rs201264306

Variant summary

Our verdict is Likely pathogenic. The variant received 6 ACMG points: 6P and 0B. PM1PP3_Strong

The NM_000525.4(KCNJ11):​c.526C>T​(p.Arg176Cys) variant causes a missense change. The variant allele was found at a frequency of 0.0000434 in 1,613,088 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Uncertain significance (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. R176H) has been classified as Uncertain significance.

Frequency

Genomes: 𝑓 0.000072 ( 0 hom., cov: 33)
Exomes 𝑓: 0.000040 ( 0 hom. )

Consequence

KCNJ11
NM_000525.4 missense

Scores

14
1
2

Clinical Significance

Uncertain significance criteria provided, multiple submitters, no conflicts U:5

Conservation

PhyloP100: 6.83

Publications

20 publications found
Variant links:
Genes affected
KCNJ11 (HGNC:6257): (potassium inwardly rectifying channel subfamily J member 11) Potassium channels are present in most mammalian cells, where they participate in a wide range of physiologic responses. The protein encoded by this gene is an integral membrane protein and inward-rectifier type potassium channel. The encoded protein, which has a greater tendency to allow potassium to flow into a cell rather than out of a cell, is controlled by G-proteins and is found associated with the sulfonylurea receptor SUR. Mutations in this gene are a cause of familial persistent hyperinsulinemic hypoglycemia of infancy (PHHI), an autosomal recessive disorder characterized by unregulated insulin secretion. Defects in this gene may also contribute to autosomal dominant non-insulin-dependent diabetes mellitus type II (NIDDM), transient neonatal diabetes mellitus type 3 (TNDM3), and permanent neonatal diabetes mellitus (PNDM). Multiple alternatively spliced transcript variants that encode different protein isoforms have been described for this gene. [provided by RefSeq, Oct 2009]
KCNJ11 Gene-Disease associations (from GenCC):
  • diabetes mellitus, transient neonatal, 3
    Inheritance: AD Classification: DEFINITIVE, STRONG, LIMITED Submitted by: Labcorp Genetics (formerly Invitae), Genomics England PanelApp, G2P
  • monogenic diabetes
    Inheritance: AD Classification: DEFINITIVE Submitted by: ClinGen
  • hyperinsulinemic hypoglycemia, familial, 2
    Inheritance: AR, AD Classification: DEFINITIVE, STRONG Submitted by: Genomics England PanelApp, Myriad Women’s Health, Labcorp Genetics (formerly Invitae), G2P, Ambry Genetics
  • diabetes mellitus, noninsulin-dependent
    Inheritance: AD Classification: STRONG Submitted by: Genomics England PanelApp
  • diabetes mellitus, permanent neonatal 2
    Inheritance: AD Classification: STRONG Submitted by: Genomics England PanelApp
  • maturity-onset diabetes of the young type 13
    Inheritance: AD Classification: STRONG Submitted by: Genomics England PanelApp, Labcorp Genetics (formerly Invitae)
  • autosomal dominant hyperinsulinism due to Kir6.2 deficiency
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • DEND syndrome
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • intermediate DEND syndrome
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • maturity-onset diabetes of the young
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • permanent neonatal diabetes mellitus
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • transient neonatal diabetes mellitus
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • autosomal recessive hyperinsulinism due to Kir6.2 deficiency
    Inheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet
  • diazoxide-resistant focal hyperinsulinism due to Kir6.2 deficiency
    Inheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Likely_pathogenic. The variant received 6 ACMG points.

PM1
In a hotspot region, there are 3 aminoacids with missense pathogenic changes in the window of +-8 aminoacids around while only 1 benign, 6 uncertain in NM_000525.4
PP3
MetaRNN computational evidence supports a deleterious effect, 0.944

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
KCNJ11NM_000525.4 linkc.526C>T p.Arg176Cys missense_variant Exon 1 of 1 ENST00000339994.5 NP_000516.3
KCNJ11NM_001166290.2 linkc.265C>T p.Arg89Cys missense_variant Exon 2 of 2 NP_001159762.1
KCNJ11NM_001377296.1 linkc.265C>T p.Arg89Cys missense_variant Exon 3 of 3 NP_001364225.1
KCNJ11NM_001377297.1 linkc.265C>T p.Arg89Cys missense_variant Exon 2 of 2 NP_001364226.1

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
KCNJ11ENST00000339994.5 linkc.526C>T p.Arg176Cys missense_variant Exon 1 of 1 6 NM_000525.4 ENSP00000345708.4

Frequencies

GnomAD3 genomes
AF:
0.0000723
AC:
11
AN:
152174
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:
0.0000942
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.000147
Gnomad OTH
AF:
0.00
GnomAD2 exomes
AF:
0.0000241
AC:
6
AN:
248678
AF XY:
0.00000743
show subpopulations
Gnomad AFR exome
AF:
0.00
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:
0.0000534
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000404
AC:
59
AN:
1460914
Hom.:
0
Cov.:
63
AF XY:
0.0000330
AC XY:
24
AN XY:
726764
show subpopulations
African (AFR)
AF:
0.0000597
AC:
2
AN:
33478
American (AMR)
AF:
0.00
AC:
0
AN:
44670
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
26134
East Asian (EAS)
AF:
0.00
AC:
0
AN:
39692
South Asian (SAS)
AF:
0.00
AC:
0
AN:
86224
European-Finnish (FIN)
AF:
0.0000570
AC:
3
AN:
52666
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
5768
European-Non Finnish (NFE)
AF:
0.0000477
AC:
53
AN:
1111898
Other (OTH)
AF:
0.0000166
AC:
1
AN:
60384
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.508
Heterozygous variant carriers
0
5
10
14
19
24
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome 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
GnomAD4 genome
AF:
0.0000723
AC:
11
AN:
152174
Hom.:
0
Cov.:
33
AF XY:
0.0000404
AC XY:
3
AN XY:
74344
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
41430
American (AMR)
AF:
0.00
AC:
0
AN:
15278
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3472
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5190
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4832
European-Finnish (FIN)
AF:
0.0000942
AC:
1
AN:
10614
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
316
European-Non Finnish (NFE)
AF:
0.000147
AC:
10
AN:
68038
Other (OTH)
AF:
0.00
AC:
0
AN:
2092
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.430
Heterozygous variant carriers
0
1
2
2
3
4
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:
0.0000976
Hom.:
0
Bravo
AF:
0.0000416
ESP6500AA
AF:
0.00
AC:
0
ESP6500EA
AF:
0.000233
AC:
2
ExAC
AF:
0.0000494
AC:
6
EpiCase
AF:
0.00
EpiControl
AF:
0.0000593

ClinVar

Significance: Uncertain significance
Submissions summary: Uncertain:5
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

not specified Uncertain:2
Feb 08, 2013
Genetic Services Laboratory, University of Chicago
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Nov 25, 2024
Women's Health and Genetics/Laboratory Corporation of America, LabCorp
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

Variant summary: KCNJ11 c.526C>T (p.Arg176Cys) results in a non-conservative amino acid change in the encoded protein sequence. Five of five in-silico tools predict a damaging effect of the variant on protein function. The variant allele was found at a frequency of 2.4e-05 in 248678 control chromosomes. The available data on variant occurrences in the general population are insufficient to allow any conclusion about variant significance. c.526C>T has been reported in the literature in individuals affected with Neonatal Diabetes Mellitus/Maturity Onset Diabetes Of The Young, but not cosegregate with disease (Flechtner_2006, Dron_2020, Edghill_2004). It has also been reported in an individual with hypertrophic Cardiomyopathy, without strong evidence for causality (Burstein_2021). These report(s) do not provide unequivocal conclusions about association of the variant with Neonatal Diabetes Mellitus/Maturity Onset Diabetes Of The Young. One publication reports experimental evidence evaluating an impact on protein function, however, does not allow convincing conclusions about the variant effect (John_2001). The following publications have been ascertained in the context of this evaluation (PMID: 32746448, 32041611, 15504982, 17296510, 11585851). ClinVar contains an entry for this variant (Variation ID: 211223). Based on the evidence outlined above, the variant was classified as uncertain significance. -

KCNJ11-related disorder Uncertain:1
Jun 13, 2023
PreventionGenetics, part of Exact Sciences
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The KCNJ11 c.526C>T variant is predicted to result in the amino acid substitution p.Arg176Cys. This variant has been reported in individuals with diabetes but did not segregate with disease within the family (Edghill EL et al 2004. PubMed ID: 15504982; Flechtner et al 2006. PubMed ID: 17296510). Functional studies using artificial mutation showed that this variant may affect KCNJ11 function (John SA et al 2001. PubMed ID: 11585851). This variant is reported in 0.0086% of alleles in individuals of European (Non-Finnish) descent in gnomAD (http://gnomad.broadinstitute.org/variant/11-17409113-G-A). This variant is classified as variant of uncertain significance in ClinVar (https://www.ncbi.nlm.nih.gov/clinvar/variation/211223/). At this time, the clinical significance of this variant is uncertain due to the absence of conclusive functional and genetic evidence. -

not provided Uncertain:1
Dec 02, 2024
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This sequence change replaces arginine, which is basic and polar, with cysteine, which is neutral and slightly polar, at codon 176 of the KCNJ11 protein (p.Arg176Cys). This variant is present in population databases (rs201264306, gnomAD 0.009%). This missense change has been observed in individual(s) with diabetes mellitus (PMID: 15504982). ClinVar contains an entry for this variant (Variation ID: 211223). 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 expected to disrupt KCNJ11 protein function with a positive predictive value of 95%. Experimental studies have shown that this missense change affects KCNJ11 function (PMID: 11585851). 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. -

Maturity-onset diabetes of the young type 13 Uncertain:1
Oct 04, 2022
Institute of Human Genetics, University of Leipzig Medical Center
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

_x000D_ Criteria applied: PM5_STR, PP3 -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.34
BayesDel_addAF
Pathogenic
0.28
D
BayesDel_noAF
Pathogenic
0.47
CADD
Pathogenic
29
DANN
Pathogenic
1.0
Eigen
Pathogenic
0.79
Eigen_PC
Pathogenic
0.75
FATHMM_MKL
Uncertain
0.93
D
LIST_S2
Pathogenic
0.98
D;.;D
M_CAP
Pathogenic
0.65
D
MetaRNN
Pathogenic
0.94
D;D;D
MetaSVM
Pathogenic
1.0
D
PhyloP100
6.8
PrimateAI
Pathogenic
0.87
D
PROVEAN
Pathogenic
-6.0
D;D;D
REVEL
Pathogenic
0.90
Sift
Pathogenic
0.0
D;D;D
Sift4G
Pathogenic
0.0010
D;D;.
Vest4
0.75
MVP
0.99
MPC
1.9
ClinPred
0.97
D
GERP RS
5.2
gMVP
0.96
Mutation Taster
=6/94
disease causing

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: rs201264306; hg19: chr11-17409113; COSMIC: COSV60595667; COSMIC: COSV60595667; API