rs748792378

Variant summary

Our verdict is Uncertain significance. The variant received 4 ACMG points: 5P and 1B. PM1PM5PP2BS2_Supporting

The NM_000444.6(PHEX):​c.1952G>A​(p.Arg651Gln) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.0000791 in 1,200,938 control chromosomes in the GnomAD database, with no homozygous occurrence. There are 40 hemizygotes in GnomAD. 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. R651P) has been classified as Pathogenic.

Frequency

Genomes: 𝑓 0.000055 ( 0 hom., 2 hem., cov: 21)
Exomes 𝑓: 0.000082 ( 0 hom. 38 hem. )

Consequence

PHEX
NM_000444.6 missense

Scores

6
8
3

Clinical Significance

Not reported in ClinVar

Conservation

PhyloP100: 8.04

Publications

6 publications found
Variant links:
Genes affected
PHEX (HGNC:8918): (phosphate regulating endopeptidase X-linked) The protein encoded by this gene is a transmembrane endopeptidase that belongs to the type II integral membrane zinc-dependent endopeptidase family. The protein is thought to be involved in bone and dentin mineralization and renal phosphate reabsorption. Mutations in this gene cause X-linked hypophosphatemic rickets. Alternative splicing results in multiple transcript variants. [provided by RefSeq, Sep 2013]
PTCHD1-AS (HGNC:37703): (PTCHD1 antisense RNA (head to head))

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Uncertain_significance. The variant received 4 ACMG points.

PM1
In a hotspot region, there are 13 aminoacids with missense pathogenic changes in the window of +-8 aminoacids around while only 1 benign, 4 uncertain in NM_000444.6
PM5
Other missense variant is known to change same aminoacid residue: Variant chrX-22226495-G-C is described in ClinVar as Pathogenic. ClinVar VariationId is 438548.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.
PP2
Missense variant in the gene, where a lot of missense mutations are associated with disease in ClinVar. The gene has 135 curated pathogenic missense variants (we use a threshold of 10). The gene has 25 curated benign missense variants. Gene score misZ: 1.7091 (below the threshold of 3.09). Trascript score misZ: NaN (below the threshold of 3.09). GenCC associations: The gene is linked to X-linked dominant hypophosphatemic rickets.
BS2
High Hemizygotes in GnomAd4 at 2 XL geneVariant has number of hemizygotes lower than other variant known as pathogenic in the gene, so the strength is limited to Supporting.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
PHEXNM_000444.6 linkc.1952G>A p.Arg651Gln missense_variant Exon 19 of 22 ENST00000379374.5 NP_000435.3 P78562B4DWG8

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
PHEXENST00000379374.5 linkc.1952G>A p.Arg651Gln missense_variant Exon 19 of 22 1 NM_000444.6 ENSP00000368682.4 P78562

Frequencies

GnomAD3 genomes
AF:
0.0000550
AC:
6
AN:
109054
Hom.:
0
Cov.:
21
show subpopulations
Gnomad AFR
AF:
0.00
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00
Gnomad ASJ
AF:
0.00
Gnomad EAS
AF:
0.00
Gnomad SAS
AF:
0.00121
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.0000571
Gnomad OTH
AF:
0.00
GnomAD2 exomes
AF:
0.0000382
AC:
7
AN:
183443
AF XY:
0.0000589
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 FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.0000244
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000815
AC:
89
AN:
1091884
Hom.:
0
Cov.:
29
AF XY:
0.000106
AC XY:
38
AN XY:
357496
show subpopulations
African (AFR)
AF:
0.0000761
AC:
2
AN:
26291
American (AMR)
AF:
0.00
AC:
0
AN:
35201
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
19339
East Asian (EAS)
AF:
0.0000331
AC:
1
AN:
30171
South Asian (SAS)
AF:
0.000315
AC:
17
AN:
53999
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
40517
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
4120
European-Non Finnish (NFE)
AF:
0.0000777
AC:
65
AN:
836348
Other (OTH)
AF:
0.0000871
AC:
4
AN:
45898
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.457
Heterozygous variant carriers
0
3
6
10
13
16
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome Het
Exome Hom
Variant carriers
0
4
8
12
16
20
<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:
0.0000550
AC:
6
AN:
109054
Hom.:
0
Cov.:
21
AF XY:
0.0000637
AC XY:
2
AN XY:
31390
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
29825
American (AMR)
AF:
0.00
AC:
0
AN:
10174
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
2619
East Asian (EAS)
AF:
0.00
AC:
0
AN:
3456
South Asian (SAS)
AF:
0.00121
AC:
3
AN:
2479
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
5618
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
235
European-Non Finnish (NFE)
AF:
0.0000571
AC:
3
AN:
52504
Other (OTH)
AF:
0.00
AC:
0
AN:
1463
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.488
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
Genome Hom
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
Bravo
AF:
0.0000453
ExAC
AF:
0.00000824
AC:
1
EpiCase
AF:
0.000218
EpiControl
AF:
0.000119

ClinVar

Not reported in ClinVar

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Uncertain
0.53
BayesDel_addAF
Pathogenic
0.24
D
BayesDel_noAF
Pathogenic
0.40
CADD
Pathogenic
28
DANN
Pathogenic
1.0
DEOGEN2
Uncertain
0.76
D
FATHMM_MKL
Pathogenic
0.99
D
LIST_S2
Uncertain
0.97
D
M_CAP
Pathogenic
0.67
D
MetaRNN
Uncertain
0.52
D
MetaSVM
Uncertain
0.22
D
MutationAssessor
Benign
1.4
L
PhyloP100
8.0
PrimateAI
Uncertain
0.67
T
PROVEAN
Benign
-2.1
N
REVEL
Pathogenic
0.77
Sift
Uncertain
0.018
D
Sift4G
Uncertain
0.020
D
Polyphen
1.0
D
Vest4
0.22
MVP
0.94
MPC
1.3
ClinPred
0.44
T
GERP RS
5.9
Varity_R
0.79
gMVP
0.79
Mutation Taster
=78/22
polymorphism

Splicing

Name
Calibrated prediction
Score
Prediction
Splicevardb
1.0
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: rs748792378; hg19: chrX-22244612; COSMIC: COSV101039641; API