rs199967562

Variant summary

Our verdict is Likely benign. The variant received -5 ACMG points: 0P and 5B. BS1BP4

This summary comes from the ClinGen Evidence Repository: The NM_000156.6:c.570+4C>T variant in GAMT is an intronic variant affecting a nucleotide within the consensus splice site of intron 5. To our knowledge, this variant has not been reported in the literature and results of functional studies are unavailable. The highest population frequency in gnomAD v4.1.0. is 0.001148 (86/74912 alleles; no homozygotes) in the African / African American population, which is higher than the ClinGen CCDS VCEP’s threshold for BS1 (>0.001), and therefore meets this criterion (BS1). The computational splicing predictor SpliceAI gives a score of 0.01 for donor loss and suggests that the variant has no impact on splicing (BP4). There is a ClinVar entry for this variant (Variation ID: 582572). In summary, this variant meets the criteria to be classified as likely benign for GAMT deficiency. GAMT-specific ACMG/AMP codes met, as specified by the ClinGen Cerebral Creatine Deficiency Syndromes VCEP (Specifications Version 2.0.0): BS1, BP4.(Classification approved by the ClinGen Creatine Deficiency Syndromes Variant Curation Expert Panel on April 16, 2025) LINK:https://erepo.genome.network/evrepo/ui/classification/CA9043611/MONDO:0012999/026

Frequency

Genomes: 𝑓 0.00035 ( 0 hom., cov: 32)
Exomes 𝑓: 0.000036 ( 0 hom. )

Consequence

GAMT
NM_000156.6 splice_region, intron

Scores

4
13

Clinical Significance

Likely benign reviewed by expert panel U:4B:2

Conservation

PhyloP100: -1.55

Publications

2 publications found
Variant links:
Genes affected
GAMT (HGNC:4136): (guanidinoacetate N-methyltransferase) The protein encoded by this gene is a methyltransferase that converts guanidoacetate to creatine, using S-adenosylmethionine as the methyl donor. Defects in this gene have been implicated in neurologic syndromes and muscular hypotonia, probably due to creatine deficiency and accumulation of guanidinoacetate in the brain of affected individuals. Two transcript variants encoding different isoforms have been described for this gene. Pseudogenes of this gene are found on chromosomes 2 and 13. [provided by RefSeq, Feb 2012]
GAMT Gene-Disease associations (from GenCC):
  • guanidinoacetate methyltransferase deficiency
    Inheritance: AR Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Orphanet, G2P, Labcorp Genetics (formerly Invitae), ClinGen, Ambry Genetics

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Likely_benign. The variant received -5 ACMG points.

BP4
For more information check the summary or visit ClinGen Evidence Repository.
BS1
For more information check the summary or visit ClinGen Evidence Repository.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
GAMTNM_000156.6 linkc.570+4C>T splice_region_variant, intron_variant Intron 5 of 5 ENST00000252288.8 NP_000147.1
GAMTNM_138924.3 linkc.574C>T p.Arg192Cys missense_variant Exon 5 of 5 NP_620279.1

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
GAMTENST00000252288.8 linkc.570+4C>T splice_region_variant, intron_variant Intron 5 of 5 1 NM_000156.6 ENSP00000252288.1

Frequencies

GnomAD3 genomes
AF:
0.000355
AC:
54
AN:
152166
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.00113
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.000327
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:
0.0000294
Gnomad OTH
AF:
0.00
GnomAD2 exomes
AF:
0.0000839
AC:
21
AN:
250176
AF XY:
0.0000590
show subpopulations
Gnomad AFR exome
AF:
0.00112
Gnomad AMR exome
AF:
0.00
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.0000266
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000363
AC:
53
AN:
1460992
Hom.:
0
Cov.:
32
AF XY:
0.0000385
AC XY:
28
AN XY:
726796
show subpopulations
African (AFR)
AF:
0.00116
AC:
39
AN:
33480
American (AMR)
AF:
0.00
AC:
0
AN:
44708
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
26132
East Asian (EAS)
AF:
0.00
AC:
0
AN:
39700
South Asian (SAS)
AF:
0.00
AC:
0
AN:
86248
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
52588
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
5768
European-Non Finnish (NFE)
AF:
0.00000989
AC:
11
AN:
1111982
Other (OTH)
AF:
0.0000497
AC:
3
AN:
60386
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.461
Heterozygous variant carriers
0
3
7
10
14
17
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome Het
Variant carriers
0
2
4
6
8
10
<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:
0.000355
AC:
54
AN:
152166
Hom.:
0
Cov.:
32
AF XY:
0.000269
AC XY:
20
AN XY:
74326
show subpopulations
African (AFR)
AF:
0.00113
AC:
47
AN:
41432
American (AMR)
AF:
0.000327
AC:
5
AN:
15284
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3472
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5194
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4830
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10614
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
316
European-Non Finnish (NFE)
AF:
0.0000294
AC:
2
AN:
68020
Other (OTH)
AF:
0.00
AC:
0
AN:
2092
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.509
Heterozygous variant carriers
0
4
7
11
14
18
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Genome Het
Variant carriers
0
2
4
6
8
10
<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:
0.000211
Hom.:
0
Bravo
AF:
0.000506
ESP6500AA
AF:
0.00295
AC:
13
ESP6500EA
AF:
0.00
AC:
0
ExAC
AF:
0.000107
AC:
13

ClinVar

Significance: Likely benign
Submissions summary: Uncertain:4Benign:2
Revision: reviewed by expert panel
LINK: link

Submissions by phenotype

Deficiency of guanidinoacetate methyltransferase Uncertain:2Benign:1
Sep 10, 2021
New York Genome Center
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Apr 16, 2025
ClinGen Cerebral Creatine Deficiency Syndromes Variant Curation Expert Panel, ClinGen
Significance:Likely benign
Review Status:reviewed by expert panel
Collection Method:curation

The NM_000156.6:c.570+4C>T variant in GAMT is an intronic variant affecting a nucleotide within the consensus splice site of intron 5. To our knowledge, this variant has not been reported in the literature and results of functional studies are unavailable. The highest population frequency in gnomAD v4.1.0. is 0.001148 (86/74912 alleles; no homozygotes) in the African / African American population, which is higher than the ClinGen CCDS VCEP’s threshold for BS1 (>0.001), and therefore meets this criterion (BS1). The computational splicing predictor SpliceAI gives a score of 0.01 for donor loss and suggests that the variant has no impact on splicing (BP4). There is a ClinVar entry for this variant (Variation ID: 582572). In summary, this variant meets the criteria to be classified as likely benign for GAMT deficiency. GAMT-specific ACMG/AMP codes met, as specified by the ClinGen Cerebral Creatine Deficiency Syndromes VCEP (Specifications Version 2.0.0): BS1, BP4. (Classification approved by the ClinGen Creatine Deficiency Syndromes Variant Curation Expert Panel on April 16, 2025) -

Sep 16, 2020
Natera, Inc.
Significance:Uncertain significance
Review Status:no assertion criteria provided
Collection Method:clinical testing

- -

Inborn genetic diseases Uncertain:1
Nov 08, 2024
Ambry Genetics
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The c.570+4C>T intronic alteration consists of a C to T substitution nucleotides after coding exon 5 in the GAMT gene. Based on insufficient or conflicting evidence, the clinical significance of this alteration remains unclear. -

Cerebral creatine deficiency syndrome Uncertain:1
Aug 10, 2022
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This sequence change falls in intron 5 of the GAMT gene. It does not directly change the encoded amino acid sequence of the GAMT protein. It affects a nucleotide within the consensus splice site. This variant is present in population databases (rs199967562, gnomAD 0.1%). This variant has not been reported in the literature in individuals affected with GAMT-related conditions. ClinVar contains an entry for this variant (Variation ID: 582572). Variants that disrupt the consensus splice site are a relatively common cause of aberrant splicing (PMID: 17576681, 9536098). Algorithms developed to predict the effect of sequence changes on RNA splicing suggest that this variant is not likely to affect RNA splicing. 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. -

not provided Benign:1
Mar 03, 2015
GeneDx
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.11
BayesDel_addAF
Benign
-0.39
T
BayesDel_noAF
Benign
-0.39
CADD
Benign
0.036
DANN
Benign
0.71
Eigen
Benign
-1.4
Eigen_PC
Benign
-1.7
FATHMM_MKL
Benign
0.0047
N
LIST_S2
Benign
0.41
T
M_CAP
Uncertain
0.14
D
MetaRNN
Benign
0.023
T
MetaSVM
Uncertain
-0.18
T
PhyloP100
-1.6
PrimateAI
Benign
0.29
T
PROVEAN
Benign
-0.20
N
REVEL
Uncertain
0.35
Sift
Uncertain
0.0030
D
Sift4G
Benign
0.077
T
Vest4
0.063
MVP
0.46
MPC
0.20
ClinPred
0.021
T
GERP RS
-6.7
RBP_binding_hub_radar
0.0
RBP_regulation_power_radar
1.0
gMVP
0.61
Mutation Taster
=96/4
polymorphism

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.080
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: rs199967562; hg19: chr19-1398911; API