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rs397517953

Variant summary

Our verdict is Uncertain significance. Variant got 4 ACMG points: 4P and 0B. PM2PM4

The NM_001099404.2(SCN5A):c.1756_1761del(p.Ala586_Leu587del) variant causes a inframe deletion change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.0000738 in 1,612,764 control chromosomes in the GnomAD database, including 1 homozygotes. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars).

Frequency

Genomes: 𝑓 0.000026 ( 0 hom., cov: 32)
Exomes 𝑓: 0.000079 ( 1 hom. )

Consequence

SCN5A
NM_001099404.2 inframe_deletion

Scores

Not classified

Clinical Significance

Conflicting classifications of pathogenicity criteria provided, conflicting classifications U:4B:3

Conservation

PhyloP100: 2.43
Variant links:
Genes affected
SCN5A (HGNC:10593): (sodium voltage-gated channel alpha subunit 5) The protein encoded by this gene is an integral membrane protein and tetrodotoxin-resistant voltage-gated sodium channel subunit. This protein is found primarily in cardiac muscle and is responsible for the initial upstroke of the action potential in an electrocardiogram. Defects in this gene have been associated with long QT syndrome type 3 (LQT3), atrial fibrillation, cardiomyopathy, and Brugada syndrome 1, all autosomal dominant cardiac diseases. Alternative splicing results in several transcript variants encoding different isoforms. [provided by RefSeq, May 2022]

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ACMG classification

Classification made for transcript

Verdict is Uncertain_significance. Variant got 4 ACMG points.

PM2
Very rare variant in population databases, with high coverage;
PM4
Nonframeshift variant in NON repetitive region in NM_001099404.2.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE UniProt
SCN5ANM_000335.5 linkuse as main transcriptc.1756_1761del p.Ala586_Leu587del inframe_deletion 12/28 ENST00000423572.7
SCN5ANM_001099404.2 linkuse as main transcriptc.1756_1761del p.Ala586_Leu587del inframe_deletion 12/28 ENST00000413689.6

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Appris UniProt
SCN5AENST00000413689.6 linkuse as main transcriptc.1756_1761del p.Ala586_Leu587del inframe_deletion 12/285 NM_001099404.2 P4
SCN5AENST00000423572.7 linkuse as main transcriptc.1756_1761del p.Ala586_Leu587del inframe_deletion 12/281 NM_000335.5 A1Q14524-2

Frequencies

GnomAD3 genomes
AF:
0.0000263
AC:
4
AN:
152178
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:
0.000829
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.00
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.000149
AC:
37
AN:
248138
Hom.:
1
AF XY:
0.000216
AC XY:
29
AN XY:
134538
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 SAS exome
AF:
0.00118
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.00
Gnomad OTH exome
AF:
0.000166
GnomAD4 exome
AF:
0.0000787
AC:
115
AN:
1460468
Hom.:
1
AF XY:
0.000124
AC XY:
90
AN XY:
726418
show subpopulations
Gnomad4 AFR exome
AF:
0.00
Gnomad4 AMR exome
AF:
0.00
Gnomad4 ASJ exome
AF:
0.00
Gnomad4 EAS exome
AF:
0.00
Gnomad4 SAS exome
AF:
0.00125
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.00000180
Gnomad4 OTH exome
AF:
0.0000663
GnomAD4 genome
AF:
0.0000263
AC:
4
AN:
152296
Hom.:
0
Cov.:
32
AF XY:
0.0000403
AC XY:
3
AN XY:
74474
show subpopulations
Gnomad4 AFR
AF:
0.00
Gnomad4 AMR
AF:
0.00
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.000829
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.00
Gnomad4 OTH
AF:
0.00

ClinVar

Significance: Conflicting classifications of pathogenicity
Submissions summary: Uncertain:4Benign:3
Revision: criteria provided, conflicting classifications
LINK: link

Submissions by phenotype

not provided Uncertain:1Benign:2
Uncertain significance, criteria provided, single submitterclinical testingLaboratory for Molecular Medicine, Mass General Brigham Personalized MedicineJun 30, 2022The p.Ala586_Leu587del variant in SCN5A has been reported in a case of SIDS and was absent from 364 controls (Amestad 2007). It has also been identified in 0.08% (4/4828) of South Asian chromosomes by gnomAD v. 3 (http://gnomad.broadinstitute.org). This variant results in the deletion of an alanine (Ala) and a leucine (Leu) at position 586 and 587, but does not alter the amino acid reading frame. It is unclear how this deletion may impact the protein. In vitro functional studies showed that the variant did not exhibit a LongQT phenotype, however did have functional disturbances such as greater peak sodium densitites and changes in recovery from inactivation (Wang 2007 PMID: 17210841); however, these types of assays may not accurately represent biological function. In summary, the clinical significance of this variant is uncertain. ACMG/AMP Criteria applied: BS1. -
Likely benign, criteria provided, single submitterclinical testingInvitaeJan 08, 2024- -
Likely benign, criteria provided, single submitterclinical testingGeneDxOct 22, 2018This variant is associated with the following publications: (PMID: 28316956, 17210841, 17210839, 21215473, 27332903, 21167004, 25923670, 31043699) -
Brugada syndrome 1 Uncertain:1
Uncertain significance, criteria provided, single submitterclinical testingMendelicsMay 28, 2019- -
Cardiovascular phenotype Uncertain:1
Uncertain significance, criteria provided, single submitterclinical testingAmbry GeneticsOct 12, 2020The c.1756_1761delGCCCTC variant (also known as p.A586_L587del) is located in coding exon 11 of the SCN5A gene. This variant results from an in-frame GCCCTC deletion at nucleotide positions 1756 to 1761. This results in the in-frame deletion of the alanine and leucine residues at codons 586 and 587. This alteration has been reported in a sudden infant death syndrome (SIDS) case, a sudden cardiac death (SCD) case, and in a long QT syndrome (LQTS) cohort (Arnestad M et al. Circulation. 2007;115:361-7; Kapplinger JD et al. Heart Rhythm. 2009;6:1297-303; Bagnall RD et al. N Engl J Med. 2016 Jun;374:2441-52). One functional study demonstrated a small effect of the deletion on peak sodium current density; however, the authors deemed the change insufficient to provoke pathological behavior (Wang DW et al. Circulation, 2007;115:368-76). This amino acid region is poorly conserved in available vertebrate species. Since supporting evidence is limited at this time, the clinical significance of this alteration remains unclear. -
Cardiac arrhythmia Uncertain:1
Uncertain significance, criteria provided, single submitterclinical testingColor Diagnostics, LLC DBA Color HealthApr 15, 2021This variant deletes two amino acids from the linker region between transmembrane domains DI and DII of the SCN5A protein. Computational splicing tools suggest that this variant may not impact RNA splicing. To our knowledge, functional assays have not been performed for this variant. This variant has been reported in an individual affected with sudden cardiac death (PMID: 27332903). This variant has also been identified in 36/245052 chromosomes (35/30726 South Asian chromosomes) in the general population by the Genome Aggregation Database (gnomAD). The relatively high frequency of this variant in the general population suggests that this variant is unlikely to be disease-causing. However, additional studies are necessary to determine the role of this variant in disease conclusively. -
Sudden unexplained death Benign:1
Likely benign, criteria provided, single submitterresearchAgnes Ginges Centre for Molecular Cardiology, Centenary InstituteNov 18, 2016The SCN5A Ala586_Leu587del has been previously reported in a case of Sudden Infant Death Syndrome (Arnestad et al, 2007). We identified this variant in a patient presenting with sudden unexplained death at 27yo. The allele frequency is 0.00015 in the Exome Aggregation Consortium (http://exac.broadinstitute.org/), which is higher than expected. Based on the relative rarity of arrhythmia syndromes causing unexplained SCD, we believe this variant could not cause disease. As a result we have classified this variant as 'likely benign'. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction

Splicing

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: rs397517953; hg19: chr3-38645331; API