rs606231167

Variant summary

Our verdict is Pathogenic. The variant received 16 ACMG points: 16P and 0B. PVS1PP5_Very_Strong

The NM_001166114.2(PNPLA6):​c.3058_3061dupAGCC​(p.Arg1021GlnfsTer38) variant causes a frameshift change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.000165 in 1,613,668 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Pathogenic (★★). Synonymous variant affecting the same amino acid position (i.e. R1021R) has been classified as Likely benign. Variant results in nonsense mediated mRNA decay.

Frequency

Genomes: 𝑓 0.00012 ( 0 hom., cov: 32)
Exomes 𝑓: 0.00017 ( 0 hom. )

Consequence

PNPLA6
NM_001166114.2 frameshift

Scores

Not classified

Clinical Significance

Pathogenic criteria provided, multiple submitters, no conflicts P:15O:1

Conservation

PhyloP100: 2.08

Publications

5 publications found
Variant links:
Genes affected
PNPLA6 (HGNC:16268): (patatin like phospholipase domain containing 6) This gene encodes a phospholipase that deacetylates intracellular phosphatidylcholine to produce glycerophosphocholine. It is thought to function in neurite outgrowth and process elongation during neuronal differentiation. The protein is anchored to the cytoplasmic face of the endoplasmic reticulum in both neurons and non-neuronal cells. Mutations in this gene result in autosomal recessive spastic paraplegia, and the protein is the target for neurodegeneration induced by organophosphorus compounds and chemical warfare agents. Multiple transcript variants encoding different isoforms have been found for this gene. [provided by RefSeq, Oct 2009]
PNPLA6 Gene-Disease associations (from GenCC):
  • ataxia-hypogonadism-choroidal dystrophy syndrome
    Inheritance: AR Classification: DEFINITIVE, SUPPORTIVE Submitted by: G2P, Orphanet
  • PNPLA6-related spastic paraplegia with or without ataxia
    Inheritance: AR Classification: DEFINITIVE Submitted by: ClinGen
  • retinal dystrophy-ataxia-pituitary hormone abnormality-hypogonadism syndrome
    Inheritance: AR Classification: DEFINITIVE Submitted by: ClinGen
  • hereditary spastic paraplegia 39
    Inheritance: AR Classification: STRONG, SUPPORTIVE Submitted by: Labcorp Genetics (formerly Invitae), Orphanet
  • cerebellar ataxia-hypogonadism syndrome
    Inheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet
  • Laurence-Moon syndrome
    Inheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet
  • trichomegaly-retina pigmentary degeneration-dwarfism syndrome
    Inheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Pathogenic. The variant received 16 ACMG points.

PVS1
Loss of function variant, product undergoes nonsense mediated mRNA decay. LoF is a known mechanism of disease.
PP5
Variant 19-7555724-C-CGCCA is Pathogenic according to our data. Variant chr19-7555724-C-CGCCA is described in ClinVar as Pathogenic. ClinVar VariationId is 6607.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
PNPLA6NM_001166114.2 linkc.3058_3061dupAGCC p.Arg1021GlnfsTer38 frameshift_variant Exon 24 of 32 ENST00000600737.6 NP_001159586.1 Q8IY17A0A384DVU0

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
PNPLA6ENST00000600737.6 linkc.3058_3061dupAGCC p.Arg1021GlnfsTer38 frameshift_variant Exon 24 of 32 1 NM_001166114.2 ENSP00000473211.1 A0A384DVU0

Frequencies

GnomAD3 genomes
AF:
0.000125
AC:
19
AN:
152138
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.0000241
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:
0.000265
Gnomad OTH
AF:
0.00
GnomAD2 exomes
AF:
0.000124
AC:
31
AN:
249798
AF XY:
0.000133
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.0000580
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.000248
Gnomad OTH exome
AF:
0.000164
GnomAD4 exome
AF:
0.000169
AC:
247
AN:
1461530
Hom.:
0
Cov.:
33
AF XY:
0.000180
AC XY:
131
AN XY:
727106
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
33476
American (AMR)
AF:
0.0000671
AC:
3
AN:
44704
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
26108
East Asian (EAS)
AF:
0.00
AC:
0
AN:
39696
South Asian (SAS)
AF:
0.00
AC:
0
AN:
86246
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
53306
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
5746
European-Non Finnish (NFE)
AF:
0.000216
AC:
240
AN:
1111872
Other (OTH)
AF:
0.0000663
AC:
4
AN:
60376
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.490
Heterozygous variant carriers
0
15
31
46
62
77
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome Het
Variant carriers
0
10
20
30
40
50
<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:
0.000125
AC:
19
AN:
152138
Hom.:
0
Cov.:
32
AF XY:
0.000108
AC XY:
8
AN XY:
74310
show subpopulations
African (AFR)
AF:
0.0000241
AC:
1
AN:
41420
American (AMR)
AF:
0.00
AC:
0
AN:
15280
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3472
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5184
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4836
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10624
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
316
European-Non Finnish (NFE)
AF:
0.000265
AC:
18
AN:
68004
Other (OTH)
AF:
0.00
AC:
0
AN:
2090
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.549
Heterozygous variant carriers
0
1
2
4
5
6
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:
0.000196
Hom.:
0
Bravo
AF:
0.000140
EpiCase
AF:
0.000218
EpiControl
AF:
0.000237

ClinVar

Significance: Pathogenic
Submissions summary: Pathogenic:15Other:1
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Hereditary spastic paraplegia 39 Pathogenic:4
-
Paris Brain Institute, Inserm - ICM
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Mar 01, 2008
OMIM
Significance:Pathogenic
Review Status:no assertion criteria provided
Collection Method:literature only

- -

Feb 13, 2020
Institute of Human Genetics Munich, TUM University Hospital
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

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

This sequence change creates a premature translational stop signal (p.Arg983Glnfs*38) in the PNPLA6 gene. It is expected to result in an absent or disrupted protein product. Loss-of-function variants in PNPLA6 are known to be pathogenic (PMID: 24355708). This variant is present in population databases (rs764267161, gnomAD 0.03%). This premature translational stop signal has been observed in individual(s) with hereditary spastic paraplegia, Gordon-Holmes syndrome, Boucher-Neuhauser syndrome, and Laurence-Moon syndrome (PMID: 18313024, 24355708, 25480986). ClinVar contains an entry for this variant (Variation ID: 6607). For these reasons, this variant has been classified as Pathogenic. -

not provided Pathogenic:3
Jan 01, 2017
CeGaT Center for Human Genetics Tuebingen
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Nov 05, 2020
Athena Diagnostics
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant is expected to result in the loss of a functional protein. The frequency of this variant in the general population is consistent with pathogenicity (http://gnomad.broadinstitute.org). This variant has been identified in at least one individual with clinical features associated with this gene. This variant is also referred to as c.2946_2947_insCAGC, c.3084_3085insGCCA, and c.3091_3092insAGCC in published literature. -

Jun 06, 2025
GeneDx
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

Has been reported previously (as c.2946_2947insCAGC or c.3084_3085insGCCA in some reports due to use of alternate nomenclature) with a second PNPLA6 variant in multiple individuals with spasticity and other PNPLA6-related symptoms (PMID: 18313024, 24355708, 31135245); Fibroblasts from two affected siblings demonstrated significantly reduced NTE special activity (PMID: 20603202); Frameshift variant predicted to result in protein truncation or nonsense mediated decay in a gene for which loss of function is a known mechanism of disease; This variant is associated with the following publications: (PMID: 35069422, 25480986, 25574898, 23733235, 24355708, 31135245, 33726816, 34531397, 34256108, 35947152, 3963113, 8053762, 34906470, 34983064, 36344503, 36460718, 35872528, 20603202, 18313024, 36825042) -

PNPLA6-related disorder Pathogenic:2
Oct 12, 2022
Women's Health and Genetics/Laboratory Corporation of America, LabCorp
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

Variant summary: PNPLA6 c.2944_2947dupAGCC (p.Arg983GlnfsX38), which has also been referred to in the literature as c.2946_2947insCAGC (p.S982fs1019), c.3084_3085insGCCA (p.Arg1031GlufsX38), and c.3091_3092insAGCC (p.Arg1031fsX38), results in a premature termination codon, predicted to cause a truncation of the encoded protein or absence of the protein due to nonsense mediated decay, which are commonly known mechanisms for disease. The variant allele was found at a frequency of 0.00012 in 249798 control chromosomes, predominantly at a frequency of 0.00025 within the Non-Finnish European subpopulation in the gnomAD database. c.2944_2947dupAGCC has been reported in the literature in the compound heterozygous state in multiple individuals affected with PNPLA6-Related Disorders including spastic paraplegia, sporadic ataxia, Gordon Holmes syndrome, Oliver-McFarlane syndrome and Laurence-Moon syndrome (e.g. Rainier_2008, Synofzik_2014, Hufnagel_2015). 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 and found reduced enzyme activity (approximately 60% of normal) in fibroblasts from affected compound heterozygous individuals and also reduced activity (approximately 40% of normal) in unaffected carriers of the variant (Hein_2010). Eight submitters have provided assessments for this variant to ClinVar after 2014 and all classified the variant as pathogenic. Based on the evidence outlined above, the variant was classified as pathogenic. -

Dec 07, 2018
Illumina Laboratory Services, Illumina
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The PNPLA6 c.2944_2947dupAGCC (p.Arg983GlnfsTer38) variant results in a frameshift predicted to result in premature termination of the protein. The variant is also referred to in the literature as c.3084_3085insGCCA (p.Arg1031GlufsTer38). The p.Arg983GlnfsTer38 variant has been reported in at least three studies in which it is found in a compound heterozygous state with a missense variant in at least seven patients with a range of phenotypes, two of whom are siblings (Rainier et al. 2008; Synofzik et al. 2014; Hufnagel et al. 2015). The two siblings presented with progressive spastic paraplegia and distal muscle wasting (Rainer et al. 2008). The affected individuals reported by Synofzik et al. (2014) were diagnosed with sporadic ataxia and Gordon Holmes syndrome respectively while the three reported by Hufnagel et al. (2015) presented with Laurence-Moon syndrome. The variant is absent from 405 controls and is reported at a frequency of 0.000485 in the European American population of the Exome Sequencing Project. The p.Arg983GlnfsTer38 variant is predicted to result in the truncation of a large part of the catalytic domain of the protein (Rainier et al. 2008). Based on the potential impact of frameshift variants and the collective evidence, the p.Arg983GlnfsTer38 variant is classified as pathogenic for PNPLA6-related disorders. This variant was observed by ICSL as part of a predisposition screen in an ostensibly healthy population. -

Laurence-Moon syndrome Pathogenic:1
Feb 01, 2015
OMIM
Significance:Pathogenic
Review Status:no assertion criteria provided
Collection Method:literature only

- -

Trichomegaly-retina pigmentary degeneration-dwarfism syndrome Pathogenic:1
Feb 01, 2015
OMIM
Significance:Pathogenic
Review Status:no assertion criteria provided
Collection Method:literature only

- -

Inborn genetic diseases Pathogenic:1
Nov 29, 2021
Ambry Genetics
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The c.2944_2947dupAGCC (p.R983Qfs*38) alteration, located in exon 27 (coding exon 25) of the PNPLA6 gene, consists of a duplication of AGCC at position 2944, causing a translational frameshift with a predicted alternate stop codon after 38 amino acids. This alteration is expected to result in loss of function by premature protein truncation or nonsense-mediated mRNA decay. This alteration has been reported in multiple individuals with PNPLA6-related disorders and a second alteration in PNPLA6; however, the phase of the alterations was unclear (Rainier, 2008; Synofzik, 2013; Hufnagel, 2015; Kmoch, 2015; O'Neil, 2019). Based on the available evidence, this alteration is classified as pathogenic. -

Laurence-Moon syndrome;C1848745:Trichomegaly-retina pigmentary degeneration-dwarfism syndrome;C1859093:Ataxia-hypogonadism-choroidal dystrophy syndrome;C2677586:Hereditary spastic paraplegia 39 Pathogenic:1
Mar 09, 2022
Fulgent Genetics, Fulgent Genetics
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Hereditary spastic paraplegia Pathogenic:1
Dec 13, 2021
Genome Diagnostics Laboratory, The Hospital for Sick Children
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Retinal dystrophy Pathogenic:1
Jan 01, 2023
Institute of Human Genetics, Univ. Regensburg, Univ. Regensburg
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Ataxia-hypogonadism-choroidal dystrophy syndrome Other:1
-
GeneReviews
Significance:not provided
Review Status:no classification provided
Collection Method:literature only

Reported across the PNPLA6 disorders phenotypic spectrum -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
PhyloP100
2.1
Mutation Taster
=0/200
disease causing (ClinVar)

Splicing

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

Publications

Other links and lift over

dbSNP: rs606231167; hg19: chr19-7620610; API