rs753757730

Variant summary

Our verdict is Likely benign. The variant received -1 ACMG points: 3P and 4B. PM1PP2BS2

The NM_001184880.2(PCDH19):​c.571G>C​(p.Val191Leu) variant causes a missense change. The variant allele was found at a frequency of 0.00000828 in 1,207,445 control chromosomes in the GnomAD database, with no homozygous occurrence. There are 3 hemizygotes in GnomAD. Variant has been reported in ClinVar as Uncertain significance (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. V191M) has been classified as Uncertain significance.

Frequency

Genomes: 𝑓 0.000018 ( 0 hom., 1 hem., cov: 25)
Exomes 𝑓: 0.0000073 ( 0 hom. 2 hem. )

Consequence

PCDH19
NM_001184880.2 missense

Scores

3
10
4

Clinical Significance

Uncertain significance criteria provided, multiple submitters, no conflicts U:2

Conservation

PhyloP100: 6.17

Publications

7 publications found
Variant links:
Genes affected
PCDH19 (HGNC:14270): (protocadherin 19) The protein encoded by this gene is a member of the delta-2 protocadherin subclass of the cadherin superfamily. The encoded protein is thought to be a calcium-dependent cell-adhesion protein that is primarily expressed in the brain. Mutations in this gene on human chromosome X are associated with sporadic infantile epileptic encephalopathy and to a female-restricted form of epilepsy (EFMR; also known as PCDH19RE). Multiple transcript variants encoding different isoforms have been found for this gene. [provided by RefSeq, Jul 2017]
PCDH19 Gene-Disease associations (from GenCC):
  • developmental and epileptic encephalopathy, 9
    Inheritance: XL, Unknown Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: G2P, Orphanet, Labcorp Genetics (formerly Invitae), Ambry Genetics
  • X-linked complex neurodevelopmental disorder
    Inheritance: XL Classification: DEFINITIVE Submitted by: ClinGen
  • Dravet syndrome
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Likely_benign. The variant received -1 ACMG points.

PM1
In a hotspot region, there are 5 aminoacids with missense pathogenic changes in the window of +-8 aminoacids around while only 0 benign, 7 uncertain in NM_001184880.2
PP2
Missense variant in the gene, where a lot of missense mutations are associated with disease in ClinVar. The gene has 107 curated pathogenic missense variants (we use a threshold of 10). The gene has 20 curated benign missense variants. Gene score misZ: 2.5929 (below the threshold of 3.09). Trascript score misZ: NaN (below the threshold of 3.09). GenCC associations: The gene is linked to Dravet syndrome, developmental and epileptic encephalopathy, 9, X-linked complex neurodevelopmental disorder.
BS2
High AC in GnomAdExome4 at 8 AD,XL,Unknown gene.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
PCDH19NM_001184880.2 linkc.571G>C p.Val191Leu missense_variant Exon 1 of 6 ENST00000373034.8 NP_001171809.1 Q8TAB3-1
PCDH19NM_001105243.2 linkc.571G>C p.Val191Leu missense_variant Exon 1 of 5 NP_001098713.1 Q8TAB3-2B3KU71
PCDH19NM_020766.3 linkc.571G>C p.Val191Leu missense_variant Exon 1 of 5 NP_065817.2 Q8TAB3-3B3KU71

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
PCDH19ENST00000373034.8 linkc.571G>C p.Val191Leu missense_variant Exon 1 of 6 1 NM_001184880.2 ENSP00000362125.4 Q8TAB3-1
PCDH19ENST00000255531.8 linkc.571G>C p.Val191Leu missense_variant Exon 1 of 5 1 ENSP00000255531.7 Q8TAB3-2
PCDH19ENST00000420881.6 linkc.571G>C p.Val191Leu missense_variant Exon 1 of 5 1 ENSP00000400327.2 Q8TAB3-3

Frequencies

GnomAD3 genomes
AF:
0.0000176
AC:
2
AN:
113348
Hom.:
0
Cov.:
25
show subpopulations
Gnomad AFR
AF:
0.0000320
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:
0.0000187
Gnomad OTH
AF:
0.00
GnomAD2 exomes
AF:
0.00000562
AC:
1
AN:
177954
AF XY:
0.0000153
show subpopulations
Gnomad AFR exome
AF:
0.0000810
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:
0.00
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.00000731
AC:
8
AN:
1094097
Hom.:
0
Cov.:
33
AF XY:
0.00000553
AC XY:
2
AN XY:
361537
show subpopulations
African (AFR)
AF:
0.0000379
AC:
1
AN:
26401
American (AMR)
AF:
0.00
AC:
0
AN:
35204
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
19386
East Asian (EAS)
AF:
0.00
AC:
0
AN:
30206
South Asian (SAS)
AF:
0.00
AC:
0
AN:
54146
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
36474
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
4137
European-Non Finnish (NFE)
AF:
0.00000831
AC:
7
AN:
842070
Other (OTH)
AF:
0.00
AC:
0
AN:
46073
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.517
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
Exome 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
GnomAD4 genome
AF:
0.0000176
AC:
2
AN:
113348
Hom.:
0
Cov.:
25
AF XY:
0.0000282
AC XY:
1
AN XY:
35478
show subpopulations
African (AFR)
AF:
0.0000320
AC:
1
AN:
31239
American (AMR)
AF:
0.00
AC:
0
AN:
10876
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
2660
East Asian (EAS)
AF:
0.00
AC:
0
AN:
3568
South Asian (SAS)
AF:
0.00
AC:
0
AN:
2795
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
6312
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
240
European-Non Finnish (NFE)
AF:
0.0000187
AC:
1
AN:
53435
Other (OTH)
AF:
0.00
AC:
0
AN:
1539
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.625
Heterozygous variant carriers
0
0
1
1
2
2
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance
Alfa
AF:
0.00
Hom.:
0
Bravo
AF:
0.0000302
ExAC
AF:
0.0000165
AC:
2

ClinVar

Significance: Uncertain significance
Submissions summary: Uncertain:2
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

not provided Uncertain:1
Nov 08, 2024
GeneDx
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

Reported previously in a patient with Dravet syndrome, abnormal EEG, diffuse mild atrophy on brain MRI, autism, and an IQ of 31; however, no segregation information was provided (PMID: 22050978); Published functional studies suggest that this variant negatively affects gene function and likely contributes to abnormal cell aggregation; however, further studies are needed (PMID: 34082468, 38516276); Not observed at significant frequency in large population cohorts (gnomAD); In silico analysis supports that this missense variant has a deleterious effect on protein structure/function; This variant is associated with the following publications: (PMID: 27787195, 38516276, 34082468, 22050978) -

Developmental and epileptic encephalopathy, 9 Uncertain:1
Sep 30, 2024
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This sequence change replaces valine, which is neutral and non-polar, with leucine, which is neutral and non-polar, at codon 191 of the PCDH19 protein (p.Val191Leu). This variant is present in population databases (rs753757730, gnomAD 0.008%). This missense change has been observed in individual(s) with clinical features of developmental and epileptic encephalopathy (PMID: 22050978). ClinVar contains an entry for this variant (Variation ID: 533851). Invitae Evidence Modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) has been performed for this missense variant. However, the output from this modeling did not meet the statistical confidence thresholds required to predict the impact of this variant on PCDH19 protein function. Experimental studies have shown that this missense change affects PCDH19 function (PMID: 34082468). In summary, the available evidence is currently insufficient to determine the role of this variant in disease. Therefore, it has been classified as a Variant of Uncertain Significance. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Uncertain
0.45
BayesDel_addAF
Pathogenic
0.17
D
BayesDel_noAF
Pathogenic
0.19
CADD
Uncertain
25
DANN
Uncertain
1.0
DEOGEN2
Benign
0.24
.;T;.
FATHMM_MKL
Pathogenic
0.99
D
LIST_S2
Uncertain
0.92
D;D;D
M_CAP
Uncertain
0.13
D
MetaRNN
Uncertain
0.70
D;D;D
MetaSVM
Benign
-0.59
T
MutationAssessor
Benign
1.7
L;L;L
PhyloP100
6.2
PrimateAI
Uncertain
0.79
T
PROVEAN
Uncertain
-2.5
D;D;D
REVEL
Uncertain
0.48
Sift
Uncertain
0.0030
D;D;D
Sift4G
Uncertain
0.0070
D;D;D
Polyphen
1.0, 0.99
.;D;D
Vest4
0.79
MutPred
0.56
Loss of sheet (P = 0.0817);Loss of sheet (P = 0.0817);Loss of sheet (P = 0.0817);
MVP
0.91
MPC
2.3
ClinPred
0.53
D
GERP RS
5.8
Varity_R
0.86
gMVP
0.67
Mutation Taster
=2/98
disease causing

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: rs753757730; hg19: chrX-99663025; API