rs6471

Variant summary

Our verdict is Likely pathogenic. Variant got 7 ACMG points: 7P and 0B. PM1PM2PM5PP3

The NM_000500.9(CYP21A2):​c.844G>A​(p.Val282Met) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.00000747 in 1,607,240 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. No clinical diagnostic laboratories have submitted clinical-significance assessments for this variant to ClinVar. Another variant affecting the same amino acid position, but resulting in a different missense (i.e. V282L) has been classified as Pathogenic.

Frequency

Genomes: 𝑓 0.0000066 ( 0 hom., cov: 32)
Exomes 𝑓: 0.0000076 ( 0 hom. )

Consequence

CYP21A2
NM_000500.9 missense

Scores

1
10
4

Clinical Significance

Not reported in ClinVar

Conservation

PhyloP100: 2.60
Variant links:
Genes affected
CYP21A2 (HGNC:2600): (cytochrome P450 family 21 subfamily A member 2) This gene encodes a member of the cytochrome P450 superfamily of enzymes. The cytochrome P450 proteins are monooxygenases which catalyze many reactions involved in drug metabolism and synthesis of cholesterol, steroids and other lipids. This protein localizes to the endoplasmic reticulum and hydroxylates steroids at the 21 position. Its activity is required for the synthesis of steroid hormones including cortisol and aldosterone. Mutations in this gene cause congenital adrenal hyperplasia. A related pseudogene is located near this gene; gene conversion events involving the functional gene and the pseudogene are thought to account for many cases of steroid 21-hydroxylase deficiency. 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.

PM1
In a helix (size 31) in uniprot entity CP21A_HUMAN there are 17 pathogenic changes around while only 1 benign (94%) in NM_000500.9
PM2
Very rare variant in population databases, with high coverage;
PM5
Other missense variant is known to change same aminoacid residue: Variant chr6-32040110-G-T is described in Lovd as [Pathogenic].
PP3
MetaRNN computational evidence supports a deleterious effect, 0.821

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE Protein UniProt
CYP21A2NM_000500.9 linkuse as main transcriptc.844G>A p.Val282Met missense_variant 7/10 ENST00000644719.2 NP_000491.4
CYP21A2NM_001128590.4 linkuse as main transcriptc.754G>A p.Val252Met missense_variant 6/9 NP_001122062.3
CYP21A2NM_001368143.2 linkuse as main transcriptc.439G>A p.Val147Met missense_variant 7/10 NP_001355072.1
CYP21A2NM_001368144.2 linkuse as main transcriptc.439G>A p.Val147Met missense_variant 6/9 NP_001355073.1

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Protein Appris UniProt
CYP21A2ENST00000644719.2 linkuse as main transcriptc.844G>A p.Val282Met missense_variant 7/10 NM_000500.9 ENSP00000496625 P1

Frequencies

GnomAD3 genomes
AF:
0.00000659
AC:
1
AN:
151774
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.00
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.0000659
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:
0.0000124
AC:
3
AN:
242232
Hom.:
0
AF XY:
0.00000757
AC XY:
1
AN XY:
132026
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:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.0000276
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.00000756
AC:
11
AN:
1455466
Hom.:
0
Cov.:
38
AF XY:
0.00000690
AC XY:
5
AN XY:
724188
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:
0.00
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.00000993
Gnomad4 OTH exome
AF:
0.00
GnomAD4 genome
AF:
0.00000659
AC:
1
AN:
151774
Hom.:
0
Cov.:
32
AF XY:
0.00
AC XY:
0
AN XY:
74142
show subpopulations
Gnomad4 AFR
AF:
0.00
Gnomad4 AMR
AF:
0.0000659
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
ExAC
AF:
0.00000831
AC:
1

ClinVar

Not reported in ClinVar

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
BayesDel_addAF
Uncertain
0.094
D
BayesDel_noAF
Benign
-0.10
CADD
Pathogenic
28
DANN
Uncertain
1.0
Eigen
Uncertain
0.47
Eigen_PC
Uncertain
0.42
FATHMM_MKL
Uncertain
0.90
D
M_CAP
Uncertain
0.22
D
MetaRNN
Pathogenic
0.82
D;D;D;D
MetaSVM
Benign
-0.52
T
MutationTaster
Benign
0.96
D;D
PrimateAI
Uncertain
0.53
T
PROVEAN
Benign
-1.3
N;.;N;.
REVEL
Uncertain
0.54
Sift
Uncertain
0.0030
D;.;T;.
Sift4G
Uncertain
0.0090
D;.;D;.
Polyphen
1.0
D;D;.;D
Vest4
0.55
MutPred
0.75
Gain of disorder (P = 0.0622);Gain of disorder (P = 0.0622);.;Gain of disorder (P = 0.0622);
MVP
0.89
MPC
1.4
ClinPred
0.84
D
GERP RS
4.0
gMVP
0.57

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: rs6471; hg19: chr6-32007887; API