rs369574719

Variant summary

Our verdict is Pathogenic. The variant received 11 ACMG points: 11P and 0B. PM1PM2PM5PP3_StrongPP5

The NM_000158.4(GBE1):​c.785G>A​(p.Arg262His) variant causes a missense, splice region change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.0000318 in 1,601,384 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. 1/1 splice prediction tools predict no significant impact on normal splicing. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. R262C) has been classified as Likely pathogenic.

Frequency

Genomes: 𝑓 0.000053 ( 0 hom., cov: 32)
Exomes 𝑓: 0.000030 ( 0 hom. )

Consequence

GBE1
NM_000158.4 missense, splice_region

Scores

15
3
1

Clinical Significance

Conflicting classifications of pathogenicity criteria provided, conflicting classifications P:6U:4

Conservation

PhyloP100: 7.45
Variant links:
Genes affected
GBE1 (HGNC:4180): (1,4-alpha-glucan branching enzyme 1) The protein encoded by this gene is a glycogen branching enzyme that catalyzes the transfer of alpha-1,4-linked glucosyl units from the outer end of a glycogen chain to an alpha-1,6 position on the same or a neighboring glycogen chain. Branching of the chains is essential to increase the solubility of the glycogen molecule and, consequently, in reducing the osmotic pressure within cells. Highest level of this enzyme are found in liver and muscle. Mutations in this gene are associated with glycogen storage disease IV (also known as Andersen's disease). [provided by RefSeq, Jul 2008]

Genome browser will be placed here

ACMG classification

Classification was made for transcript

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

PM1
In a hotspot region, there are 4 aminoacids with missense pathogenic changes in the window of +-8 aminoacids around while only 0 benign, 5 uncertain in NM_000158.4
PM2
Very rare variant in population databases, with high coverage;
PM5
Other missense variant is known to change same aminoacid residue: Variant chr3-81642989-G-A is described in ClinVar as [Conflicting_classifications_of_pathogenicity]. Clinvar id is 2791.We mark this variant Likely_pathogenic, oryginal submissions are: {Uncertain_significance=1, Likely_pathogenic=2, Pathogenic=1}.
PP3
MetaRNN computational evidence supports a deleterious effect, 0.943
PP5
Variant 3-81642988-C-T is Pathogenic according to our data. Variant chr3-81642988-C-T is described in ClinVar as [Conflicting_classifications_of_pathogenicity]. Clinvar id is 437422.We mark this variant Likely_pathogenic, oryginal submissions are: {Uncertain_significance=4, Likely_pathogenic=5, Pathogenic=1}.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
GBE1NM_000158.4 linkc.785G>A p.Arg262His missense_variant, splice_region_variant Exon 7 of 16 ENST00000429644.7 NP_000149.4 Q04446Q59ET0
GBE1XR_007095662.1 linkn.913G>A splice_region_variant, non_coding_transcript_exon_variant Exon 7 of 15

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
GBE1ENST00000429644.7 linkc.785G>A p.Arg262His missense_variant, splice_region_variant Exon 7 of 16 1 NM_000158.4 ENSP00000410833.2 Q04446
GBE1ENST00000489715.1 linkc.662G>A p.Arg221His missense_variant, splice_region_variant Exon 7 of 16 2 ENSP00000419638.1 E9PGM4
GBE1ENST00000498468.1 linkn.335G>A splice_region_variant, non_coding_transcript_exon_variant Exon 4 of 4 3

Frequencies

GnomAD3 genomes
AF:
0.0000526
AC:
8
AN:
151998
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.0000725
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00
Gnomad ASJ
AF:
0.00
Gnomad EAS
AF:
0.000193
Gnomad SAS
AF:
0.00
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.0000588
Gnomad OTH
AF:
0.00
GnomAD2 exomes
AF:
0.0000298
AC:
7
AN:
234522
AF XY:
0.00
show subpopulations
Gnomad AFR exome
AF:
0.0000686
Gnomad AMR exome
AF:
0.0000620
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.0000595
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.0000190
Gnomad OTH exome
AF:
0.000174
GnomAD4 exome
AF:
0.0000297
AC:
43
AN:
1449386
Hom.:
0
Cov.:
28
AF XY:
0.0000236
AC XY:
17
AN XY:
720640
show subpopulations
Gnomad4 AFR exome
AF:
0.000151
AC:
5
AN:
33206
Gnomad4 AMR exome
AF:
0.0000231
AC:
1
AN:
43202
Gnomad4 ASJ exome
AF:
0.00
AC:
0
AN:
25940
Gnomad4 EAS exome
AF:
0.0000508
AC:
2
AN:
39348
Gnomad4 SAS exome
AF:
0.00
AC:
0
AN:
85116
Gnomad4 FIN exome
AF:
0.00
AC:
0
AN:
53144
Gnomad4 NFE exome
AF:
0.0000281
AC:
31
AN:
1103746
Gnomad4 Remaining exome
AF:
0.0000501
AC:
3
AN:
59940
Heterozygous variant carriers
0
3
6
9
12
15
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance
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:
0.0000526
AC:
8
AN:
151998
Hom.:
0
Cov.:
32
AF XY:
0.0000674
AC XY:
5
AN XY:
74206
show subpopulations
Gnomad4 AFR
AF:
0.0000725
AC:
0.0000724638
AN:
0.0000724638
Gnomad4 AMR
AF:
0.00
AC:
0
AN:
0
Gnomad4 ASJ
AF:
0.00
AC:
0
AN:
0
Gnomad4 EAS
AF:
0.000193
AC:
0.00019253
AN:
0.00019253
Gnomad4 SAS
AF:
0.00
AC:
0
AN:
0
Gnomad4 FIN
AF:
0.00
AC:
0
AN:
0
Gnomad4 NFE
AF:
0.0000588
AC:
0.0000588235
AN:
0.0000588235
Gnomad4 OTH
AF:
0.00
AC:
0
AN:
0
Heterozygous variant carriers
0
1
1
2
2
3
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance
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:
0.000115
Hom.:
0
Bravo
AF:
0.0000529
ESP6500AA
AF:
0.000264
AC:
1
ESP6500EA
AF:
0.00
AC:
0
ExAC
AF:
0.0000249
AC:
3

ClinVar

Significance: Conflicting classifications of pathogenicity
Submissions summary: Pathogenic:6Uncertain:4
Revision: criteria provided, conflicting classifications
LINK: link

Submissions by phenotype

Glycogen storage disease, type IV Pathogenic:3Uncertain:1
May 05, 2025
Broad Center for Mendelian Genomics, Broad Institute of MIT and Harvard
Significance:Likely pathogenic
Review Status:criteria provided, single submitter
Collection Method:curation

The p.Arg262His variant in GBE1 has been reported in 2 individuals with glycogen storage disease type IV (GSD IV) (PMID: 33332610, 33820833) and has been identified in 0.01% (8/74606) of African chromosomes by the Genome Aggregation Database (gnomAD, http://gnomad.broadinstitute.org; dbSNP ID: rs369574719). Although this variant has been seen in the general population in a heterozygous state, its frequency is low enough to be consistent with a recessive carrier frequency. This variant has also been reported in ClinVar (Variation ID#: 437422) and has been interpreted as likely pathogenic/pathogenic by Nilou-Genome lab, Center of Genomic medicine (Geneva, University Hospital of Geneva), Institute of Medical Genetics and Applied Genomics (University Hospital Tübingen), and Baylor Genetics, and as uncertain significance by GeneDx, Women's Health and Genetics/Laboratory Corporation of America, Labcorp Genetics (formerly Invitae), and Counsyl. Of the two affected individuals, both were compound heterozygotes that carried a reported pathogenic/likely pathogenic variant in trans which increases the likelihood that the p.Arg262His variant is pathogenic (Variation ID: 208584, 2792; PMID: 33332610, 33820833). Computational prediction tools and conservation analyses suggest that this variant may impact the protein, though this information is not predictive enough to determine pathogenicity. In summary, although additional studies are required to fully establish its clinical significance, this variant is likely pathogenic for autosomal recessive GSD IV. ACMG/AMP Criteria applied: PP3_moderate, PM3_strong, PM2_supporting (Richards 2015). -

May 18, 2021
Genome-Nilou Lab
Significance:Likely pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

May 03, 2018
Counsyl
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Mar 20, 2024
Baylor Genetics
Significance:Likely pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Adult polyglucosan body disease Pathogenic:3
Nov 15, 2016
Center of Genomic medicine, Geneva, University Hospital of Geneva
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This heterozygous variant in the GBE1 gene (autosomal recessive transmission), inherited from the father, was present in a female patient who also harbours a second variant in the same codon of the same gene inherited by the mother (compound heterozygosity). -

Apr 02, 2025
Institute of Human Genetics, University of Leipzig Medical Center
Significance:Likely pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

Criteria applied: PM1,PM3,PM5,PM2_SUP,PP3 -

Feb 08, 2024
Institute of Medical Genetics and Applied Genomics, University Hospital Tübingen
Significance:Likely pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

not specified Uncertain:1
Dec 09, 2022
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: GBE1 c.785G>A (p.Arg262His) results in a non-conservative amino acid change in the encoded protein sequence. Four of four in-silico tools predict a damaging effect of the variant on protein function. 4/4 computational tools predict no significant impact on normal splicing. However, these predictions have yet to be confirmed by functional studies. The variant allele was found at a frequency of 3e-05 in 234522 control chromosomes. The available data on variant occurrences in the general population are insufficient to allow any conclusion about variant significance. To our knowledge, no occurrence of c.785G>A in individuals affected with Glycogen Storage Disease, Type IV and no experimental evidence demonstrating its impact on protein function have been reported. Five clinical diagnostic laboratories have submitted clinical-significance assessments for this variant to ClinVar after 2014 without evidence for independent evaluation. Multiple laboratories reported the variant with conflicting assessments. Based on the evidence outlined above, the variant was classified as uncertain significance. -

not provided Uncertain:1
May 15, 2019
GeneDx
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

Not observed at a significant frequency in large population cohorts (Lek et al., 2016); In silico analysis, which includes protein predictors and evolutionary conservation, supports a deleterious effect; Has not been previously published as pathogenic or benign to our knowledge -

Glycogen storage disease, type IV;C1856301:Glycogen storage disease IV, classic hepatic Uncertain:1
Jun 10, 2022
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 histidine, which is basic and polar, at codon 262 of the GBE1 protein (p.Arg262His). This variant is present in population databases (rs369574719, gnomAD 0.01%). This variant has not been reported in the literature in individuals affected with GBE1-related conditions. ClinVar contains an entry for this variant (Variation ID: 437422). Algorithms developed to predict the effect of missense changes on protein structure and function are either unavailable or do not agree on the potential impact of this missense change (SIFT: "Not Available"; PolyPhen-2: "Probably Damaging"; Align-GVGD: "Not Available"). 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. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Uncertain
0.46
BayesDel_addAF
Pathogenic
0.30
D
BayesDel_noAF
Pathogenic
0.38
CADD
Pathogenic
32
DANN
Pathogenic
1.0
DEOGEN2
Pathogenic
0.88
D;D
Eigen
Pathogenic
0.89
Eigen_PC
Pathogenic
0.73
FATHMM_MKL
Pathogenic
0.98
D
LIST_S2
Pathogenic
1.0
D;D
M_CAP
Pathogenic
0.33
D
MetaRNN
Pathogenic
0.94
D;D
MetaSVM
Pathogenic
1.1
D
MutationAssessor
Uncertain
2.6
M;.
PrimateAI
Uncertain
0.76
T
PROVEAN
Pathogenic
-4.8
D;D
REVEL
Pathogenic
0.90
Sift
Pathogenic
0.0
D;D
Sift4G
Pathogenic
0.0010
D;D
Polyphen
1.0
D;D
Vest4
0.94
MVP
0.97
MPC
0.25
ClinPred
0.94
D
GERP RS
5.0
RBP_binding_hub_radar
0.0
RBP_regulation_power_radar
1.7
Varity_R
0.89
gMVP
0.88
Mutation Taster
=4/96
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

LitVar

Below is the list of publications found by LitVar. It may be empty.

Other links and lift over

dbSNP: rs369574719; hg19: chr3-81692139; COSMIC: COSV70096518; API