rs747268471
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Variant summary
Our verdict is Pathogenic. Variant got 14 ACMG points: 14P and 0B. PM2PP3_StrongPP5_Very_Strong
The NM_000016.6(ACADM):c.928G>A(p.Gly310Arg) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.0000391 in 1,611,262 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 Likely pathogenic (★★).
Frequency
Genomes: 𝑓 0.000026 ( 0 hom., cov: 31)
Exomes 𝑓: 0.000040 ( 0 hom. )
Consequence
ACADM
NM_000016.6 missense
NM_000016.6 missense
Scores
15
3
1
Clinical Significance
Conservation
PhyloP100: 9.20
Genes affected
ACADM (HGNC:89): (acyl-CoA dehydrogenase medium chain) This gene encodes the medium-chain specific (C4 to C12 straight chain) acyl-Coenzyme A dehydrogenase. The homotetramer enzyme catalyzes the initial step of the mitochondrial fatty acid beta-oxidation pathway. Defects in this gene cause medium-chain acyl-CoA dehydrogenase deficiency, a disease characterized by hepatic dysfunction, fasting hypoglycemia, and encephalopathy, which can result in infantile death. Alternatively spliced transcript variants encoding different isoforms have been found for this gene. [provided by RefSeq, Jul 2008]
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ACMG classification
Classification made for transcript
Verdict is Pathogenic. Variant got 14 ACMG points.
PM2
Very rare variant in population databases, with high coverage;
PP3
MetaRNN computational evidence supports a deleterious effect, 0.991
PP5
Variant 1-75750529-G-A is Pathogenic according to our data. Variant chr1-75750529-G-A is described in ClinVar as [Likely_pathogenic]. Clinvar id is 193539.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.
Transcripts
RefSeq
Gene | Transcript | HGVSc | HGVSp | Effect | #exon/exons | MANE | Protein | UniProt |
---|---|---|---|---|---|---|---|---|
ACADM | NM_000016.6 | c.928G>A | p.Gly310Arg | missense_variant | 10/12 | ENST00000370841.9 | NP_000007.1 |
Ensembl
Gene | Transcript | HGVSc | HGVSp | Effect | #exon/exons | TSL | MANE | Protein | Appris | UniProt |
---|---|---|---|---|---|---|---|---|---|---|
ACADM | ENST00000370841.9 | c.928G>A | p.Gly310Arg | missense_variant | 10/12 | 1 | NM_000016.6 | ENSP00000359878 | P4 |
Frequencies
GnomAD3 genomes AF: 0.0000263 AC: 4AN: 152072Hom.: 0 Cov.: 31
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GnomAD3 exomes AF: 0.0000240 AC: 6AN: 250160Hom.: 0 AF XY: 0.0000222 AC XY: 3AN XY: 135144
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GnomAD4 exome AF: 0.0000404 AC: 59AN: 1459190Hom.: 0 Cov.: 30 AF XY: 0.0000331 AC XY: 24AN XY: 725912
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GnomAD4 genome AF: 0.0000263 AC: 4AN: 152072Hom.: 0 Cov.: 31 AF XY: 0.00 AC XY: 0AN XY: 74282
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ClinVar
Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:7Uncertain:1
Revision: criteria provided, multiple submitters, no conflicts
LINK: link
Submissions by phenotype
Medium-chain acyl-coenzyme A dehydrogenase deficiency Pathogenic:7
Pathogenic, criteria provided, single submitter | clinical testing | Labcorp Genetics (formerly Invitae), Labcorp | Nov 11, 2023 | This sequence change replaces glycine, which is neutral and non-polar, with arginine, which is basic and polar, at codon 310 of the ACADM protein (p.Gly310Arg). This variant is present in population databases (rs747268471, gnomAD 0.004%). This missense change has been observed in individual(s) with MCAD deficiency (PMID: 11349232, 18241067, 20434380, 23509891). 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: 193539). Advanced modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) performed at Invitae indicates that this missense variant is expected to disrupt ACADM protein function with a positive predictive value of 80%. For these reasons, this variant has been classified as Pathogenic. - |
Likely pathogenic, criteria provided, single submitter | clinical testing | Myriad Genetics, Inc. | Oct 27, 2021 | NM_000016.4(ACADM):c.928G>A(G310R) is a missense variant classified as likely pathogenic in the context of medium chain acyl-CoA dehydrogenase deficiency. G310R has been observed in cases with relevant disease (PMID: 22630369, 20434380, 18241067, 27477829, 11349232). Functional assessments of this variant are available in the literature (PMID: 11349232). G310R has been observed in population frequency databases (gnomAD: AFR 0.01%). In summary, NM_000016.4(ACADM):c.928G>A(G310R) is a missense variant that has been observed more frequently in cases with the relevant disease than in healthy populations. Please note: this variant was assessed in the context of healthy population screening. - |
Pathogenic, criteria provided, single submitter | clinical testing | ARUP Laboratories, Molecular Genetics and Genomics, ARUP Laboratories | Feb 20, 2015 | - - |
Likely pathogenic, criteria provided, single submitter | clinical testing | Women's Health and Genetics/Laboratory Corporation of America, LabCorp | Nov 20, 2017 | Variant summary: The ACADM c.928G>A (p.Gly310Arg) variant involves the alteration of a highly conserved nucleotide. The variant is located within the conserved Acyl-CoA dehydrogenase/oxidase C-terminal domain (InterPro) and 5/5 in silico tools predict a damaging outcome for this variant. These predictions were confirmed by functional studies, where G310R was shown to be defective and unstable due to compromised folding (Andresen_ 2001). This variant was found in 6/275998 control chromosomes in gnomAD at a frequency of 0.000021, which does not exceed the estimated maximal expected allele frequency of a pathogenic ACADM variant (0.0054006). The variant was identified in several affected individuals with biochemical profiles suggestive of an intermediate MCAD phenotype (Andresen_ 2001, Smith_2010, Touw_2013, Nichols_2008). The variant has been reported with conflicting interpretations of pathogenicity (VUS/Pathogenic) by different clinical diagnostic laboratories/reputable databases. Taken together, this variant is classified as Likely Pathogenic. - |
Likely pathogenic, criteria provided, single submitter | clinical testing | Revvity Omics, Revvity | May 18, 2020 | - - |
Pathogenic, no assertion criteria provided | clinical testing | Undiagnosed Diseases Network, NIH | Apr 30, 2020 | - - |
Pathogenic, criteria provided, single submitter | clinical testing | Baylor Genetics | Feb 07, 2024 | - - |
not provided Uncertain:1
Uncertain significance, flagged submission | clinical testing | Eurofins Ntd Llc (ga) | Oct 31, 2014 | - - |
Computational scores
Source:
Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
BayesDel_addAF
Pathogenic
D
BayesDel_noAF
Pathogenic
CADD
Pathogenic
DANN
Uncertain
DEOGEN2
Pathogenic
D;D;D;.
Eigen
Pathogenic
Eigen_PC
Pathogenic
FATHMM_MKL
Pathogenic
D
LIST_S2
Uncertain
D;D;D;D
M_CAP
Pathogenic
D
MetaRNN
Pathogenic
D;D;D;D
MetaSVM
Pathogenic
D
MutationAssessor
Pathogenic
.;M;.;.
MutationTaster
Benign
D;D;D;D;D
PrimateAI
Uncertain
T
PROVEAN
Pathogenic
D;D;D;D
REVEL
Pathogenic
Sift
Pathogenic
D;D;D;D
Sift4G
Pathogenic
D;D;D;D
Polyphen
D;D;D;D
Vest4
MutPred
0.92
.;.;Gain of MoRF binding (P = 0.0054);.;
MVP
MPC
0.81
ClinPred
D
GERP RS
RBP_binding_hub_radar
RBP_regulation_power_radar
Varity_R
gMVP
Splicing
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SpliceAI score (max)
Details are displayed if max score is > 0.2
Find out detailed SpliceAI scores and Pangolin per-transcript scores at