rs201029006

Variant summary

Our verdict is Uncertain significance. The variant received 1 ACMG points: 1P and 0B. PM2_Supporting

This summary comes from the ClinGen Evidence Repository: The NM_000156.6:c.707G>C (p.Gly236Ala) variant in GAMT is a missense variant predicted to cause substitution of glycine by alanine at amino acid 236 (p.Gly236Ala). The highest population minor allele frequency in gnomAD v4.1.0. is 0.0001679 (198/1179492 alleles) in the European non-Finnish population, which is lower than the ClinGen CCDS VCEP's threshold for PM2_Supporting (<0.0004), meeting this criterion (PM2_Supporting). The computational predictor REVEL gives a score of 0.323 which is neither above nor below the thresholds predicting a damaging (>0.644) or benign (<0.29) impact on GAMT function. SpliceAI predicts that the variant has no impact on splicing. To our knowledge, this variant has not been reported in the published literature. This variant is noted in ClinVar (ID 205596). In summary, this variant meets the criteria to be classified as a variant of uncertain significance for GAMT deficiency. GAMT-specific ACMG/AMP codes met, as specified by the ClinGen Cerebral Creatine Deficiency Syndromes VCEP (Specifications Version 2.0.0): PM2_Supporting(Classification approved by the ClinGen CCDS VCEP on April 28, 2025). LINK:https://erepo.genome.network/evrepo/ui/classification/CA314836/MONDO:0012999/026

Frequency

Genomes: 𝑓 0.000098 ( 0 hom., cov: 33)
Exomes 𝑓: 0.00014 ( 0 hom. )

Consequence

GAMT
NM_000156.6 missense

Scores

1
1
15

Clinical Significance

Uncertain significance reviewed by expert panel U:6B:1

Conservation

PhyloP100: 1.38

Publications

1 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

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ACMG classification

Classification was made for transcript

Our verdict: Uncertain_significance. The variant received 1 ACMG points.

PM2
For more information check the summary or visit ClinGen Evidence Repository.

Variant Effect in Transcripts

ACMG analysis was done for transcript: NM_000156.6. You can select a different transcript below to see updated ACMG assignments.

RefSeq Transcripts

Selected
GeneTranscriptTagsHGVScHGVSpEffectExon RankProteinUniProt
GAMT
NM_000156.6
MANE Select
c.707G>Cp.Gly236Ala
missense
Exon 6 of 6NP_000147.1

Ensembl Transcripts

Selected
GeneTranscriptTagsHGVScHGVSpEffectExon RankProteinUniProt
GAMT
ENST00000252288.8
TSL:1 MANE Select
c.707G>Cp.Gly236Ala
missense
Exon 6 of 6ENSP00000252288.1
GAMT
ENST00000902474.1
c.977G>Cp.Gly326Ala
missense
Exon 6 of 6ENSP00000572533.1
GAMT
ENST00000902472.1
c.710G>Cp.Gly237Ala
missense
Exon 6 of 6ENSP00000572531.1

Frequencies

GnomAD3 genomes
AF:
0.0000986
AC:
15
AN:
152170
Hom.:
0
Cov.:
33
show subpopulations
Gnomad AFR
AF:
0.000121
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:
0.000147
Gnomad OTH
AF:
0.00
GnomAD2 exomes
AF:
0.0000859
AC:
21
AN:
244584
AF XY:
0.000105
show subpopulations
Gnomad AFR exome
AF:
0.000192
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:
0.000163
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.000136
AC:
199
AN:
1458868
Hom.:
0
Cov.:
30
AF XY:
0.000120
AC XY:
87
AN XY:
725754
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
33460
American (AMR)
AF:
0.00
AC:
0
AN:
44604
Ashkenazi Jewish (ASJ)
AF:
0.0000383
AC:
1
AN:
26082
East Asian (EAS)
AF:
0.00
AC:
0
AN:
39648
South Asian (SAS)
AF:
0.00
AC:
0
AN:
86114
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
51428
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
5766
European-Non Finnish (NFE)
AF:
0.000169
AC:
188
AN:
1111476
Other (OTH)
AF:
0.000166
AC:
10
AN:
60290
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.480
Heterozygous variant carriers
0
12
24
37
49
61
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome Het
Variant carriers
0
10
20
30
40
50
<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:
0.0000985
AC:
15
AN:
152288
Hom.:
0
Cov.:
33
AF XY:
0.000107
AC XY:
8
AN XY:
74458
show subpopulations
African (AFR)
AF:
0.000120
AC:
5
AN:
41546
American (AMR)
AF:
0.00
AC:
0
AN:
15300
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3470
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5184
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4830
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10626
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
294
European-Non Finnish (NFE)
AF:
0.000147
AC:
10
AN:
68016
Other (OTH)
AF:
0.00
AC:
0
AN:
2110
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.508
Heterozygous variant carriers
0
1
2
4
5
6
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:
0.000182
Hom.:
0
Bravo
AF:
0.000159
TwinsUK
AF:
0.000270
AC:
1
ALSPAC
AF:
0.000519
AC:
2
ESP6500AA
AF:
0.00
AC:
0
ESP6500EA
AF:
0.000233
AC:
2
ExAC
AF:
0.0000992
AC:
12
EpiCase
AF:
0.000164
EpiControl
AF:
0.000298

ClinVar

ClinVar submissions as Germline
Significance:Uncertain significance
Revision:reviewed by expert panel
View on ClinVar
Pathogenic
VUS
Benign
Condition
-
3
-
Deficiency of guanidinoacetate methyltransferase (3)
-
1
1
not provided (2)
-
1
-
Cerebral creatine deficiency syndrome (1)
-
1
-
Inborn genetic diseases (1)

Computational scores

Source: dbNSFP v4.9

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.086
BayesDel_addAF
Benign
-0.28
T
BayesDel_noAF
Benign
-0.35
CADD
Benign
4.8
DANN
Benign
0.73
DEOGEN2
Benign
0.26
T
Eigen
Benign
-0.94
Eigen_PC
Benign
-0.73
FATHMM_MKL
Benign
0.74
D
LIST_S2
Benign
0.50
T
M_CAP
Benign
0.071
D
MetaRNN
Benign
0.059
T
MetaSVM
Benign
-0.81
T
MutationAssessor
Benign
-1.2
N
PhyloP100
1.4
PROVEAN
Benign
0.19
N
REVEL
Uncertain
0.32
Sift
Benign
0.32
T
Sift4G
Pathogenic
0.0
D
Polyphen
0.0
B
Vest4
0.13
MVP
0.29
ClinPred
0.017
T
GERP RS
4.1
RBP_binding_hub_radar
0.0
RBP_regulation_power_radar
1.7
Varity_R
0.15
Mutation Taster
=83/17
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: rs201029006; hg19: chr19-1397362; COSMIC: COSV106086045; COSMIC: COSV106086045; API