rs746097144

Variant summary

Our verdict is Pathogenic. The variant received 18 ACMG points: 18P and 0B. PVS1PM2PP5_Very_Strong

The NM_000500.9(CYP21A2):​c.60G>A​(p.Trp20*) variant causes a stop gained change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.00000693 in 1,587,140 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Pathogenic (★★).

Frequency

Genomes: 𝑓 0.000020 ( 0 hom., cov: 32)
Exomes 𝑓: 0.0000056 ( 0 hom. )

Consequence

CYP21A2
NM_000500.9 stop_gained

Scores

3
2
1

Clinical Significance

Pathogenic criteria provided, multiple submitters, no conflicts P:2

Conservation

PhyloP100: 3.17

Publications

5 publications found
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]
CYP21A2 Gene-Disease associations (from GenCC):
  • classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency
    Inheritance: AR Classification: DEFINITIVE, STRONG Submitted by: Labcorp Genetics (formerly Invitae), Myriad Women’s Health, Laboratory for Molecular Medicine
  • classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency, salt wasting form
    Inheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet
  • classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency, simple virilizing form
    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 18 ACMG points.

PVS1
Loss of function variant, product does not undergo nonsense mediated mRNA decay. Variant located near the start codon (<100nt), not predicted to undergo nonsense mediated mRNA decay. There are 116 pathogenic variants in the truncated region.
PM2
Very rare variant in population databases, with high coverage;
PP5
Variant 6-32038482-G-A is Pathogenic according to our data. Variant chr6-32038482-G-A is described in ClinVar as Pathogenic. ClinVar VariationId is 804727.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.

Variant Effect in Transcripts

ACMG analysis was done for transcript: NM_000500.9. You can select a different transcript below to see updated ACMG assignments.

RefSeq Transcripts

Sel.
GeneTranscriptTagsHGVScHGVSpEffectExon RankProteinUniProt
CYP21A2
NM_000500.9
MANE Select
c.60G>Ap.Trp20*
stop_gained
Exon 1 of 10NP_000491.4
CYP21A2
NM_001128590.4
c.60G>Ap.Trp20*
stop_gained
Exon 1 of 9NP_001122062.3P08686-2
CYP21A2
NM_001368143.2
c.-365G>A
5_prime_UTR
Exon 1 of 10NP_001355072.1

Ensembl Transcripts

Sel.
GeneTranscriptTagsHGVScHGVSpEffectExon RankProteinUniProt
CYP21A2
ENST00000644719.2
MANE Select
c.60G>Ap.Trp20*
stop_gained
Exon 1 of 10ENSP00000496625.1P08686-1
CYP21A2
ENST00000960600.1
c.60G>Ap.Trp20*
stop_gained
Exon 1 of 10ENSP00000630659.1
CYP21A2
ENST00000960597.1
c.60G>Ap.Trp20*
stop_gained
Exon 1 of 10ENSP00000630656.1

Frequencies

GnomAD3 genomes
AF:
0.0000197
AC:
3
AN:
152106
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.0000483
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:
0.0000147
Gnomad OTH
AF:
0.00
GnomAD4 exome
AF:
0.00000557
AC:
8
AN:
1435034
Hom.:
0
Cov.:
104
AF XY:
0.00000422
AC XY:
3
AN XY:
711674
show subpopulations
African (AFR)
AF:
0.0000305
AC:
1
AN:
32740
American (AMR)
AF:
0.00
AC:
0
AN:
40932
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
25688
East Asian (EAS)
AF:
0.0000778
AC:
3
AN:
38566
South Asian (SAS)
AF:
0.00
AC:
0
AN:
83362
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
50434
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
5642
European-Non Finnish (NFE)
AF:
0.00000364
AC:
4
AN:
1098354
Other (OTH)
AF:
0.00
AC:
0
AN:
59316
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.450
Heterozygous variant carriers
0
1
2
2
3
4
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome 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
GnomAD4 genome
AF:
0.0000197
AC:
3
AN:
152106
Hom.:
0
Cov.:
32
AF XY:
0.0000269
AC XY:
2
AN XY:
74288
show subpopulations
African (AFR)
AF:
0.0000483
AC:
2
AN:
41430
American (AMR)
AF:
0.00
AC:
0
AN:
15276
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3472
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5156
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4832
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10620
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
316
European-Non Finnish (NFE)
AF:
0.0000147
AC:
1
AN:
68000
Other (OTH)
AF:
0.00
AC:
0
AN:
2092
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.558
Heterozygous variant carriers
0
0
1
1
2
2
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:
0.00
Hom.:
0

ClinVar

ClinVar submissions
Significance:Pathogenic
Revision:criteria provided, multiple submitters, no conflicts
View on ClinVar
Pathogenic
VUS
Benign
Condition
2
-
-
not provided (2)

Computational scores

Source: dbNSFP v4.9

Name
Calibrated prediction
Score
Prediction
BayesDel_addAF
Pathogenic
0.54
D
BayesDel_noAF
Pathogenic
0.54
CADD
Pathogenic
36
DANN
Uncertain
0.99
Eigen
Pathogenic
0.75
Eigen_PC
Uncertain
0.54
FATHMM_MKL
Benign
0.69
D
PhyloP100
3.2
Vest4
0.69
GERP RS
4.5
PromoterAI
-0.014
Neutral
Mutation Taster
=0/200
disease causing (ClinVar)

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

Other links and lift over

dbSNP: rs746097144; hg19: chr6-32006259; COSMIC: COSV64489381; COSMIC: COSV64489381; API