rs5030872

Variant summary

Our verdict is Likely pathogenic. Variant got 7 ACMG points: 8P and 1B. PP5_Very_StrongBP4

The NM_001360016.2(G6PD):​c.542A>T​(p.Asp181Val) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.0000777 in 1,209,769 control chromosomes in the GnomAD database, with no homozygous occurrence. There are 22 hemizygotes in GnomAD. In-silico tool predicts a benign outcome for this variant. Variant has been reported in ClinVar as Likely pathogenic (★★).

Frequency

Genomes: 𝑓 0.00044 ( 0 hom., 7 hem., cov: 23)
Exomes 𝑓: 0.000041 ( 0 hom. 15 hem. )

Consequence

G6PD
NM_001360016.2 missense

Scores

4
5
8

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:11O:1

Conservation

PhyloP100: 7.78
Variant links:
Genes affected
G6PD (HGNC:4057): (glucose-6-phosphate dehydrogenase) This gene encodes glucose-6-phosphate dehydrogenase. This protein is a cytosolic enzyme encoded by a housekeeping X-linked gene whose main function is to produce NADPH, a key electron donor in the defense against oxidizing agents and in reductive biosynthetic reactions. G6PD is remarkable for its genetic diversity. Many variants of G6PD, mostly produced from missense mutations, have been described with wide ranging levels of enzyme activity and associated clinical symptoms. G6PD deficiency may cause neonatal jaundice, acute hemolysis, or severe chronic non-spherocytic hemolytic anemia. Two transcript variants encoding different isoforms have been found for this gene. [provided by RefSeq, Jul 2008]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Likely_pathogenic. Variant got 7 ACMG points.

PP5
Variant X-154534440-T-A is Pathogenic according to our data. Variant chrX-154534440-T-A is described in ClinVar as [Likely_pathogenic]. Clinvar id is 37203.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chrX-154534440-T-A is described in Lovd as [Pathogenic]. Variant chrX-154534440-T-A is described in Lovd as [Pathogenic].
BP4
Computational evidence support a benign effect (MetaRNN=0.16829187). . Strength limited to SUPPORTING due to the PP5.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
G6PDNM_001360016.2 linkc.542A>T p.Asp181Val missense_variant Exon 6 of 13 ENST00000393562.10 NP_001346945.1
G6PDNM_000402.4 linkc.632A>T p.Asp211Val missense_variant Exon 6 of 13 NP_000393.4 P11413-3
G6PDNM_001042351.3 linkc.542A>T p.Asp181Val missense_variant Exon 6 of 13 NP_001035810.1 P11413-1A0A384NL00

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
G6PDENST00000393562.10 linkc.542A>T p.Asp181Val missense_variant Exon 6 of 13 1 NM_001360016.2 ENSP00000377192.3 P11413-1

Frequencies

GnomAD3 genomes
AF:
0.000438
AC:
49
AN:
111781
Hom.:
0
Cov.:
23
AF XY:
0.000206
AC XY:
7
AN XY:
33999
show subpopulations
Gnomad AFR
AF:
0.00124
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00103
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
GnomAD3 exomes
AF:
0.000136
AC:
25
AN:
183162
Hom.:
0
AF XY:
0.000103
AC XY:
7
AN XY:
67684
show subpopulations
Gnomad AFR exome
AF:
0.00106
Gnomad AMR exome
AF:
0.000292
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad SAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.0000245
Gnomad OTH exome
AF:
0.000221
GnomAD4 exome
AF:
0.0000410
AC:
45
AN:
1097988
Hom.:
0
Cov.:
32
AF XY:
0.0000413
AC XY:
15
AN XY:
363384
show subpopulations
Gnomad4 AFR exome
AF:
0.000871
Gnomad4 AMR exome
AF:
0.000313
Gnomad4 ASJ exome
AF:
0.00
Gnomad4 EAS exome
AF:
0.00
Gnomad4 SAS exome
AF:
0.00
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.00000238
Gnomad4 OTH exome
AF:
0.000174
GnomAD4 genome
AF:
0.000438
AC:
49
AN:
111781
Hom.:
0
Cov.:
23
AF XY:
0.000206
AC XY:
7
AN XY:
33999
show subpopulations
Gnomad4 AFR
AF:
0.00124
Gnomad4 AMR
AF:
0.00103
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.00
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.00
Gnomad4 OTH
AF:
0.00
Alfa
AF:
0.0000754
Hom.:
1
Bravo
AF:
0.000536
ESP6500AA
AF:
0.00130
AC:
5
ESP6500EA
AF:
0.00
AC:
0
ExAC
AF:
0.000140
AC:
17

ClinVar

Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:11Other:1
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

not provided Pathogenic:5
Aug 23, 2024
GeneDx
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

Biochemical studies of G6PD enzyme activity from patient blood samples showed that G6PD Malaga (D181V) and G6PD Santamaria (D181V+N126D) have similar abnormal kinetic properties, though G6PD Santamaria showed additional abnormalities thought to be due to the interaction of both variants (PMID: 8956035); Published functional studies demonstrate that the G6PD Santamaria variant (D181V+N126D) causes lower levels of expression of soluble protein as well as reduced enzyme activity compared to both wild-type GP6D and G6PD harboring the N126D variant alone (PMID: 26633385); In silico analysis indicates that this missense variant does not alter protein structure/function; This variant is associated with the following publications: (PMID: 27267757, 21931771, 26738565, 17611006, 10571945, 6433630, 1879833, 9233561, 8956035, 31589614, 36681081, 36007526, 34272389, 26633385, 33637102) -

Jun 14, 2021
Mayo Clinic Laboratories, Mayo Clinic
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

PS3, PS4 -

Jul 01, 2023
CeGaT Center for Human Genetics Tuebingen
Significance: Likely pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

G6PD: PM2, PS4:Moderate, PP4, PS3:Supporting -

Nov 05, 2012
Eurofins Ntd Llc (ga)
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Jan 08, 2018
ARUP Laboratories, Molecular Genetics and Genomics, ARUP Laboratories
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Anemia, nonspherocytic hemolytic, due to G6PD deficiency Pathogenic:4
Dec 03, 2024
Victorian Clinical Genetics Services, Murdoch Childrens Research Institute
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

Evidence in support of pathogenic classification: - Variant is present in gnomAD <0.01 (v4: 72 heterozygote(s), 0 homozygote(s), 22 hemizygote(s)) . - This variant has strong previous evidence of pathogenicity in unrelated individuals. This variant alone, known as the Malaga variant, as well as this variant in cis with c.376A>G; p.Asn126Asp, known as the Santa Maria haplotype, have both been reported in individuals with G6PD deficient haemolytic anaemia (ClinVar, PMID: 10571945, PMID: 22293322, PMID: 36681081). Additional information: - Variant is predicted to result in a missense amino acid change from aspartic acid to valine. - This variant is hemizygous. - This gene is associated with X-linked recessive disease. Hemizygous males and homozygous females are commonly affected; however, some heterozygous female carriers can also be affected depending on X-inactivation. - Variant is located in the annotated Glucose-6-phosphate dehydrogenase, NAD binding domain (DECIPHER). - Missense variant with inconclusive in silico prediction and uninformative conservation. - Loss of function is a known mechanism of disease in this gene and is associated with G6PD deficient hemolytic anemia (favism) (MIM#300908). - Inheritance information for this variant is not currently available in this individual. -

Nov 27, 2024
Labcorp Genetics (formerly Invitae), Labcorp
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

This sequence change replaces aspartic acid, which is acidic and polar, with valine, which is neutral and non-polar, at codon 181 of the G6PD protein (p.Asp181Val). The frequency data for this variant in the population databases is considered unreliable, as metrics indicate poor data quality at this position in the gnomAD database. The c.542A>T (p.Asp181Val) variant and the c.376A>G (p.Asn126Asp) variant, when co-occurring in cis as c.[376A>G;542A>T], is known as the G6PD Santa Maria haplotype. The c.542A>T (p.Asn181Val) variant alone (PMID: 10571945, 8956035) and the Santa Maria haplotype (PMID: 1879833, 22963789, 12367584, 8956035, 22906837) have both been observed in individuals affected with G6PD deficiency. ClinVar contains an entry for this variant (Variation ID: 37203). 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 G6PD protein function. Experimental studies are not available for the c.542A>T (p.Asn181Val) variant alone, but in vitro studies have shown that the G6PD Santa Maria haplotype abrogates enzyme activity and reduces affinity for the substrate (PMID: 26633385). For these reasons, this variant has been classified as Pathogenic. -

Aug 12, 2022
Dunham Lab, University of Washington
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: curation

Variant found in unrelated hemizygotes with deficiency, favism, and anemia (PS4_M, PP4). Decreased activity in red blood cells (6%) (PS3). Below expected carrier frequency in gnomAD (PM2). Reported as pathogenic by multiple clinical testing groups (PP5). Not found in gnomAD (PM2). Post_P 0.994 (odds of pathogenicity 1517, Prior_P 0.1). -

May 28, 2019
Mendelics
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Malaria, susceptibility to Pathogenic:1
Mar 08, 2024
Baylor Genetics
Significance: Likely pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

G6PD deficiency Pathogenic:1
Apr 19, 2024
Women's Health and Genetics/Laboratory Corporation of America, LabCorp
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

Variant summary: G6PD c.632A>T (p.Asp211Val) results in a non-conservative amino acid change in the encoded protein sequence. Three of five in-silico tools predict a benign effect of the variant on protein function. The variant allele was found at a frequency of 0.00014 in 183162 control chromosomes. This frequency is not significantly higher than estimated for a pathogenic variant in G6PD causing Glucose 6 Phosphate Dehydrogenase Deficiency (0.00014 vs 0.29), allowing no conclusion about variant significance. c.632A>T has been reported in the literature as c.542A>T (p.Asp181Val) or G6PD Malaga in isolation and as G6PD Santamaria association with c.376A>G (p. Asn126Asp, the nondeficient polymorphic variant G6PD A+ as stated in Al-Sweedan_2012) in multiple individuals affected with clinical manifestations of Favism and Glucose 6 Phosphate Dehydrogenase Deficiency (example, Vulliamy_1996, Al Sweedan_2012, Benmansour_2013). These data indicate that the variant is very likely to be associated with disease. At least one publication reports experimental evidence evaluating an impact on protein function in isolation and as the G6PD Santamaria haplotype (Vulliamy_1996). The most pronounced variant effect in isolation (G6PD Malaga) results in a residual RBC activity of 6.4% of normal, a slower than normal electrophoretic mobility, a markedly decreased Km for both G6P and NADP, striking decreases in utilization rates of 2-deoxy G6P and deamino NADP, a normal thermostability and pH optimum curve. The following publications have been ascertained in the context of this evaluation (PMID: 22906837, 9233561, 22963789, 8956035). ClinVar contains an entry for this variant (Variation ID: 37203). Based on the evidence outlined above, the variant in isolation and in cis with c.376A>G as G6PD Santamaria was classified as pathogenic. -

G6PD MALAGA Other:1
May 24, 2017
OMIM
Significance: other
Review Status: no assertion criteria provided
Collection Method: literature only

- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.18
BayesDel_addAF
Uncertain
0.11
D
BayesDel_noAF
Pathogenic
0.34
CADD
Benign
20
DANN
Benign
0.91
DEOGEN2
Pathogenic
0.81
D;D;D;.;D;.;D
FATHMM_MKL
Uncertain
0.91
D
LIST_S2
Pathogenic
0.98
.;.;D;D;D;D;D
M_CAP
Pathogenic
0.54
D
MetaRNN
Benign
0.17
T;T;T;T;T;T;T
MetaSVM
Uncertain
0.38
D
MutationAssessor
Benign
-0.29
N;N;N;N;.;.;.
PrimateAI
Benign
0.27
T
PROVEAN
Uncertain
-2.4
.;.;N;N;N;N;N
REVEL
Uncertain
0.61
Sift
Benign
0.073
.;.;T;T;T;T;T
Sift4G
Benign
0.16
T;.;T;T;.;.;.
Polyphen
0.0080
B;B;B;.;.;.;.
Vest4
0.68
MVP
1.0
MPC
0.29
ClinPred
0.057
T
GERP RS
5.7
Varity_R
0.71
gMVP
0.80

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: rs5030872; hg19: chrX-153762655; API