rs372282873

Variant summary

Our verdict is Likely benign. The variant received -6 ACMG points: 0P and 6B. BP4BP6BS2

The NM_004387.4(NKX2-5):​c.635C>T​(p.Pro212Leu) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.00000997 in 1,604,968 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a benign outcome for this variant. 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. P212R) has been classified as Uncertain significance.

Frequency

Genomes: 𝑓 0.000079 ( 0 hom., cov: 32)
Exomes 𝑓: 0.0000028 ( 0 hom. )

Consequence

NKX2-5
NM_004387.4 missense

Scores

1
9
8

Clinical Significance

Conflicting classifications of pathogenicity criteria provided, conflicting classifications U:1B:1

Conservation

PhyloP100: 3.28

Publications

1 publications found
Variant links:
Genes affected
NKX2-5 (HGNC:2488): (NK2 homeobox 5) This gene encodes a homeobox-containing transcription factor. This transcription factor functions in heart formation and development. Mutations in this gene cause atrial septal defect with atrioventricular conduction defect, and also tetralogy of Fallot, which are both heart malformation diseases. Mutations in this gene can also cause congenital hypothyroidism non-goitrous type 5, a non-autoimmune condition. Alternative splicing results in multiple transcript variants. [provided by RefSeq, Oct 2009]
NKX2-5 Gene-Disease associations (from GenCC):
  • atrial septal defect 7
    Inheritance: AD Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Genomics England PanelApp, G2P, Ambry Genetics, Labcorp Genetics (formerly Invitae), Laboratory for Molecular Medicine, Orphanet
  • hypothyroidism, congenital, nongoitrous, 5
    Inheritance: AD, Unknown Classification: DEFINITIVE, MODERATE, LIMITED Submitted by: G2P, Labcorp Genetics (formerly Invitae), Ambry Genetics
  • NKX2.5-related congenital, conduction and myopathic heart disease
    Inheritance: AD Classification: DEFINITIVE Submitted by: ClinGen
  • tetralogy of fallot
    Inheritance: AD Classification: DEFINITIVE Submitted by: G2P
  • conotruncal heart malformations
    Inheritance: SD, AD Classification: DEFINITIVE, STRONG Submitted by: Ambry Genetics, Labcorp Genetics (formerly Invitae)
  • athyreosis
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • familial atrial fibrillation
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • familial bicuspid aortic valve
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • familial isolated congenital asplenia
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • dilated cardiomyopathy
    Inheritance: AD Classification: LIMITED Submitted by: ClinGen

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Likely_benign. The variant received -6 ACMG points.

BP4
Computational evidence support a benign effect (MetaRNN=0.30525133).
BP6
Variant 5-173232909-G-A is Benign according to our data. Variant chr5-173232909-G-A is described in ClinVar as Conflicting_classifications_of_pathogenicity. ClinVar VariationId is 1055168.
BS2
High AC in GnomAd4 at 12 AD,Unknown,SD gene.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
NKX2-5NM_004387.4 linkc.635C>T p.Pro212Leu missense_variant Exon 2 of 2 ENST00000329198.5 NP_004378.1
NKX2-5NM_001166176.2 linkc.*434C>T 3_prime_UTR_variant Exon 2 of 2 NP_001159648.1
NKX2-5NM_001166175.2 linkc.*588C>T 3_prime_UTR_variant Exon 2 of 2 NP_001159647.1

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
NKX2-5ENST00000329198.5 linkc.635C>T p.Pro212Leu missense_variant Exon 2 of 2 1 NM_004387.4 ENSP00000327758.4
NKX2-5ENST00000424406.2 linkc.*588C>T 3_prime_UTR_variant Exon 2 of 2 1 ENSP00000395378.2
NKX2-5ENST00000521848.1 linkc.*434C>T 3_prime_UTR_variant Exon 2 of 2 2 ENSP00000427906.1

Frequencies

GnomAD3 genomes
AF:
0.0000723
AC:
11
AN:
152208
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.000265
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:
0.00
Gnomad OTH
AF:
0.00
GnomAD2 exomes
AF:
0.00000896
AC:
2
AN:
223214
AF XY:
0.00
show subpopulations
Gnomad AFR exome
AF:
0.000160
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:
0.00
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.00000275
AC:
4
AN:
1452642
Hom.:
0
Cov.:
35
AF XY:
0.00
AC XY:
0
AN XY:
722208
show subpopulations
African (AFR)
AF:
0.0000600
AC:
2
AN:
33352
American (AMR)
AF:
0.00
AC:
0
AN:
43308
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
25940
East Asian (EAS)
AF:
0.00
AC:
0
AN:
39266
South Asian (SAS)
AF:
0.00
AC:
0
AN:
85650
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
50946
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
5700
European-Non Finnish (NFE)
AF:
0.00000180
AC:
2
AN:
1108586
Other (OTH)
AF:
0.00
AC:
0
AN:
59894
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.488
Heterozygous variant carriers
0
1
1
2
2
3
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

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:
0.0000788
AC:
12
AN:
152326
Hom.:
0
Cov.:
32
AF XY:
0.0000671
AC XY:
5
AN XY:
74490
show subpopulations
African (AFR)
AF:
0.000289
AC:
12
AN:
41574
American (AMR)
AF:
0.00
AC:
0
AN:
15302
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3472
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5174
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4830
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10624
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
294
European-Non Finnish (NFE)
AF:
0.00
AC:
0
AN:
68030
Other (OTH)
AF:
0.00
AC:
0
AN:
2114
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.516
Heterozygous variant carriers
0
1
2
3
4
5
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:
0.00
Hom.:
0
Bravo
AF:
0.0000642
ExAC
AF:
0.0000171
AC:
2

ClinVar

Significance: Conflicting classifications of pathogenicity
Submissions summary: Uncertain:1Benign:1
Revision: criteria provided, conflicting classifications
LINK: link

Submissions by phenotype

Cardiovascular phenotype Uncertain:1
Aug 30, 2025
Ambry Genetics
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The p.P212L variant (also known as c.635C>T), located in coding exon 2 of the NKX2-5 gene, results from a C to T substitution at nucleotide position 635. The proline at codon 212 is replaced by leucine, an amino acid with similar properties. This amino acid position is well conserved in available vertebrate species. In addition, the in silico prediction for this alteration is inconclusive. Since supporting evidence is limited at this time, the clinical significance of this alteration remains unclear.

Atrial septal defect 7 Benign:1
Feb 02, 2025
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.12
BayesDel_addAF
Benign
-0.10
T
BayesDel_noAF
Benign
-0.12
CADD
Uncertain
24
DANN
Uncertain
0.99
DEOGEN2
Uncertain
0.45
T
Eigen
Benign
-0.34
Eigen_PC
Benign
-0.31
FATHMM_MKL
Uncertain
0.95
D
LIST_S2
Benign
0.78
T
M_CAP
Pathogenic
0.36
D
MetaRNN
Benign
0.31
T
MetaSVM
Benign
-0.34
T
MutationAssessor
Uncertain
2.3
M
PhyloP100
3.3
PrimateAI
Uncertain
0.77
T
PROVEAN
Uncertain
-3.1
D
REVEL
Uncertain
0.36
Sift
Uncertain
0.0020
D
Sift4G
Uncertain
0.0080
D
Vest4
0.36
ClinPred
0.81
D
GERP RS
2.8
Varity_R
0.27
gMVP
0.62
Mutation Taster
=89/11
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: rs372282873; hg19: chr5-172659912; API