rs587776498
Variant summary
Our verdict is Pathogenic. Variant got 10 ACMG points: 10P and 0B. PM2PP5_Very_Strong
The NM_004092.4(ECHS1):c.5C>T(p.Ala2Val) variant causes a missense change. The variant allele was found at a frequency of 0.0000306 in 1,502,630 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Pathogenic (★★).
Frequency
Consequence
NM_004092.4 missense
Scores
Clinical Significance
Conservation
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ACMG classification
Verdict is Pathogenic. Variant got 10 ACMG points.
Transcripts
RefSeq
Ensembl
Frequencies
GnomAD3 genomes AF: 0.0000395 AC: 6AN: 152090Hom.: 0 Cov.: 33
GnomAD3 exomes AF: 0.0000101 AC: 1AN: 98522Hom.: 0 AF XY: 0.0000182 AC XY: 1AN XY: 54884
GnomAD4 exome AF: 0.0000296 AC: 40AN: 1350540Hom.: 0 Cov.: 34 AF XY: 0.0000195 AC XY: 13AN XY: 666302
GnomAD4 genome AF: 0.0000395 AC: 6AN: 152090Hom.: 0 Cov.: 33 AF XY: 0.0000269 AC XY: 2AN XY: 74290
ClinVar
Submissions by phenotype
Mitochondrial short-chain Enoyl-Coa hydratase 1 deficiency Pathogenic:4
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The ECHS1 c.5C>T; p.Ala2Val variant (rs587776498) is reported in the literature in the compound heterozygous state in several individuals affected with Leigh syndrome (Kuwajima 2021, Ogawa 2020, Sakai 2015, Sato-Shirai 2021, Stenton 2022, Sun 2020, Uesugi 2020, Yang 2022). This variant is also reported in ClinVar (Variation ID: 156434), but is only observed on three alleles in the Genome Aggregation Database, indicating it is not a common polymorphism. The alanine at codon 2 is weakly conserved, and computational analyses are uncertain whether this variant is neutral or deleterious (REVEL: 0.604). However, functional analyses of the variant protein show decreased expression and enzyme activity (Sakai 2015). Based on available information, this variant is considered to be pathogenic. References: Kuwajima M et al. Valine metabolites analysis in ECHS1 deficiency. Mol Genet Metab Rep. 2021 Oct 9;29:100809. PMID: 34667719. Ogawa E et al. Mortality of Japanese patients with Leigh syndrome: Effects of age at onset and genetic diagnosis. J Inherit Metab Dis. 2020 Jul;43(4):819-826. PMID: 31967322. Sakai C et al. ECHS1 mutations cause combined respiratory chain deficiency resulting in Leigh syndrome. Hum Mutat. 2015 Feb;36(2):232-9. PMID: 25393721. Sato-Shirai I et al. Valine-restricted diet for patients with ECHS1 deficiency: Divergent clinical outcomes in two Japanese siblings. Brain Dev. 2021 Feb;43(2):308-313. PMID: 33139125. Stenton SL et al. Leigh Syndrome: A Study of 209 Patients at the Beijing Children's Hospital. Ann Neurol. 2022 Apr;91(4):466-482. PMID: 35094435. Sun D et al. Novel ECHS1 mutations in Leigh syndrome identified by whole-exome sequencing in five Chinese families: case report. BMC Med Genet. 2020 Jul 16;21(1):149. PMID: 32677908. Uesugi M et al. Short-chain enoyl-CoA hydratase deficiency causes prominent ketoacidosis with normal plasma lactate levels: A case report. Mol Genet Metab Rep. 2020 Oct 30;25:100672. PMID: 33163364. Yang Z et al. Whole-exome sequencing identified novel variants in three Chinese Leigh syndrome pedigrees. Am J Med Genet A. 2022 Apr;188(4):1214-1225. PMID: 35014173. -
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not provided Pathogenic:2
This sequence change replaces alanine, which is neutral and non-polar, with valine, which is neutral and non-polar, at codon 2 of the ECHS1 protein (p.Ala2Val). 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. This missense change has been observed in individual(s) with ECHS1-related conditions (PMID: 25393721, 32677908, 33139125, 33163364). In at least one individual the data is consistent with being in trans (on the opposite chromosome) from a pathogenic variant. ClinVar contains an entry for this variant (Variation ID: 156434). An algorithm developed to predict the effect of missense changes on protein structure and function (PolyPhen-2) suggests that this variant is likely to be tolerated. Studies have shown that this missense change alters ECHS1 gene expression (PMID: 25393721). For these reasons, this variant has been classified as Pathogenic. -
Published functional studies demonstrate a damaging effect as A2V was associated with a reduction in protein expression and enzyme activity (Sakai et al., 2015); In silico analysis, which includes protein predictors and evolutionary conservation, supports that this variant does not alter protein structure/function; This variant is associated with the following publications: (PMID: 25393721, 31967322, 33139125, 32677908, 33163364) -
Leigh syndrome Pathogenic:1
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Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at