Our verdict is Pathogenic. Variant got 12 ACMG points: 12P and 0B. PVS1PM2PP5_Moderate
The NM_014489.4(PGAP2):c.732dupA(p.Gln245ThrfsTer26) variant causes a frameshift change involving the alteration of a conserved nucleotide. The variant was absent in control chromosomes in GnomAD project. Variant has been reported in ClinVar as Likely pathogenic (★). Variant results in nonsense mediated mRNA decay.
PGAP2 (HGNC:17893): (post-GPI attachment to proteins 2) The protein encoded by this gene plays a role in the maturation of glycosylphosphatidylinositol (GPI) anchors on GPI-anchored proteins. Mutations in this gene are associated with an autosomal recessive syndrome characterized by hyperphosphatasia and intellectual disability. [provided by RefSeq, Jul 2017]
Verdict is Pathogenic. Variant got 12 ACMG points.
PVS1
Loss of function variant, product undergoes nonsense mediated mRNA decay. LoF is a known mechanism of disease.
PM2
Very rare variant in population databases, with high coverage;
PP5
Variant 11-3825040-G-GA is Pathogenic according to our data. Variant chr11-3825040-G-GA is described in ClinVar as [Likely_pathogenic]. Clinvar id is 522122.Status of the report is criteria_provided_single_submitter, 1 stars.
Review Status: criteria provided, single submitter
Collection Method: clinical testing
The c.732dupA (p.Q245Tfs*26) alteration, located in exon 6 (coding exon 5) of the PGAP2 gene, consists of a duplication of A at position 732, causing a translational frameshift with a predicted alternate stop codon after 26 amino acids. This alteration occurs at the 3' terminus of the PGAP2 gene, is not expected to trigger nonsense-mediated mRNA decay, and impacts the last 23% of the protein. Premature stop codons are typically deleterious in nature, the impacted region is critical for protein function, and a significant portion of the protein is affected (Ambry internal data). Based on data from gnomAD, the c.732dupA allele has an overall frequency of <0.001% (1/251474) total alleles studied. The highest observed frequency was 0.001% (1/113764) of European (non-Finnish) alleles. Based on the available evidence, this alteration is classified as likely pathogenic. -