rs766209297

Variant summary

Our verdict is Likely pathogenic. The variant received 8 ACMG points: 12P and 4B. PP3_StrongPP5_Very_StrongBS2

The NM_001005242.3(PKP2):​c.1162C>T​(p.Arg388Trp) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.0000093 in 1,612,918 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 (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. R388Q) has been classified as Uncertain significance.

Frequency

Genomes: 𝑓 0.0000066 ( 0 hom., cov: 33)
Exomes 𝑓: 0.0000096 ( 0 hom. )

Consequence

PKP2
NM_001005242.3 missense

Scores

4
11
4

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:9

Conservation

PhyloP100: 2.91

Publications

13 publications found
Variant links:
Genes affected
PKP2 (HGNC:9024): (plakophilin 2) This gene encodes a member of the arm-repeat (armadillo) and plakophilin gene families. Plakophilin proteins contain numerous armadillo repeats, localize to cell desmosomes and nuclei, and participate in linking cadherins to intermediate filaments in the cytoskeleton. This gene may regulate the signaling activity of beta-catenin and is required to maintain transcription of genes that control intracellular calcium cycling including ryanodine receptor 2, ankyrin-B, triadin, and calcium channel, voltage-dependent, L type, alpha 1C. Mutations in this gene are associated with different inherited cardiac conditions including Arrythmogenic Cardiomyopathy, Brugada Syndrome, and Idiopathic Ventricular Fibrillation. A processed pseudogene with high similarity to this gene has been mapped to chromosome 12p13. [provided by RefSeq, May 2022]
PKP2 Gene-Disease associations (from GenCC):
  • arrhythmogenic right ventricular cardiomyopathy
    Inheritance: AD Classification: DEFINITIVE Submitted by: ClinGen
  • arrhythmogenic right ventricular dysplasia 9
    Inheritance: AD Classification: DEFINITIVE, STRONG Submitted by: Labcorp Genetics (formerly Invitae), G2P
  • left ventricular noncompaction
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • Brugada syndrome
    Inheritance: AD Classification: LIMITED Submitted by: Genomics England PanelApp
  • Brugada syndrome 1
    Inheritance: AD Classification: NO_KNOWN Submitted by: ClinGen
  • catecholaminergic polymorphic ventricular tachycardia
    Inheritance: AD Classification: NO_KNOWN Submitted by: ClinGen
  • dilated cardiomyopathy
    Inheritance: AD Classification: NO_KNOWN Submitted by: ClinGen

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Likely_pathogenic. The variant received 8 ACMG points.

PP3
MetaRNN computational evidence supports a deleterious effect, 0.984
PP5
Variant 12-32868935-G-A is Pathogenic according to our data. Variant chr12-32868935-G-A is described in ClinVar as [Likely_pathogenic]. Clinvar id is 201979.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.
BS2
High AC in GnomAdExome4 at 14 AD gene.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
PKP2NM_001005242.3 linkc.1162C>T p.Arg388Trp missense_variant Exon 4 of 13 ENST00000340811.9 NP_001005242.2 Q99959-2

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
PKP2ENST00000340811.9 linkc.1162C>T p.Arg388Trp missense_variant Exon 4 of 13 1 NM_001005242.3 ENSP00000342800.5 Q99959-2

Frequencies

GnomAD3 genomes
AF:
0.00000657
AC:
1
AN:
152184
Hom.:
0
Cov.:
33
show subpopulations
Gnomad AFR
AF:
0.0000241
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:
0.00
Gnomad OTH
AF:
0.00
GnomAD2 exomes
AF:
0.00000398
AC:
1
AN:
251320
AF XY:
0.00000736
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:
0.00
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.00000958
AC:
14
AN:
1460734
Hom.:
0
Cov.:
31
AF XY:
0.0000110
AC XY:
8
AN XY:
726700
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
33450
American (AMR)
AF:
0.00
AC:
0
AN:
44722
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
26136
East Asian (EAS)
AF:
0.0000504
AC:
2
AN:
39696
South Asian (SAS)
AF:
0.0000116
AC:
1
AN:
86190
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
53298
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
4976
European-Non Finnish (NFE)
AF:
0.00000630
AC:
7
AN:
1111962
Other (OTH)
AF:
0.0000663
AC:
4
AN:
60304
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.454
Heterozygous variant carriers
0
1
3
4
6
7
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:
0.00000657
AC:
1
AN:
152184
Hom.:
0
Cov.:
33
AF XY:
0.00
AC XY:
0
AN XY:
74342
show subpopulations
African (AFR)
AF:
0.0000241
AC:
1
AN:
41446
American (AMR)
AF:
0.00
AC:
0
AN:
15270
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3472
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5202
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4830
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10610
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
316
European-Non Finnish (NFE)
AF:
0.00
AC:
0
AN:
68034
Other (OTH)
AF:
0.00
AC:
0
AN:
2092
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.475
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:
0.00000378
ExAC
AF:
0.00000824
AC:
1

ClinVar

Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:9
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Arrhythmogenic right ventricular dysplasia 9 Pathogenic:4
Oct 09, 2024
Victorian Clinical Genetics Services, Murdoch Childrens Research Institute
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

Based on the classification scheme VCGS_Germline_v1.3.4, this variant is classified as Pathogenic. Following criteria are met: 0102 - Loss of function is a known mechanism of disease in this gene and is associated with arrhythmogenic right ventricular cardiomyopathy (ARVC) (MIM#609040). On the other hand, dominant-negative is the proposed mechanism for missense variants in this gene (PMID: 23183494, 24967631). (I) 0107 - This gene is associated with autosomal dominant disease. (I) 0112 - The condition associated with this gene has incomplete penetrance (PMID: 17010805, 23183494). (I) 0115 - Variants in this gene are known to have variable expressivity. (PMID: 17010805, 23183494). (I) 0200 - Variant is predicted to result in a missense amino acid change from arginine to tryptophan. (I) 0251 - This variant is heterozygous. (I) 0302 - Variant is present in gnomAD <0.001 for a dominant condition (v2+v3: 2 heterozygotes, 0 homozygotes). (SP) 0309 - Multiple alternative amino acid changes at the same position have been observed in gnomAD (highest allele count: v2: 3 heterozygotes, 0 homozygotes). (I) 0501 - Missense variant consistently predicted to be damaging by multiple in silico tools or highly conserved with a major amino acid change. (SP) 0600 - Variant is located in the annotated Armadillo/beta-catenin-like repeat (DECIPHER). (I) 0801 - This variant has strong previous evidence of pathogenicity in unrelated individuals. It has been reported in at least ten heterozygous and compound heterozygous individuals with ARVC. It was noted that compound heterozygous individuals presented with an earlier age of onset and severe disease (PMID: 19880068, 20152563, 24967631, 32268277; ClinVar). (SP) 1208 - Inheritance information for this variant is not currently available in this individual. (I) Legend: (SP) - Supporting pathogenic, (I) - Information, (SB) - Supporting benign -

Nov 12, 2017
Human Genome Sequencing Center Clinical Lab, Baylor College of Medicine
Significance:Likely pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The c.1162C>T (p.Arg388Trp) variant in the PKP2 gene has been observed in two unrelated individuals with Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) as well as in three unrelated families affected by ARVC with incomplete penetrance (PMID 19880068, 20152563). Both studies reported that this variant was not observed in a large number of ethnically matched controls. Additionally, the gnomAD database reports this variant in 1 out of 246,082 individuals indicating it is not a common variant in general population. The c.1162C>T (p.Arg388Trp) variant in the PKP2 gene is classified as likely pathogenic. -

Dec 23, 2024
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This sequence change replaces arginine, which is basic and polar, with tryptophan, which is neutral and slightly polar, at codon 388 of the PKP2 protein (p.Arg388Trp). This variant is present in population databases (rs766209297, gnomAD 0.003%). This missense change has been observed in individuals with arrhythmogenic right ventricular cardiomyopathy (PMID: 19880068, 20152563, 24967631). It has also been observed to segregate with disease in related individuals. ClinVar contains an entry for this variant (Variation ID: 201979). An algorithm developed to predict the effect of missense changes on protein structure and function (PolyPhen-2) suggests that this variant is likely to be disruptive. For these reasons, this variant has been classified as Pathogenic. -

Dec 10, 2019
Institute of Human Genetics, University of Leipzig Medical Center
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Arrhythmogenic right ventricular cardiomyopathy Pathogenic:3
Jun 18, 2015
Blueprint Genetics
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Jul 19, 2023
All of Us Research Program, National Institutes of Health
Significance:Likely pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This missense variant replaces arginine with tryptophan at codon 388 of the PKP2 protein. Computational tools predict that this variant may have deleterious impact on protein structure and function. To our knowledge, functional studies have not been reported for this variant. This variant is a recurrent mutation in the South Afrikaner population (PMID 19880068; Machipisa 2016, dissertation, University of Cape Town) and has been observed in seven unrelated individuals affected with arrhythmogenic cardiomyopathy (PMID: 19880068, 24967631, 28472724, 31319917, 32268277). This variant has been observed in compound heterozygosity with a pathogenic truncation variant in individuals from two different families affected with severe, early-onset arrhythmogenic right ventricular cardiomyopathy (PMID: 19880068, 20152563). Heterozygous individuals from these families (PMID: 19880068, 20152563) and another unrelated heterozygous adult were reported to be asymptomatic (PMID: 34135346), consistent with low penetrance expected of pathogenic PKP2 variants. This variant has been identified in 1/251320 chromosomes in the general population by the Genome Aggregation Database (gnomAD). Based on the available evidence, this variant is classified as Likely Pathogenic. -

Apr 14, 2020
Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

proposed classification - variant undergoing re-assessment, contact laboratory -

Cardiomyopathy Pathogenic:1
May 10, 2023
Color Diagnostics, LLC DBA Color Health
Significance:Likely pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This missense variant replaces arginine with tryptophan at codon 388 of the PKP2 protein. Computational tools predict that this variant may have deleterious impact on protein structure and function. To our knowledge, functional studies have not been reported for this variant. This variant is a recurrent mutation in the South Afrikaner population (PMID 19880068; Machipisa 2016, dissertation, University of Cape Town) and has been observed in seven unrelated individuals affected with arrhythmogenic cardiomyopathy (PMID: 19880068, 24967631, 28472724, 31319917, 32268277). This variant has been observed in compound heterozygosity with a pathogenic truncation variant in individuals from two different families affected with severe, early-onset arrhythmogenic right ventricular cardiomyopathy (PMID: 19880068, 20152563). Heterozygous individuals from these families (PMID: 19880068, 20152563) and another unrelated heterozygous adult were reported to be asymptomatic (PMID: 34135346), consistent with low penetrance expected of pathogenic PKP2 variants. This variant has been identified in 1/251320 chromosomes in the general population by the Genome Aggregation Database (gnomAD). Based on the available evidence, this variant is classified as Likely Pathogenic. -

not provided Pathogenic:1
May 13, 2025
GeneDx
Significance:Likely pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

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: 31737537, 31402444, 20152563, 24967631, 19880068, 31447099, 31589614, 34135346, 34120153, 32268277, 31319917, 28472724, 38747331) -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
0.93
BayesDel_addAF
Uncertain
0.14
D
BayesDel_noAF
Uncertain
0.060
CADD
Pathogenic
28
DANN
Uncertain
1.0
DEOGEN2
Uncertain
0.62
.;D
Eigen
Uncertain
0.26
Eigen_PC
Benign
0.17
FATHMM_MKL
Benign
0.60
D
LIST_S2
Uncertain
0.92
D;D
M_CAP
Pathogenic
0.38
D
MetaRNN
Pathogenic
0.98
D;D
MetaSVM
Benign
-0.53
T
MutationAssessor
Uncertain
2.1
M;M
PhyloP100
2.9
PrimateAI
Uncertain
0.57
T
PROVEAN
Pathogenic
-5.5
D;D
REVEL
Uncertain
0.51
Sift
Uncertain
0.0010
D;D
Sift4G
Uncertain
0.0020
D;D
Polyphen
0.99
D;D
Vest4
0.92
MutPred
0.93
Loss of disorder (P = 0.0114);Loss of disorder (P = 0.0114);
MVP
0.91
MPC
0.67
ClinPred
0.99
D
GERP RS
4.0
Varity_R
0.86
gMVP
0.74
Mutation Taster
=27/73
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: rs766209297; hg19: chr12-33021869; COSMIC: COSV99298059; API