rs786203218

Variant summary

Our verdict is Pathogenic. Variant got 11 ACMG points: 11P and 0B. PM2PM4_SupportingPP5_Very_Strong

The NM_144997.7(FLCN):​c.469_471del​(p.Phe157del) variant causes a inframe deletion change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.00000248 in 1,613,458 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Likely pathogenic (★★).

Frequency

Genomes: 𝑓 0.0000066 ( 0 hom., cov: 33)
Exomes 𝑓: 0.0000021 ( 0 hom. )

Consequence

FLCN
NM_144997.7 inframe_deletion

Scores

Not classified

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:10

Conservation

PhyloP100: 8.69
Variant links:
Genes affected
FLCN (HGNC:27310): (folliculin) This gene is located within the Smith-Magenis syndrome region on chromosome 17. Mutations in this gene are associated with Birt-Hogg-Dube syndrome, which is characterized by fibrofolliculomas, renal tumors, lung cysts, and pneumothorax. Alternative splicing of this gene results in two transcript variants encoding different isoforms. [provided by RefSeq, Jul 2008]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 11 ACMG points.

PM2
Very rare variant in population databases, with high coverage;
PM4
Nonframeshift variant in NON repetitive region in NM_144997.7. Strenght limited to Supporting due to length of the change: 1aa.
PP5
Variant 17-17224068-TGAA-T is Pathogenic according to our data. Variant chr17-17224068-TGAA-T is described in ClinVar as [Likely_pathogenic]. Clinvar id is 186785.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr17-17224068-TGAA-T is described in Lovd as [Likely_pathogenic].

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE UniProt
FLCNNM_144997.7 linkuse as main transcriptc.469_471del p.Phe157del inframe_deletion 6/14 ENST00000285071.9

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Appris UniProt
FLCNENST00000285071.9 linkuse as main transcriptc.469_471del p.Phe157del inframe_deletion 6/141 NM_144997.7 P1Q8NFG4-1
FLCNENST00000389169.9 linkuse as main transcriptc.469_471del p.Phe157del inframe_deletion 6/81 Q8NFG4-2
FLCNENST00000417064.1 linkuse as main transcriptc.310_312del p.Phe104del inframe_deletion 4/42
FLCNENST00000480316.1 linkuse as main transcriptn.435_437del non_coding_transcript_exon_variant 1/32

Frequencies

GnomAD3 genomes
AF:
0.00000657
AC:
1
AN:
152204
Hom.:
0
Cov.:
33
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:
0.00
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.0000147
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.00000400
AC:
1
AN:
249864
Hom.:
0
AF XY:
0.00
AC XY:
0
AN XY:
135290
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 SAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.00000886
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.00000205
AC:
3
AN:
1461254
Hom.:
0
AF XY:
0.00000275
AC XY:
2
AN XY:
726886
show subpopulations
Gnomad4 AFR exome
AF:
0.00
Gnomad4 AMR exome
AF:
0.00
Gnomad4 ASJ exome
AF:
0.00
Gnomad4 EAS exome
AF:
0.00
Gnomad4 SAS exome
AF:
0.00
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.00000270
Gnomad4 OTH exome
AF:
0.00
GnomAD4 genome
AF:
0.00000657
AC:
1
AN:
152204
Hom.:
0
Cov.:
33
AF XY:
0.00
AC XY:
0
AN XY:
74360
show subpopulations
Gnomad4 AFR
AF:
0.00
Gnomad4 AMR
AF:
0.00
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.00
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.0000147
Gnomad4 OTH
AF:
0.00
EpiCase
AF:
0.0000545
EpiControl
AF:
0.00

ClinVar

Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:10
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

not provided Pathogenic:3
Pathogenic, criteria provided, single submitterclinical testingQuest Diagnostics Nichols Institute San Juan CapistranoMar 01, 2023The frequency of this variant in the general population, 0.000004 (1/249864 chromosomes, http://gnomad.broadinstitute.org), is uninformative in assessment of its pathogenicity. In the published literature, the variant has been reported in in individuals with Brit-Hogg-Dube Syndrome (PMIDs: 18505456 (2008), 22146830 (2011), 27906882 (2016), 33313181 (2020), 31258130 (2019), 22571569 (2012), 25655561 (2015), 30360018 (2019), 31615547 (2019)). Published functional study reports that this variant affects the protein stability and is damaging to the protein function (PMID: 21538689 (2011)). Based on the available information, this variant is classified as pathogenic. -
Pathogenic, criteria provided, single submitterclinical testingGeneDxDec 27, 2021In-frame deletion of one amino acid in a non-repeat region; Published functional studies demonstrate a damaging effect: disrupted protein stability, reduced protein expression (Nahorski et al., 2011); In silico analysis supports a deleterious effect on protein structure/function; Not observed at significant frequency in large population cohorts (Lek et al., 2016); Also known as c.924_926del; This variant is associated with the following publications: (PMID: 22725638, 27229674, 21538689, 22571569, 25655561, 19802896, 22146830, 22446046, 18505456, 27906882, 28724667, 28869776, 29357828, 30360018, 31625278, 31615547, 34048023, 34604083) -
Pathogenic, criteria provided, single submitterclinical testingCeGaT Center for Human Genetics TuebingenMay 01, 2018- -
Birt-Hogg-Dube syndrome Pathogenic:3
Pathogenic, no assertion criteria providedclinical testingDivision of Respiratory Medicine of Juntendo University, Juntendo University Faculty of Medicine and Graduate School of MedicineJul 01, 2023- -
Likely pathogenic, criteria provided, single submitterclinical testingGenomic Diagnostic Laboratory, Division of Genomic Diagnostics, Children's Hospital of PhiladelphiaJul 18, 2016- -
Pathogenic, criteria provided, single submitterclinical testingInvitaeJan 18, 2024This variant, c.469_471del, results in the deletion of 1 amino acid(s) of the FLCN protein (p.Phe157del), but otherwise preserves the integrity of the reading frame. This variant is present in population databases (rs786203218, gnomAD 0.0009%). This variant has been observed in individuals with Birt-Hogg-Dubé syndrome (PMID: 18505456, 22146830, 22571569, 27906882, 28724667). It has also been observed to segregate with disease in related individuals. This variant is also known as c.924_926del. ClinVar contains an entry for this variant (Variation ID: 186785). Algorithms developed to predict the effect of variants on protein structure and function are not available or were not evaluated for this variant. Experimental studies have shown that this variant affects FLCN function (PMID: 21538689). For these reasons, this variant has been classified as Pathogenic. -
Birt-Hogg-Dube syndrome 1 Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingBaylor GeneticsMar 05, 2024- -
Familial spontaneous pneumothorax Pathogenic:1
Pathogenic, no assertion criteria providedliterature onlyOMIMSep 01, 2009- -
Birt-Hogg-Dube syndrome;C0346629:Colorectal cancer;C1868193:Familial spontaneous pneumothorax;C2931246:Potocki-Lupski syndrome;CN074294:Nonpapillary renal cell carcinoma Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingFulgent Genetics, Fulgent GeneticsDec 02, 2021- -
Hereditary cancer-predisposing syndrome Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingAmbry GeneticsFeb 01, 2022The c.469_471delTTC pathogenic mutation (also known as p.F157del) is located in coding exon 3 of the FLCN gene. This pathogenic mutation results from an in-frame TTC deletion at nucleotide positions 469 to 471. This results in the in-frame deletion of a phenylalanine at codon 157. This amino acid position is highly conserved in available vertebrate species. This alteration has been reported in numerous individuals and families with clinical features of Birt-Hogg-Dube syndrome (Lim D et al. Hum Mutat. 2010 Jan;31(1):E1043-51; Houweling AC et al. British Journal of Cancer 2011;105:1912&ndash;1919; Byrne M et al. Australas J Dermatol. 2012 May;53(2):151-4; Shvartsbeyn M et al. J Cutan Pathol. 2012 Jul;39(7):675-9;Radzikowska E et al. Pol. Arch. Med. Wewn., 2016 Nov;126:897-898). This alteration has been shown to segregate with disease in the literature and in two families tested in our laboratory (Bondavalli D et al. Am. J. Med. Genet. 2015 Apr;167A(4):802-4; Ren H et al. Clin Genet. 2008 Aug;74(2):178-83; Ambry internal data). In vivo analyses indicated that this alteration led to a significantly less stable protein when compared to wildtype (p<0.01) (Nahorski M et al. Hum Mutat. 2011 Aug;32(8):921-9). Of note, this alteration has been referred to as c.924_926delTTC in some literature. Based on the available evidence, this alteration is classified as a pathogenic mutation. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.010
Details are displayed if max score is > 0.2

Find out detailed SpliceAI scores and Pangolin per-transcript scores at spliceailookup.broadinstitute.org

Publications

LitVar

Below is the list of publications found by LitVar. It may be empty.

Other links and lift over

dbSNP: rs786203218; hg19: chr17-17127382; API