rs63751121
Variant summary
Our verdict is Uncertain significance. The variant received 0 ACMG points: 0P and 0B.
The NM_000179.3(MSH6):āc.1857A>Cā(p.Glu619Asp) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.0000266 in 1,614,112 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. E619K) has been classified as Uncertain significance.
Frequency
Consequence
NM_000179.3 missense
Scores
Clinical Significance
Conservation
Publications
- intellectual developmental disorder with dysmorphic facies and behavioral abnormalitiesInheritance: AD Classification: DEFINITIVE, STRONG Submitted by: Labcorp Genetics (formerly Invitae), Ambry Genetics, G2P
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ACMG classification
Our verdict: Uncertain_significance. The variant received 0 ACMG points.
Transcripts
RefSeq
Ensembl
Frequencies
GnomAD3 genomes  0.0000460  AC: 7AN: 152248Hom.:  0  Cov.: 32 show subpopulations 
GnomAD2 exomes  AF:  0.0000160  AC: 4AN: 250676 AF XY:  0.0000147   show subpopulations 
GnomAD4 exome  AF:  0.0000246  AC: 36AN: 1461864Hom.:  0  Cov.: 34 AF XY:  0.0000316  AC XY: 23AN XY: 727226 show subpopulations 
Age Distribution
GnomAD4 genome  0.0000460  AC: 7AN: 152248Hom.:  0  Cov.: 32 AF XY:  0.0000403  AC XY: 3AN XY: 74378 show subpopulations 
Age Distribution
ClinVar
Submissions by phenotype
not provided    Uncertain:2 
Not observed at significant frequency in large population cohorts (gnomAD); In silico analysis indicates that this missense variant does not alter protein structure/function; Observed in individuals with a personal or family history including colorectal, pancreatic, and unspecified Lynch syndrome-related cancer; the variant was also identified in an individual with breast and endometrial cancer in whom tumor studies revealed presence of all mismatch repair proteins and microsatellite stability in the endometrial tumor (PMID: 15483016, 27601186, 32113160, 16813607); This variant is associated with the following publications: (PMID: 16813607, 15483016, 23621914, 27601186, 32113160, 26934580, 36897649, 27930734, 17531815, 21120944) -
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Hereditary cancer-predisposing syndrome    Uncertain:2 
The p.E619D variant (also known as c.1857A>C), located in coding exon 4 of the MSH6 gene, results from an A to C substitution at nucleotide position 1857. The glutamic acid at codon 619 is replaced by aspartic acid, an amino acid with highly similar properties. This alteration was reported in conjunction with a pathogenic mutation in MSH6 in an individual diagnosed with MSI-H colon cancer demonstrating absent MSH6 on IHC. This alteration was found to be in cis with the pathogenic mutation. The pathogenic mutation was found to be de novo in this individual, while the p.E619D alteration was paternally inherited (Plaschke J et al. J. Clin. Oncol. 2004 Nov;22:4486-94). This alteration has also been reported in a Polish individual with metachronous bilateral breast cancer diagnosed at ages 57 and 73 years and endometrial cancer diagnosed at age 75 years. The only reported family history of cancer was a sister diagnosed with liver cancer at age 74 and a sister diagnosed with gallbladder cancer at an unknown age. This proband's tumor was not tested by IHC and no family members were tested for this alteration (Suchy J et al. Clin. Genet. 2006 Jul;70:68-70). This variant was also previously detected in a Spanish patient with a strong family history of pancreatic cancer (Earl J et al. EBioMedicine, 2020 Mar;53:102675). In addition, this alteration has been identified in at least one Swedish family with a history of Lynch syndrome (Lagerstedt-Robinson K et al. Oncol. Rep. 2016 Nov;36(5):2823-2835). This amino acid position is highly conserved in available vertebrate species. In addition, the in silico prediction for this alteration is inconclusive. Since supporting evidence is limited at this time, the clinical significance of this alteration remains unclear. -
This missense variant replaces glutamic acid with aspartic acid at codon 619 of the MSH6 protein. Computational prediction is inconclusive regarding the impact of this variant on protein structure and function (internally defined REVEL score threshold 0.5 < inconclusive < 0.7, PMID: 27666373). To our knowledge, functional studies have not been reported for this variant. This variant has been reported in an individual affected with Lynch syndrome (PMID: 27601186), an individual affected with colorectal cancer who carried a pathogenic mutation in the same gene (PMID: 15483016), an individual affected with breast and endometrial cancer with tumor showing microsatellite stability and normal MSH6 gene expression (PMID: 16813607), and an individual affected with pancreatic cancer (PMID: 32113160) . This variant has been identified in 5/282082 chromosomes in the general population by the Genome Aggregation Database (gnomAD). The available evidence is insufficient to determine the role of this variant in disease conclusively. Therefore, this variant is classified as a Variant of Uncertain Significance. -
Lynch syndrome 5    Uncertain:1Benign:1 
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This variant is considered benign. This variant has been observed in trans with a known pathogenic variant in one or more individuals lacking clinical features consistent with gene-specific recessive disease. This variant is strongly associated with less severe personal and family histories of cancer, typical for individuals without pathogenic variants in this gene [PMID: 27363726]. -
Mismatch repair cancer syndrome 3    Uncertain:1 
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Lynch syndrome    Uncertain:1 
This missense variant replaces glutamic acid with aspartic acid at codon 619 of the MSH6 protein. Computational prediction is inconclusive regarding the impact of this variant on protein structure and function (internally defined REVEL score threshold 0.5 < inconclusive < 0.7, PMID: 27666373). To our knowledge, functional studies have not been reported for this variant. This variant has been reported in an individual affected with Lynch syndrome (PMID: 27601186), an individual affected with colorectal cancer who carried a pathogenic mutation in the same gene (PMID: 15483016), an individual affected with breast and endometrial cancer with tumor showing microsatellite stability and normal MSH6 gene expression (PMID: 16813607), and an individual affected with pancreatic cancer (PMID: 32113160) . This variant has been identified in 5/282082 chromosomes in the general population by the Genome Aggregation Database (gnomAD). The available evidence is insufficient to determine the role of this variant in disease conclusively. Therefore, this variant is classified as a Variant of Uncertain Significance. -
Endometrial carcinoma    Uncertain:1 
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Hereditary nonpolyposis colorectal neoplasms    Benign:1 
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Computational scores
Source: 
Splicing
 Find out detailed SpliceAI scores and Pangolin per-transcript scores at