rs200379491
Variant summary
Our verdict is Pathogenic. The variant received 10 ACMG points: 10P and 0B. PP3PP4PM3_StrongPP1_Strong
This summary comes from the ClinGen Evidence Repository: The NM_000070.3: c.2120A>G variant in CAPN3 is a missense variant predicted to cause substitution of asparagine with glycine at amino acid position 707, p.(Asp707Gly). This variant has been reported in over 20 patients with features of LGMD and is particularly common among patients with East Asian ancestry (PMID:28403181, 17258832, 10567047, 19556129, 27066573, 37974208, 32994280, 33899113, 30127231, 39188286, 11525884; LOVD CAPN3_000118). These reports include at least five unrelated homozygous cases without reported familial consanguinity (1.0 pt; PMID:17258832, 10567047, 32994280, 11525884) and at least one observation where the variant was confirmed in trans with a likely pathogenic or pathogenic variant (c.2201_2202del p.(Tyr734Ter), 1.0 pt, PMID:33899113) (PM3_Strong). It has also been reported to segregate with the LGMD phenotype in six affected family members from four families (PP1_Strong; PMID:37974208, 32994280, 39188286, 11525884). At least one patient with this variant displayed progressive limb girdle muscle weakness and significantly reduced calpain-3 protein expression, which is specific for CAPN3-related LGMD (PMID:26632398, 19556129, 10567047, 17258832; PP4 (capped with PP1_Strong)). The filtering allele frequency in gnomAD v4.1.0 exomes is 0.001250 (the lower threshold of the 95% CI of 62/39700 East Asian chromosomes), which is above the LGMD VCEP threshold (0.001) for BS1. However, this variant is one of the most commonly described CAPN3 variants reported in patients in this population, and the VCEP opted not to apply this code (BS1 exception). The computational predictor REVEL gives a score of 0.966, which is above the LGMD VCEP threshold of ≥0.70, evidence that correlates with impact to CAPN3 function (PP3). In summary, this variant meets the criteria to be classified as Pathogenic for autosomal recessive limb girdle muscular dystrophy based on the ACMG/AMP criteria applied, as specified by the ClinGen LGMD VCEP (LGMD VCEP specifications version 1.0.0; 04/22/2025): PM3_Strong, PP1_Strong, PP4, PP3. LINK:https://erepo.genome.network/evrepo/ui/classification/CA7511744/MONDO:0015152/187
Frequency
Consequence
NM_000070.3 missense
Scores
Clinical Significance
Conservation
Publications
- autosomal recessive limb-girdle muscular dystrophyInheritance: AR Classification: DEFINITIVE Submitted by: ClinGen
- autosomal recessive limb-girdle muscular dystrophy type 2AInheritance: AR Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Orphanet, Myriad Women’s Health, Labcorp Genetics (formerly Invitae)
- muscular dystrophy, limb-girdle, autosomal dominant 4Inheritance: AD Classification: STRONG, MODERATE Submitted by: Ambry Genetics, Labcorp Genetics (formerly Invitae)
- muscular dystrophy, limb-girdle, autosomal dominantInheritance: AD Classification: LIMITED Submitted by: ClinGen
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ACMG classification
Our verdict: Pathogenic. The variant received 10 ACMG points.
Transcripts
RefSeq
Ensembl
| Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | TSL | MANE | Protein | Appris | UniProt | 
|---|---|---|---|---|---|---|---|---|---|---|
| CAPN3 | ENST00000397163.8 | c.2120A>G | p.Asp707Gly | missense_variant | Exon 20 of 24 | 1 | NM_000070.3 | ENSP00000380349.3 | ||
| CAPN3 | ENST00000673886.1 | c.125A>G | p.Asp42Gly | missense_variant | Exon 7 of 11 | ENSP00000501155.1 | ||||
| CAPN3 | ENST00000673928.1 | c.125A>G | p.Asp42Gly | missense_variant | Exon 7 of 11 | ENSP00000501099.1 | ||||
| CAPN3 | ENST00000674146.1 | c.125A>G | p.Asp42Gly | missense_variant | Exon 8 of 12 | ENSP00000501175.1 | ||||
| CAPN3 | ENST00000674149.1 | c.125A>G | p.Asp42Gly | missense_variant | Exon 7 of 11 | ENSP00000501112.1 | ||||
| CAPN3 | ENST00000673743.1 | c.23A>G | p.Asp8Gly | missense_variant | Exon 7 of 11 | ENSP00000500989.1 | ||||
| ENSG00000258461 | ENST00000495723.1 | n.*2556A>G | non_coding_transcript_exon_variant | Exon 22 of 26 | 2 | ENSP00000492063.1 | ||||
| ENSG00000258461 | ENST00000495723.1 | n.*2556A>G | 3_prime_UTR_variant | Exon 22 of 26 | 2 | ENSP00000492063.1 | 
Frequencies
GnomAD3 genomes  0.0000723  AC: 11AN: 152150Hom.:  0  Cov.: 31 show subpopulations 
GnomAD2 exomes  AF:  0.000151  AC: 38AN: 251460 AF XY:  0.000140   show subpopulations 
GnomAD4 exome  AF:  0.0000438  AC: 64AN: 1461846Hom.:  0  Cov.: 32 AF XY:  0.0000385  AC XY: 28AN XY: 727226 show subpopulations 
Age Distribution
GnomAD4 genome  0.0000722  AC: 11AN: 152268Hom.:  0  Cov.: 31 AF XY:  0.0000940  AC XY: 7AN XY: 74474 show subpopulations 
Age Distribution
ClinVar
Submissions by phenotype
Autosomal recessive limb-girdle muscular dystrophy type 2A    Pathogenic:10 
The variant is observed at an extremely low frequency in the gnomAD v2.1.1 dataset (total allele frequency: 0.015%). Predicted Consequence/Location: The variant is located in a mutational hot spot and/or well-established functional domain in which established pathogenic variants have been reported (PMID: 26632398). In silico tool predictions suggest damaging effect of the variant on gene or gene product [REVEL: 0.97 (>=0.6, sensitivity 0.68 and specificity 0.92); 3Cnet: 0.91 (>=0.6, sensitivity 0.72 and precision 0.9)]. Same nucleotide change resulting in same amino acid change has been previously reported as pathogenic/likely pathogenic with strong evidence (ClinVar ID: VCV000468648 /PMID: 10567047 /3billion dataset). The variant has been reported to be in trans with a pathogenic variant as either compound heterozygous or homozygous in at least 2 similarly affected unrelated individuals (PMID: 26632398). A different missense change at the same codon (p.Asp707His) has been reported to be associated with CAPN3 related disorder (ClinVar ID: VCV000290334). Therefore, this variant is classified as Pathogenic according to the recommendation of ACMG/AMP guideline. -
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This sequence change replaces aspartic acid, which is acidic and polar, with glycine, which is neutral and non-polar, at codon 707 of the CAPN3 protein (p.Asp707Gly). This variant is present in population databases (rs200379491, gnomAD 0.2%). This missense change has been observed in individual(s) with autosomal recessive limb-girdle muscular dystrophy (PMID: 10567047, 11525884, 25252031, 26632398). In at least one individual the data is consistent with being in trans (on the opposite chromosome) from a pathogenic variant. ClinVar contains an entry for this variant (Variation ID: 468648). Invitae Evidence Modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) indicates that this missense variant is not expected to disrupt CAPN3 protein function with a negative predictive value of 80%. For these reasons, this variant has been classified as Pathogenic. -
NM_000070.2(CAPN3):c.2120A>G(D707G) is classified as pathogenic in the context of calpainopathy. Sources cited for classification include the following: PMID 25079074, 26632398, 11525884 and 27066573. Classification of NM_000070.2(CAPN3):c.2120A>G(D707G) is based on the following criteria: This is a well-established pathogenic variant in the literature that has been observed more frequently in patients with clinical diagnoses than in healthy populations. Please note: this variant was assessed in the context of healthy population screening. -
The missense variant c.2120A>G/p.(Asp707Gly) in exon 20 resulted in a single-nucleotide polymorphism (A to G) at site 2120 in the coding region of CAPN3 (NM_000070.2), which introduced an aspartic acid residue that replaced a glycine in codon 707 (Fig. 3A). This variant was previously reported in multiple (>10) homozygous or compound heterozygous patients with LGMDs (PM3-PVS), which co-segregated within a family (PP1-PM). The normal population database includes this variant; its frequency is 0.0148% (42/282854, gnomAD) (PM2); bioinformatics analysis software SIFT, PolyPhen2, and Variant Taster consistently predicted the variant to be harmful (PP3). In addition, the variant is included in ClinVar as a “pathogenic/suspected pathogenic variant.†According to available evidence, the variant is defined as pathogenic (PM3-PVS+PM2+PP1-PM+PP3) based on the 2015 ACMG guidelines for sequence variant interpretation.The WES of this patient revealed compound heterozygous variants in CAPN3, c.2120A>G/p. (Asp707Gly) in exon 20 and c.2201_2202delAT/p.(Tyr734*) in exon 21, which were inherited from his parents and absent from 200 control individuals of similar ethnic origin, indicating that these variants are the pathogenic triggers of the LGMDR1 phenotype. In summary, we observed a sporadic male case of LGMDR1 and identified two compound heterozygous variants in CAPN3, namely c.2120A>G/p. (Asp707Gly) and c.2201_2202delAT/ p.(Tyr734*)), which co-segregated with the LGMDR1 phenotypes in the proband’s family. -
The missense c.2120A>G (p.Asp707Gly) variant in CAPN3 gene has been reported in compound heterozygous state in multiple individuals affected with autosomal recessive Muscular dystrophy, limb-girdle (Park et. al., 2016; Park et. al., 2017). The p.Asp707Gly variant is present with allele frequency of 0.01% in gnomAD exomes database. This variant has been submitted to the ClinVar database as Pathogenic / Likely Pathogenic. The variant is located in a well-established functional domain or exonic hotspot, where pathogenic variants have frequently reported. Multiple lines of computational evidence (Polyphen - probably damaging, SIFT - damaging and MutationTaster - disease causing) predict a damaging effect on protein structure and function for this variant. The reference amino acid at this position on CAPN3 gene is predicted as as conserved by GERP++ and PhyloP across 100 vertebrates. The amino acid Asp at position 707 is changed to a Gly changing protein sequence and it might alter its composition and physico-chemical properties. For these reasons, this variant has been classified as Likely Pathogenic. In the absence of another reportable variant in CAPN3 gene, the molecular diagnosis is not confirmed. The above variant has also been reported in heterozygous state in father . -
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Based on the classification scheme VCGS_Germline_v1.3.4, this variant is classified as Pathogenic. Following criteria are met: 0102 - Loss of function is a known mechanism of disease in this gene and is associated with autosomal recessive limb-girdle muscular dystrophy 1 (MIM#253600). Dominant-negative is the suggested mechanism for autosomal dominant limb-girdle muscular dystrophy 4 (MIM#618129; PMIDs: 27259757, 28881388). (I) 0108 - This gene is associated with both recessive and dominant disease. Autosomal dominant limb-girdle muscular dystrophy is associated with milder presentation and later onset (PMID: 32342993). (I) 0200 - Variant is predicted to result in a missense amino acid change from aspartic acid to glycine. (I) 0251 - This variant is heterozygous. (I) 0304 - Variant is present in gnomAD <0.01 (v2: 42 heterozygotes, 0 homozygotes). (SP) 0501 - Missense variant consistently predicted to be damaging by multiple in silico tools or highly conserved with a major amino acid change. (SP) 0604 - Variant is not located in an established domain, motif, hotspot or informative constraint region. (I) 0801 - This variant has strong previous evidence of pathogenicity in unrelated individuals. It has been reported in several affected individuals, including at least one homozygote, and classified as likely pathogenic and pathogenic by diagnostic laboratories in ClinVar (Shariant; PMID: 32994280 ). (SP) 1101 - Very strong and specific phenotype match for this individual. (SP) 1208 - Inheritance information for this variant is not currently available in this individual. (I) Legend: (SP) - Supporting pathogenic, (I) - Information, (SB) - Supporting benign -
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PM1,PM2,PP3,PP5 -
not provided    Pathogenic:3 
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Published functional studies demonstrate no detectable protein in the muscle tissue of a patient homozygous for this variant (PMID: 10567047); In silico analysis supports that this missense variant has a deleterious effect on protein structure/function; This variant is associated with the following publications: (PMID: 36066420, 25525159, 27363342, 30127231, 30919934, 10567047, 26632398, 31656265, 33899113, 25252031, 25079074, 32573981, 27066573, 34323405, 11525884, 27500519, 32994280, 35314707, 28403181) -
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Muscular dystrophy, limb-girdle, autosomal dominant 4    Pathogenic:1 
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Autosomal recessive limb-girdle muscular dystrophy    Pathogenic:1 
The NM_000070.3: c.2120A>G variant in CAPN3 is a missense variant predicted to cause substitution of asparagine with glycine at amino acid position 707, p.(Asp707Gly). This variant has been reported in over 20 patients with features of LGMD and is particularly common among patients with East Asian ancestry (PMID: 28403181, 17258832, 10567047, 19556129, 27066573, 37974208, 32994280, 33899113, 30127231, 39188286, 11525884; LOVD CAPN3_000118). These reports include at least five unrelated homozygous cases without reported familial consanguinity (1.0 pt; PMID: 17258832, 10567047, 32994280, 11525884) and at least one observation where the variant was confirmed in trans with a likely pathogenic or pathogenic variant (c.2201_2202del p.(Tyr734Ter), 1.0 pt, PMID: 33899113) (PM3_Strong). It has also been reported to segregate with the LGMD phenotype in six affected family members from four families (PP1_Strong; PMID: 37974208, 32994280, 39188286, 11525884). At least one patient with this variant displayed progressive limb girdle muscle weakness and significantly reduced calpain-3 protein expression, which is specific for CAPN3-related LGMD (PMID: 26632398, 19556129, 10567047, 17258832; PP4 (capped with PP1_Strong)). The filtering allele frequency in gnomAD v4.1.0 exomes is 0.001250 (the lower threshold of the 95% CI of 62/39700 East Asian chromosomes), which is above the LGMD VCEP threshold (0.001) for BS1. However, this variant is one of the most commonly described CAPN3 variants reported in patients in this population, and the VCEP opted not to apply this code (BS1 exception). The computational predictor REVEL gives a score of 0.966, which is above the LGMD VCEP threshold of ≥0.70, evidence that correlates with impact to CAPN3 function (PP3). In summary, this variant meets the criteria to be classified as Pathogenic for autosomal recessive limb girdle muscular dystrophy based on the ACMG/AMP criteria applied, as specified by the ClinGen LGMD VCEP (LGMD VCEP specifications version 1.0.0; 04/22/2025): PM3_Strong, PP1_Strong, PP4, PP3. -
Autosomal recessive limb-girdle muscular dystrophy type 2A;C4748295:Muscular dystrophy, limb-girdle, autosomal dominant 4    Pathogenic:1 
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CAPN3-related disorder    Pathogenic:1 
The CAPN3 c.2120A>G variant is predicted to result in the amino acid substitution p.Asp707Gly. This variant has been reported with a second CAPN3 variant or in the homozygous state in individuals with limb-girdle muscular dystrophy (see, for example, Minami et al. 1999. PubMed ID: 10567047; Chae et al. 2001. PubMed ID: 11525884; Park et al. 2016. PubMed ID: 26632398). This variant is reported in 0.21% of alleles in individuals of East Asian descent in gnomAD. This variant is interpreted as pathogenic. -
Computational scores
Source: 
Splicing
 Find out detailed SpliceAI scores and Pangolin per-transcript scores at