rs386834192

Variant summary

Our verdict is Uncertain significance. The variant received 5 ACMG points: 5P and 0B. PM2PP3_ModeratePP5

The NM_153704.6(TMEM67):​c.2322+2dupT variant causes a splice region, intron change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.0000335 in 1,520,812 control chromosomes in the GnomAD database, with no homozygous occurrence. 1/1 splice prediction tools predicting alterations to normal splicing. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars).

Frequency

Genomes: 𝑓 0.000013 ( 0 hom., cov: 32)
Exomes 𝑓: 0.000036 ( 0 hom. )

Consequence

TMEM67
NM_153704.6 splice_region, intron

Scores

Not classified

Clinical Significance

Conflicting classifications of pathogenicity criteria provided, conflicting classifications P:6U:1

Conservation

PhyloP100: 7.38

Publications

2 publications found
Variant links:
Genes affected
TMEM67 (HGNC:28396): (transmembrane protein 67) The protein encoded by this gene localizes to the primary cilium and to the plasma membrane. The gene functions in centriole migration to the apical membrane and formation of the primary cilium. Multiple transcript variants encoding different isoforms have been found for this gene. Defects in this gene are a cause of Meckel syndrome type 3 (MKS3) and Joubert syndrome type 6 (JBTS6). [provided by RefSeq, Nov 2008]
TMEM67 Gene-Disease associations (from GenCC):
  • ciliopathy
    Inheritance: AR Classification: DEFINITIVE Submitted by: ClinGen
  • COACH syndrome 1
    Inheritance: AR Classification: DEFINITIVE Submitted by: G2P
  • Meckel syndrome, type 3
    Inheritance: AR Classification: DEFINITIVE Submitted by: Ambry Genetics
  • nephronophthisis 11
    Inheritance: AR Classification: DEFINITIVE, STRONG, MODERATE Submitted by: Ambry Genetics, Labcorp Genetics (formerly Invitae), G2P
  • COACH syndrome 1
    Inheritance: AR Classification: STRONG, SUPPORTIVE Submitted by: Orphanet, Ambry Genetics
  • Joubert syndrome 6
    Inheritance: AR Classification: STRONG Submitted by: Ambry Genetics, Labcorp Genetics (formerly Invitae)
  • Joubert syndrome
    Inheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet
  • Meckel syndrome
    Inheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet
  • Senior-Boichis syndrome
    Inheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Uncertain_significance. The variant received 5 ACMG points.

PM2
Very rare variant in population databases, with high coverage;
PP3
Splicing predictors support a deleterious effect. Scorers claiming Pathogenic: max_spliceai. No scorers claiming Uncertain. No scorers claiming Benign.
PP5
Variant 8-93803685-G-GT is Pathogenic according to our data. Variant chr8-93803685-G-GT is described in ClinVar as Conflicting_classifications_of_pathogenicity. ClinVar VariationId is 56773.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
TMEM67NM_153704.6 linkc.2322+2dupT splice_region_variant, intron_variant Intron 22 of 27 ENST00000453321.8 NP_714915.3 Q5HYA8

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
TMEM67ENST00000453321.8 linkc.2322+2dupT splice_region_variant, intron_variant Intron 22 of 27 1 NM_153704.6 ENSP00000389998.3 Q5HYA8

Frequencies

GnomAD3 genomes
AF:
0.0000131
AC:
2
AN:
152126
Hom.:
0
Cov.:
32
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:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.0000294
Gnomad OTH
AF:
0.00
GnomAD2 exomes
AF:
0.0000279
AC:
7
AN:
251108
AF XY:
0.0000147
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:
0.0000617
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000358
AC:
49
AN:
1368686
Hom.:
0
Cov.:
22
AF XY:
0.0000321
AC XY:
22
AN XY:
686146
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
31630
American (AMR)
AF:
0.00
AC:
0
AN:
44612
Ashkenazi Jewish (ASJ)
AF:
0.0000392
AC:
1
AN:
25522
East Asian (EAS)
AF:
0.00
AC:
0
AN:
39132
South Asian (SAS)
AF:
0.00
AC:
0
AN:
84234
European-Finnish (FIN)
AF:
0.0000188
AC:
1
AN:
53222
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
5310
European-Non Finnish (NFE)
AF:
0.0000428
AC:
44
AN:
1027852
Other (OTH)
AF:
0.0000525
AC:
3
AN:
57172
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.463
Heterozygous variant carriers
0
2
4
7
9
11
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:
0.0000131
AC:
2
AN:
152126
Hom.:
0
Cov.:
32
AF XY:
0.00
AC XY:
0
AN XY:
74328
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
41414
American (AMR)
AF:
0.00
AC:
0
AN:
15266
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3466
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5198
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4832
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10602
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
316
European-Non Finnish (NFE)
AF:
0.0000294
AC:
2
AN:
68034
Other (OTH)
AF:
0.00
AC:
0
AN:
2086
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.500
Heterozygous variant carriers
0
0
1
1
2
2
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:
0.00192
Hom.:
0
Bravo
AF:
0.0000189

ClinVar

Significance: Conflicting classifications of pathogenicity
Submissions summary: Pathogenic:6Uncertain:1
Revision: criteria provided, conflicting classifications
LINK: link

Submissions by phenotype

Joubert syndrome 6 Pathogenic:2
Feb 23, 2015
UW Hindbrain Malformation Research Program, University of Washington
Significance:Likely pathogenic
Review Status:criteria provided, single submitter
Collection Method:research

- -

Feb 10, 2019
Victorian Clinical Genetics Services, Murdoch Childrens Research Institute
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

A heterozygous canonical splice site variant, NM_153704.5(TMEM67):c.2322+2dupT, has been identified in intron 22 of 27 of the TMEM67 gene. The conservation of this nucleotide was very high (UCSC, Phylop), and in silico tools consistently predict this variant to affect splicing (Human splicing Finder, Fruit fly, Netgene2). This duplication variant may result in a truncated protein; further testing via RNA studies are required to confirm if splicing is altered. The variant is present in the gnomAD database at a frequency of 0.00283% (8 heterozygotes, 0 homozygotes). The variant has been previously described as both a VUS and pathogenic in patients with Joubert syndrome (ClinVar). Subsequent analysis of parental samples indicated this variant was paternally inherited. Based on current information, this variant has been classified as PATHOGENIC. NB: This variant has been reclassified as PATHOGENIC due to confirmation of a pathogenic variant in trans. -

Meckel syndrome, type 3 Pathogenic:1
-
Juha Muilu Group; Institute for Molecular Medicine Finland (FIMM)
Significance:Likely pathogenic
Review Status:no assertion criteria provided
Collection Method:literature only

- -

Meckel syndrome, type 3;C1853153:Joubert syndrome 6;C1865794:RHYNS syndrome;C2673874:Bardet-Biedl syndrome 14;C3150796:Nephronophthisis 11;C5435651:COACH syndrome 1 Pathogenic:1
Mar 25, 2024
Fulgent Genetics, Fulgent Genetics
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

COACH syndrome 1 Pathogenic:1
Jul 28, 2023
Pittsburgh Clinical Genomics Laboratory, University of Pittsburgh Medical Center
Significance:Likely pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This sequence variant is a single nucleotide duplication (dupT) at the +2 position of the intron 22 canonical splice donor site of the TMEM67 gene. This variant is predicted to generate a non-functiol allele through either the expression of a truncated protein or a loss of TMEM67 expression due to nonsense mediated decay. This is a previously reported variant (ClinVar 56773). Aside from literature reports on the proband (PMID: 19574260, 28125082), this variant has additiolly been observed in trans with a second TMEM67 variant in multiple individuals affected by Joubert syndrome, Meckel syndrome, or other TMEM67-related disorders (PMID: 28497568, 26092869, 20232449); in one individual with suspected monogenic kidney disease, it was unclear if a second TMEM67 variant was present (PMID: 32939031). This variant is present in 8 of 282484 alleles (0.0028%) in the gnomAD population dataset. In a lymphoblastoid cell line derived from the proband which presumably carried the variant, splicing of exon 22 was not affected (PMID: 19574260). Based upon the evidence, we consider this variant to be likely pathogenic. ACMG Criteria: PM2, PS4, PVS1 -

Meckel-Gruber syndrome;C0431399:Joubert syndrome Pathogenic:1
Jan 09, 2024
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This sequence change falls in intron 22 of the TMEM67 gene. It does not directly change the encoded amino acid sequence of the TMEM67 protein. It affects a nucleotide within the consensus splice site. This variant is present in population databases (rs781071815, gnomAD 0.006%). This variant has been observed in individual(s) with Joubert syndrome and related disorders (PMID: 20232449, 26092869, 28497568). 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.2322+2dupT. ClinVar contains an entry for this variant (Variation ID: 56773). Variants that disrupt the consensus splice site are a relatively common cause of aberrant splicing (PMID: 17576681, 9536098). Algorithms developed to predict the effect of sequence changes on RNA splicing suggest that this variant may disrupt the consensus splice site. For these reasons, this variant has been classified as Pathogenic. -

not provided Uncertain:1
Dec 10, 2014
Eurofins Ntd Llc (ga)
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
PhyloP100
7.4
Mutation Taster
=0/100
disease causing (ClinVar)

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.99
Details are displayed if max score is > 0.2
DS_DL_spliceai
0.99
Position offset: -1

Find out detailed SpliceAI scores and Pangolin per-transcript scores at spliceailookup.broadinstitute.org

Publications

Other links and lift over

dbSNP: rs386834192; hg19: chr8-94815913; API