rs34803727

Variant summary

Our verdict is Pathogenic. The variant received 11 ACMG points: 11P and 0B. PM5PP2PP5_Very_Strong

The NM_001126108.2(SLC12A3):​c.2938G>A​(p.Gly980Arg) variant causes a missense change. The variant allele was found at a frequency of 0.000148 in 1,614,068 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Likely pathogenic (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. G980W) has been classified as Likely pathogenic.

Frequency

Genomes: 𝑓 0.000046 ( 0 hom., cov: 32)
Exomes 𝑓: 0.00016 ( 0 hom. )

Consequence

SLC12A3
NM_001126108.2 missense

Scores

3
13
3

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:14

Conservation

PhyloP100: 4.79

Publications

7 publications found
Variant links:
Genes affected
SLC12A3 (HGNC:10912): (solute carrier family 12 member 3) This gene encodes a renal thiazide-sensitive sodium-chloride cotransporter that is important for electrolyte homeostasis. This cotransporter mediates sodium and chloride reabsorption in the distal convoluted tubule. Mutations in this gene cause Gitelman syndrome, a disease similar to Bartter's syndrome, that is characterized by hypokalemic alkalosis combined with hypomagnesemia, low urinary calcium, and increased renin activity associated with normal blood pressure. This cotransporter is the target for thiazide diuretics that are used for treating high blood pressure. Multiple transcript variants encoding different isoforms have been found for this gene. [provided by RefSeq, Jul 2008]
SLC12A3 Gene-Disease associations (from GenCC):
  • Gitelman syndrome
    Inheritance: AR Classification: STRONG, SUPPORTIVE Submitted by: Orphanet, Labcorp Genetics (formerly Invitae)

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Pathogenic. The variant received 11 ACMG points.

PM5
Other missense variant is known to change same aminoacid residue: Variant chr16-56913277-G-T is described in ClinVar as Likely_pathogenic. ClinVar VariationId is 2780349.Status of the report is criteria_provided_single_submitter, 1 stars.
PP2
Missense variant in the gene, where a lot of missense mutations are associated with disease in ClinVar. The gene has 138 curated pathogenic missense variants (we use a threshold of 10). The gene has 18 curated benign missense variants. Gene score misZ: -0.93606 (below the threshold of 3.09). Trascript score misZ: 0.71313 (below the threshold of 3.09). GenCC associations: The gene is linked to Gitelman syndrome.
PP5
Variant 16-56913277-G-A is Pathogenic according to our data. Variant chr16-56913277-G-A is described in ClinVar as Pathogenic/Likely_pathogenic. ClinVar VariationId is 586605.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
SLC12A3NM_001126108.2 linkc.2938G>A p.Gly980Arg missense_variant Exon 26 of 26 ENST00000563236.6 NP_001119580.2
SLC12A3NM_000339.3 linkc.2965G>A p.Gly989Arg missense_variant Exon 26 of 26 NP_000330.3
SLC12A3NM_001126107.2 linkc.2962G>A p.Gly988Arg missense_variant Exon 26 of 26 NP_001119579.2
SLC12A3NM_001410896.1 linkc.2935G>A p.Gly979Arg missense_variant Exon 26 of 26 NP_001397825.1

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
SLC12A3ENST00000563236.6 linkc.2938G>A p.Gly980Arg missense_variant Exon 26 of 26 1 NM_001126108.2 ENSP00000456149.2

Frequencies

GnomAD3 genomes
AF:
0.0000460
AC:
7
AN:
152180
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.0000241
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.0000655
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:
0.0000735
Gnomad OTH
AF:
0.00
GnomAD2 exomes
AF:
0.0000558
AC:
14
AN:
251000
AF XY:
0.0000295
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.0000578
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.000106
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.000159
AC:
232
AN:
1461888
Hom.:
0
Cov.:
31
AF XY:
0.000149
AC XY:
108
AN XY:
727246
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
33480
American (AMR)
AF:
0.0000671
AC:
3
AN:
44724
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
26136
East Asian (EAS)
AF:
0.00
AC:
0
AN:
39696
South Asian (SAS)
AF:
0.00
AC:
0
AN:
86258
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
53420
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
5768
European-Non Finnish (NFE)
AF:
0.000203
AC:
226
AN:
1112010
Other (OTH)
AF:
0.0000497
AC:
3
AN:
60396
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.487
Heterozygous variant carriers
0
14
28
41
55
69
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:
0.0000460
AC:
7
AN:
152180
Hom.:
0
Cov.:
32
AF XY:
0.0000404
AC XY:
3
AN XY:
74340
show subpopulations
African (AFR)
AF:
0.0000241
AC:
1
AN:
41454
American (AMR)
AF:
0.0000655
AC:
1
AN:
15276
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3470
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5190
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4824
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10618
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
316
European-Non Finnish (NFE)
AF:
0.0000735
AC:
5
AN:
68028
Other (OTH)
AF:
0.00
AC:
0
AN:
2092
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.511
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:
0.000167
Hom.:
0
Bravo
AF:
0.0000340
TwinsUK
AF:
0.00
AC:
0
ALSPAC
AF:
0.000519
AC:
2
ESP6500AA
AF:
0.00
AC:
0
ESP6500EA
AF:
0.000116
AC:
1
ExAC
AF:
0.0000659
AC:
8
EpiCase
AF:
0.000164
EpiControl
AF:
0.00

ClinVar

Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:14
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Familial hypokalemia-hypomagnesemia Pathogenic:6
Oct 10, 2024
Victorian Clinical Genetics Services, Murdoch Childrens Research Institute
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

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 Gitelman syndrome (MIM#263800). (I) 0106 - This gene is associated with autosomal recessive disease. (I) 0200 - Variant is predicted to result in a missense amino acid change from glycine to arginine. (I) 0251 - This variant is heterozygous. (I) 0304 - Variant is present in gnomAD <0.01 for a recessive condition (v2: 17 heterozygotes, 0 homozygotes). (SP) 0502 - Missense variant with conflicting in silico predictions and uninformative conservation. (I) 0600 - Variant is located in the annotated SLC12 family domain (DECIPHER). (I) 0801 - This variant has strong previous evidence of pathogenicity in unrelated individuals. This variant has been classified as likely pathogenic and pathogenic by multiple clinical diagnostic laboratories and is associated with Gitelman syndrome (ClinVar, PMID: 11168953). (SP) 1208 - Inheritance information for this variant is not currently available in this individual. (I) Legend: (SP) - Supporting pathogenic, (I) - Information, (SB) - Supporting benign -

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

- -

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

- -

Jul 15, 2021
Genome-Nilou Lab
Significance:Likely pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Apr 27, 2022
European Hospital Georges Pompidou Genetics Department, Assistance Publique - Hôpitaux de Paris AP-HP
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

ACMG criteria used:PS3, PS4, PM1, PM2, PM3, PP1, PP5 -

Feb 11, 2022
Revvity Omics, Revvity
Significance:Likely pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

not provided Pathogenic:6
Jan 06, 2022
GeneDx
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

In vitro functional analysis demonstrated significantly diminished metolazone-sensitive sodium uptake levels in cells harboring this variant; immunocytochemical analysis revealed that the altered protein was localized to the cytoplasm and plasma membrane rather than only the plasma membrane as observed with the wild-type protein (De Jong et al., 2002); In silico analysis, which includes protein predictors and evolutionary conservation, supports that this variant does not alter protein structure/function; Also known as p.(G980R); This variant is associated with the following publications: (PMID: 23328711, 21415153, 11168953, 22009145, 31672324, 33144682, 17329572, 29942493, 18391953, 12039972) -

Apr 10, 2018
Athena Diagnostics
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

-
Clinical Genetics DNA and cytogenetics Diagnostics Lab, Erasmus MC, Erasmus Medical Center
Significance:Likely pathogenic
Review Status:no assertion criteria provided
Collection Method:clinical testing

- -

Oct 29, 2024
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This sequence change replaces glycine, which is neutral and non-polar, with arginine, which is basic and polar, at codon 989 of the SLC12A3 protein (p.Gly989Arg). This variant is present in population databases (rs34803727, gnomAD 0.01%). This missense change has been observed in individual(s) with Gitelman syndrome (PMID: 17329572, 18391953, 21415153, 23328711, 29942493). In at least one individual the data is consistent with being in trans (on the opposite chromosome) from a pathogenic variant. This variant is also known as c.2938G>A (G980R). ClinVar contains an entry for this variant (Variation ID: 586605). 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) has been performed for this missense variant. However, the output from this modeling did not meet the statistical confidence thresholds required to predict the impact of this variant on SLC12A3 protein function. Experimental studies have shown that this missense change affects SLC12A3 function (PMID: 12039972). For these reasons, this variant has been classified as Pathogenic. -

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

SLC12A3: PM3:Very Strong, PM2, PS3:Supporting -

-
Genome Diagnostics Laboratory, University Medical Center Utrecht
Significance:Pathogenic
Review Status:no assertion criteria provided
Collection Method:clinical testing

- -

Inborn genetic diseases Pathogenic:1
Nov 12, 2020
Ambry Genetics
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The c.2965G>A (p.G989R) alteration is located in exon 26 (coding exon 26) of the SLC12A3 gene. This alteration results from a G to A substitution at nucleotide position 2965, causing the glycine (G) at amino acid position 989 to be replaced by an arginine (R). Based on data from the Genome Aggregation Database (gnomAD) database, the SLC12A3 c.2965G>A alteration was observed in 0.006% (17/282,386) of total alleles studied, with a frequency of 0.01% (14/128,704) in the European (non-Finnish) subpopulation. This alteration has been reported in multiple patients with Gitelman syndrome in both the homozygous and compound heterozygous states (Berry, 2013; Glaudemans, 2012; Vargas-Poussou, 2011; Ji, 2008). This amino acid position is not well conserved in available vertebrate species. In an assay of metolazone-sensitive sodium uptake this variant was found to be functionally abnormal (de Jong, 2002). The in silico prediction for the p.G989R alteration is inconclusive. Based on the available evidence, this alteration is classified as pathogenic. -

Bartter syndrome;C0268450:Familial hypokalemia-hypomagnesemia Pathogenic:1
Jul 13, 2018
Sydney Genome Diagnostics, Children's Hospital Westmead
Significance:Pathogenic
Review Status:no assertion criteria provided
Collection Method:clinical testing

This individual is heterozygous for the c.2965G>A variant in the SLC12A3 gene. This variant has been reported in the gnomAD browser (http://gnomad.broadinstitute.org) with a very low allele frequency of 0.006% (16 out of 276,718 alleles). The c.2965G>A p.(Gly989Arg) variant, which is equivalent to c.2938G>A p.(Gly980Arg) using transcript NM_001126108.1, has been described in many patients with Gitelman syndrome as compound heterozygous with a second pathogenic variant (e.g. De Jong et al. 2002 J Am Soc Nephrol 13: 1442-1448; Riveira-Munoz et al. 2007 J Am Soc Nephrol 18: 1271-1283; Ji et al. 2008 Nat Genet 40: 592-599). Functional studies found that the mutant protein had impaired sodium ion uptake and was also partially incorrectly localised in the cytoplasm (De Jong et al. 2002 J Am Soc Nephrol 13: 1442-1448). This variant is considered to be pathogenic according to the ACMG guidelines. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
0.75
BayesDel_addAF
Pathogenic
0.19
D
BayesDel_noAF
Pathogenic
0.24
CADD
Pathogenic
29
DANN
Uncertain
1.0
DEOGEN2
Uncertain
0.47
.;.;T;T
Eigen
Uncertain
0.44
Eigen_PC
Uncertain
0.37
FATHMM_MKL
Uncertain
0.83
D
LIST_S2
Uncertain
0.94
D;D;D;D
M_CAP
Uncertain
0.11
D
MetaRNN
Uncertain
0.47
T;T;T;T
MetaSVM
Uncertain
-0.23
T
MutationAssessor
Uncertain
2.5
.;.;M;.
PhyloP100
4.8
PrimateAI
Uncertain
0.71
T
PROVEAN
Benign
-1.9
N;N;N;N
REVEL
Benign
0.27
Sift
Uncertain
0.014
D;D;D;D
Sift4G
Uncertain
0.026
D;D;D;D
Polyphen
0.94
P;D;D;.
Vest4
0.67
MutPred
0.81
.;.;Gain of MoRF binding (P = 0.0334);.;
MVP
0.92
MPC
0.46
ClinPred
0.32
T
GERP RS
4.3
Varity_R
0.63
gMVP
0.84
Mutation Taster
=1/99
disease causing (ClinVar)

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: rs34803727; hg19: chr16-56947189; API