rs765417606

Variant summary

Our verdict is Likely benign. The variant received -5 ACMG points: 0P and 5B. BS1_SupportingBS2

The NM_005120.3(MED12):​c.1849A>G​(p.Thr617Ala) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.000034 in 1,207,230 control chromosomes in the GnomAD database, with no homozygous occurrence. There are 14 hemizygotes in GnomAD. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars). Synonymous variant affecting the same amino acid position (i.e. T617T) has been classified as Likely benign.

Frequency

Genomes: 𝑓 0.000081 ( 0 hom., 4 hem., cov: 23)
Exomes 𝑓: 0.000029 ( 0 hom. 10 hem. )

Consequence

MED12
NM_005120.3 missense

Scores

2
9
6

Clinical Significance

Conflicting classifications of pathogenicity criteria provided, conflicting classifications P:1U:3B:1

Conservation

PhyloP100: 8.95

Publications

2 publications found
Variant links:
Genes affected
MED12 (HGNC:11957): (mediator complex subunit 12) The initiation of transcription is controlled in part by a large protein assembly known as the preinitiation complex. A component of this preinitiation complex is a 1.2 MDa protein aggregate called Mediator. This Mediator component binds with a CDK8 subcomplex which contains the protein encoded by this gene, mediator complex subunit 12 (MED12), along with MED13, CDK8 kinase, and cyclin C. The CDK8 subcomplex modulates Mediator-polymerase II interactions and thereby regulates transcription initiation and reinitation rates. The MED12 protein is essential for activating CDK8 kinase. Defects in this gene cause X-linked Opitz-Kaveggia syndrome, also known as FG syndrome, and Lujan-Fryns syndrome. [provided by RefSeq, Aug 2009]
MED12 Gene-Disease associations (from GenCC):
  • FG syndrome 1
    Inheritance: XL Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Labcorp Genetics (formerly Invitae), G2P, Orphanet
  • MED12-related intellectual disability syndrome
    Inheritance: XL Classification: DEFINITIVE Submitted by: ClinGen
  • X-linked intellectual disability with marfanoid habitus
    Inheritance: XL Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Labcorp Genetics (formerly Invitae), G2P, Orphanet
  • blepharophimosis - intellectual disability syndrome, MKB type
    Inheritance: XL Classification: STRONG, SUPPORTIVE Submitted by: Labcorp Genetics (formerly Invitae), Orphanet
  • cholestasis-pigmentary retinopathy-cleft palate syndrome
    Inheritance: XL Classification: STRONG Submitted by: Labcorp Genetics (formerly Invitae)

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Likely_benign. The variant received -5 ACMG points.

BS1
Variant frequency is greater than expected in population amr. GnomAd4 allele frequency = 0.0000815 (9/110489) while in subpopulation AMR AF = 0.000479 (5/10442). AF 95% confidence interval is 0.000188. There are 0 homozygotes in GnomAd4. There are 4 alleles in the male GnomAd4 subpopulation. Median coverage is 23. This position passed quality control check. Existence of Clinvar submissions makes me limit the strength of this signal to Supporting
BS2
High Hemizygotes in GnomAd4 at 4 XL gene

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
MED12NM_005120.3 linkc.1849A>G p.Thr617Ala missense_variant Exon 13 of 45 ENST00000374080.8 NP_005111.2

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
MED12ENST00000374080.8 linkc.1849A>G p.Thr617Ala missense_variant Exon 13 of 45 1 NM_005120.3 ENSP00000363193.3

Frequencies

GnomAD3 genomes
AF:
0.0000815
AC:
9
AN:
110489
Hom.:
0
Cov.:
23
show subpopulations
Gnomad AFR
AF:
0.00
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.000479
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:
0.0000759
Gnomad OTH
AF:
0.00
GnomAD2 exomes
AF:
0.0000275
AC:
5
AN:
181757
AF XY:
0.0000444
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:
0.0000613
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000292
AC:
32
AN:
1096741
Hom.:
0
Cov.:
31
AF XY:
0.0000276
AC XY:
10
AN XY:
362107
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
26373
American (AMR)
AF:
0.000114
AC:
4
AN:
35204
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
19380
East Asian (EAS)
AF:
0.00
AC:
0
AN:
30202
South Asian (SAS)
AF:
0.00
AC:
0
AN:
54104
European-Finnish (FIN)
AF:
0.0000247
AC:
1
AN:
40528
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
4137
European-Non Finnish (NFE)
AF:
0.0000285
AC:
24
AN:
840766
Other (OTH)
AF:
0.0000652
AC:
3
AN:
46047
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.466
Heterozygous variant carriers
0
2
4
7
9
11
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:
0.0000815
AC:
9
AN:
110489
Hom.:
0
Cov.:
23
AF XY:
0.000122
AC XY:
4
AN XY:
32831
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
30326
American (AMR)
AF:
0.000479
AC:
5
AN:
10442
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
2621
East Asian (EAS)
AF:
0.00
AC:
0
AN:
3512
South Asian (SAS)
AF:
0.00
AC:
0
AN:
2597
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
5867
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
236
European-Non Finnish (NFE)
AF:
0.0000759
AC:
4
AN:
52727
Other (OTH)
AF:
0.00
AC:
0
AN:
1487
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.555
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

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:
0.000178
ExAC
AF:
0.0000248
AC:
3
EpiCase
AF:
0.00
EpiControl
AF:
0.000119

ClinVar

Significance: Conflicting classifications of pathogenicity
Submissions summary: Pathogenic:1Uncertain:3Benign:1
Revision: criteria provided, conflicting classifications
LINK: link

Submissions by phenotype

not provided Uncertain:2
Apr 29, 2016
Center for Pediatric Genomic Medicine, Children's Mercy Hospital and Clinics
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Oct 14, 2021
GeneDx
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

Not observed at significant frequency in large population cohorts (Lek et al., 2016); 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: 25326637) -

X-linked intellectual disability with marfanoid habitus;C3698541:Blepharophimosis - intellectual disability syndrome, MKB type;C5399762:FG syndrome 1 Pathogenic:1
Apr 23, 2013
UCLA Clinical Genomics Center, UCLA
Significance:Likely pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Familial thoracic aortic aneurysm and aortic dissection Uncertain:1
Aug 09, 2018
Ambry Genetics
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The p.T617A variant (also known as c.1849A>G), located in coding exon 13 of the MED12 gene, results from an A to G substitution at nucleotide position 1849. The threonine at codon 617 is replaced by alanine, an amino acid with similar properties. This alteration was identified in an individual with autism, craniofacial dysmorphic features, and it was inherited from his mother (Lee H et al. JAMA, 2014 Nov;312:1880-7). This amino acid position is highly conserved in available vertebrate species. In addition, the in silico prediction for this alteration is inconclusive. -

FG syndrome Benign:1
Jan 07, 2025
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Uncertain
0.38
BayesDel_addAF
Benign
-0.0089
T
BayesDel_noAF
Uncertain
-0.070
CADD
Uncertain
26
DANN
Uncertain
1.0
DEOGEN2
Benign
0.077
T;.;T
FATHMM_MKL
Pathogenic
0.99
D
LIST_S2
Benign
0.81
T;D;T
M_CAP
Pathogenic
0.46
D
MetaRNN
Uncertain
0.62
D;D;D
MetaSVM
Benign
-0.46
T
MutationAssessor
Uncertain
2.8
.;M;M
PhyloP100
8.9
PrimateAI
Uncertain
0.77
T
PROVEAN
Uncertain
-3.9
.;D;D
REVEL
Uncertain
0.55
Sift
Benign
0.053
.;T;T
Sift4G
Uncertain
0.0040
D;D;D
Polyphen
1.0
D;D;D
Vest4
0.55
MutPred
0.35
.;Loss of helix (P = 0.0237);Loss of helix (P = 0.0237);
MVP
0.88
MPC
2.0
ClinPred
0.78
D
GERP RS
4.8
RBP_binding_hub_radar
0.0
RBP_regulation_power_radar
1.7
Varity_R
0.60
gMVP
0.78
Mutation Taster
=72/28
disease causing (ClinVar)

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.020
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: rs765417606; hg19: chrX-70344113; COSMIC: COSV100376703; COSMIC: COSV100376703; API