Middle Eastern (MID)
AF:
0.000694
AC:
4
AN:
5766
European-Non Finnish (NFE)
AF:
0.00292
AC:
3250
AN:
1111916
Other (OTH)
AF:
0.00169
AC:
102
AN:
60380
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.490
Heterozygous variant carriers
0
240
480
719
959
1199
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome Het
Exome Hom
Variant carriers
0
130
260
390
520
650
<30
30-35
35-40
40-45
45-50
50-55
55-60
60-65
65-70
70-75
75-80
>80
Age
GnomAD4 genome
AF:
0.00149
AC:
227
AN:
152150
Hom.:
0
Cov.:
32
AF XY:
0.00137
AC XY:
102
AN XY:
74380
show subpopulations
African (AFR)
AF:
0.000555
AC:
23
AN:
41478
American (AMR)
AF:
0.000654
AC:
10
AN:
15294
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3470
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5166
South Asian (SAS)
AF:
0.00269
AC:
13
AN:
4826
European-Finnish (FIN)
AF:
0.000377
AC:
4
AN:
10608
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
294
European-Non Finnish (NFE)
AF:
0.00253
AC:
172
AN:
67988
Other (OTH)
AF:
0.000946
AC:
2
AN:
2114
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.511
Heterozygous variant carriers
0
12
23
35
46
58
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Genome Het
Variant carriers
0
4
8
12
16
20
<30
30-35
35-40
40-45
45-50
50-55
55-60
60-65
65-70
70-75
75-80
>80
Age
Alfa
AF:
0.00221
Hom.:
0
Bravo
AF:
0.00148
TwinsUK
AF:
0.00270
AC:
10
ALSPAC
AF:
0.00415
AC:
16
ESP6500AA
AF:
0.00
AC:
0
ESP6500EA
AF:
0.00279
AC:
23
ExAC
AF:
0.00163
AC:
197
EpiCase
AF:
0.00180
EpiControl
AF:
0.00308

ClinVar

Significance: Conflicting classifications of pathogenicity
Submissions summary: Uncertain:9Benign:7
Revision: criteria provided, conflicting classifications
LINK: link

Submissions by phenotype

Alstrom syndrome Uncertain:5Benign:2
Feb 02, 2025
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

May 17, 2024
ARUP Laboratories, Molecular Genetics and Genomics, ARUP Laboratories
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The ALMS1 c.2036A>G p.Tyr679Cys variant (rs199573929, ClinVar Variation ID:210126) is reported in the literature in one individual affected with dilated cardiomyopathy but without clear disease association (Burstein 2021). This variant is found in the general population with an overall allele frequency of 0.15% (423/280160 alleles) in the Genome Aggregation Database (v2.1.1). Computational analyses are uncertain whether this variant is neutral or deleterious (REVEL: 0.191). Due to limited information, the clinical significance of this variant is uncertain at this time. References: Burstein DS et al. Genetic variant burden and adverse outcomes in pediatric cardiomyopathy. Pediatr Res. 2021 May;89(6):1470-1476. PMID: 32746448. -

-
Clinical Genomics, Uppaluri K&H Personalized Medicine Clinic
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:research

Potent mutations in ALMS1 are associated with a rare condition called Alstrom syndrome. It can cause excessive eating, insulin resistance. However, no evidence is found to ascertain the role of rs199573929 in Alstrom syndrome yet. -

Jan 13, 2020
Natera, Inc.
Significance:Likely benign
Review Status:no assertion criteria provided
Collection Method:clinical testing

- -

May 18, 2021
Genome-Nilou Lab
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Apr 16, 2021
Clinical Genomics Laboratory, Stanford Medicine
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The p.Tyr680Cys (also referred to as p.Tyr678Cys) variant in the ALMS1 gene has been previously reported in 2 unrelated individuals, 1 individual was heterozygous without a second variant identified, and 1 individual was compound heterozygous but had a phenotype inconsistent with Alstrom syndrome (Campbell et al., 2018; Celestino-Soper et al., 2015). This variant has also been identified in 76/30,598 South Asian chromosomes by the Genome Aggregation Database (http://gnomad.broadinstitute.org/). This allele frequency is greater than would be expected to be disease-causing for Alstrom syndrome. Previously reported disease-causing variants in ALMS1 have been primarily truncating variants, whereas this variant results in a single amino acid substitution. The significance of this type of variation in the ALMS1 gene is currently unclear. Computational tools predict that the p.Tyr680Cys variant does not impact protein function; however, the accuracy of in silico algorithms is limited. These data were assessed using the ACMG/AMP variant interpretation guidelines. In summary, the significance of the p.Tyr680Cys variant is uncertain. Additional information is needed to resolve the significance of this variant. [ACMG evidence codes used: BS1_supporting -

Oct 31, 2018
Fulgent Genetics, Fulgent Genetics
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

not provided Uncertain:3Benign:1
Jun 07, 2016
Eurofins Ntd Llc (ga)
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Dec 05, 2016
Stanford Center for Inherited Cardiovascular Disease, Stanford University
Significance:Uncertain significance
Review Status:no assertion criteria provided
Collection Method:provider interpretation

Given its frequency in a large number of controls, no case data, and the autosomal recessive inheritance pattern of the associated disease, we consider this variant a variant of uncertain significance likely benign, and we do not feel it is suitable for assessing risk in healthy relatives ("predictive genetic testing"). The variant has not been seen in any cases of atrial fibrillation or ALMS1-related disease. Testing for our patient was performed at Invitae. The ALMS1 gene is associated with autosomal recessive Alström syndrome. Alström syndrome includes cone-rod dystrophy, obesity, progressive sensorineural hearing impairment, dilated or restrictive cardiomyopathy, the insulin resistance syndrome, and multiple organ failure. Our patient was only found to have one variant in this gene and does not have a phenotype consistent with this condition. This sequence change replaces tyrosine with cysteine at codon 680 of the ALMS1 protein (p.Tyr680Cys). The tyrosine residue is weakly conserved and there is a large physicochemical di erence between tyrosine and cysteine. Algorithms developed to predict the e ect of missense changes on protein structure and function do not agree on the potential impact of this missense change. The variant is present in 422 of 140,893 (MAF = 0.15%) total individuals in the Genome Aggregation Consortium Dataset (gnomAD; http://gnomad.broadinstitute.org/), which currently includes variant calls on >140,000 unrelated individuals of African, Asian, European, Latino, and Ashkenazi descent. Specifically, the variant is present in 292 of 63,046 European Non-Finnish individuals (MAF= 0.23%). -

Jul 22, 2022
GeneDx
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

Reported in a patient with dilated cardiomyopathy in published literature (Burstein et al., 2021); In silico analysis supports that this missense variant does not alter protein structure/function; Reported in ClinVar but additional evidence is not available (ClinVar Variant ID 210126; ClinVar); This variant is associated with the following publications: (PMID: 32746448) -

Jan 01, 2025
CeGaT Center for Human Genetics Tuebingen
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

ALMS1: BP4 -

not specified Uncertain:1Benign:2
Apr 17, 2018
Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

p.Tyr680Cys in exon 8 of ALMS1: This variant is not expected to have clinical si gnificance because it has been identified in 0.25% (76/30778) South Asian and 0. 23% (293/125986) European chromosomes by the Genome Aggregation Database (gnomAD , http://gnomad.broadinstitute.org; dbSNP rs199573929). Tyrosine (Tyr) at positi on 680 is not highly conserved in mammals and evolutionary distant species, with one mammal (golden hamster) carrying a cystine (Cys) at this position, supporti ng that this change at this position may be tolerated. Additional computational computational prediction tools and conservation analysis suggest that this varia nt may not impact the protein. ACMG/AMP Criteria applied: BS1_P; BP4. -

Jun 01, 2015
Genetic Services Laboratory, University of Chicago
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Mar 17, 2025
Women's Health and Genetics/Laboratory Corporation of America, LabCorp
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

Variant summary: ALMS1 c.2033A>G (p.Tyr678Cys) results in a non-conservative amino acid change located in the Alstrom syndrome repeat region (IPR040972) of the encoded protein sequence. Three of five in-silico tools predict a benign effect of the variant on protein function. The variant allele was found at a frequency of 0.0016 in 248830 control chromosomes, predominantly at a frequency of 0.0025 within the South Asian subpopulation in the gnomAD database. The observed variant frequency within South Asian control individuals in the gnomAD database is approximately 1.12 fold of the estimated maximal expected allele frequency for a pathogenic variant in ALMS1 causing Cardiomyopathy phenotype (0.0022). c.2033A>G has been reported in the literature in individuals affected with Cardiomyopathy wuthout strong evidence for causality (Campbell_2018, Celestino-Soper2015, Fitzgerald_2015,Londin_2011). These report(s) do not provide unequivocal conclusions about association of the variant with Cardiomyopathy. The following publications have been ascertained in the context of this evaluation (PMID: 29610177, 26636822, 25533962, 21943378). ClinVar contains an entry for this variant (Variation ID: 210126). Based on the evidence outlined above, the variant was classified as likely benign. -

Monogenic diabetes Benign:1
Jun 29, 2018
Personalized Diabetes Medicine Program, University of Maryland School of Medicine
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:research

ACMG criteria: BP1, BS1 (0.2% MAF in gnomAD SA and ENF) [REVEL 0.191, PP3 (3), BP4 (6)= conflicting evidence, not using]= likely benign -

Cardiovascular phenotype Benign:1
Jul 08, 2022
Ambry Genetics
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This alteration is classified as likely benign based on a combination of the following: seen in unaffected individuals, population frequency, intact protein function, lack of segregation with disease, co-occurrence, RNA analysis, in silico models, amino acid conservation, lack of disease association in case-control studies, and/or the mechanism of disease or impacted region is inconsistent with a known cause of pathogenicity. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.11
BayesDel_addAF
Benign
-0.22
T
BayesDel_noAF
Uncertain
-0.080
CADD
Benign
13
DANN
Benign
0.97
DEOGEN2
Benign
0.038
T;.;.
Eigen
Benign
-0.52
Eigen_PC
Benign
-0.79
FATHMM_MKL
Benign
0.079
N
LIST_S2
Benign
0.51
T;T;T
M_CAP
Benign
0.0047
T
MetaRNN
Benign
0.016
T;T;T
MetaSVM
Benign
-1.0
T
PhyloP100
-0.10
PrimateAI
Benign
0.38
T
Sift4G
Benign
0.11
T;T;T
Vest4
0.57
MVP
0.21
ClinPred
0.036
T
GERP RS
-3.6
RBP_binding_hub_radar
0.0
RBP_regulation_power_radar
1.1
Varity_R
0.058
gMVP
0.19
Mutation Taster
=96/4
polymorphism

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: rs199573929; hg19: chr2-73675690; COSMIC: COSV52512248; COSMIC: COSV52512248; API