rs794728849

Variant summary

Our verdict is Pathogenic. Variant got 18 ACMG points: 18P and 0B. PVS1PM2PP5_Very_Strong

The NM_000335.5(SCN5A):​c.664C>T​(p.Arg222Ter) variant causes a stop gained change. The variant allele was found at a frequency of 0.00000206 in 1,458,286 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Pathogenic (★★). Variant results in nonsense mediated mRNA decay.

Frequency

Genomes: not found (cov: 33)
Exomes 𝑓: 0.0000021 ( 0 hom. )

Consequence

SCN5A
NM_000335.5 stop_gained

Scores

3
4

Clinical Significance

Pathogenic criteria provided, multiple submitters, no conflicts P:9

Conservation

PhyloP100: 3.94
Variant links:
Genes affected
SCN5A (HGNC:10593): (sodium voltage-gated channel alpha subunit 5) The protein encoded by this gene is an integral membrane protein and tetrodotoxin-resistant voltage-gated sodium channel subunit. This protein is found primarily in cardiac muscle and is responsible for the initial upstroke of the action potential in an electrocardiogram. Defects in this gene have been associated with long QT syndrome type 3 (LQT3), atrial fibrillation, cardiomyopathy, and Brugada syndrome 1, all autosomal dominant cardiac diseases. Alternative splicing results in several transcript variants encoding different isoforms. [provided by RefSeq, May 2022]

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ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 18 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 3-38613782-G-A is Pathogenic according to our data. Variant chr3-38613782-G-A is described in ClinVar as [Pathogenic]. Clinvar id is 201438.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr3-38613782-G-A is described in Lovd as [Pathogenic].

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE UniProt
SCN5ANM_000335.5 linkuse as main transcriptc.664C>T p.Arg222Ter stop_gained 6/28 ENST00000423572.7
SCN5ANM_001099404.2 linkuse as main transcriptc.703+193C>T intron_variant ENST00000413689.6

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Appris UniProt
SCN5AENST00000423572.7 linkuse as main transcriptc.664C>T p.Arg222Ter stop_gained 6/281 NM_000335.5 A1Q14524-2
SCN5AENST00000413689.6 linkuse as main transcriptc.703+193C>T intron_variant 5 NM_001099404.2 P4

Frequencies

GnomAD3 genomes
Cov.:
33
GnomAD4 exome
AF:
0.00000206
AC:
3
AN:
1458286
Hom.:
0
Cov.:
30
AF XY:
0.00000276
AC XY:
2
AN XY:
725044
show subpopulations
Gnomad4 AFR exome
AF:
0.00
Gnomad4 AMR exome
AF:
0.00
Gnomad4 ASJ exome
AF:
0.0000384
Gnomad4 EAS exome
AF:
0.00
Gnomad4 SAS exome
AF:
0.00
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
9.01e-7
Gnomad4 OTH exome
AF:
0.0000166
GnomAD4 genome
Cov.:
33
Bravo
AF:
0.00000378

ClinVar

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

Submissions by phenotype

not provided Pathogenic:3
Pathogenic, no assertion criteria providedresearchGharavi Laboratory, Columbia UniversitySep 16, 2018- -
Pathogenic, criteria provided, single submitterclinical testingGeneDxNov 20, 2022Nonsense variant predicted to result in protein truncation or nonsense mediated decay in a gene for which loss of function is a known mechanism of disease; Published functional studies in Xenopus oocytes demonstrate a loss-of-function effect (Ortiz-Bonnin et al., 2016); Not observed at significant frequency in large population cohorts (gnomAD); This variant is associated with the following publications: (PMID: 25525159, 32048431, 34461752, 26467377, 19716085, 26173111, 27232914, 20129283, 27287068, 22277643, 29728395, 30193851, 31447099, 34446689, 35492839, 33131149) -
Pathogenic, criteria provided, single submitterclinical testingLabcorp Genetics (formerly Invitae), LabcorpDec 23, 2022For these reasons, this variant has been classified as Pathogenic. Algorithms developed to predict the effect of sequence changes on RNA splicing suggest that this variant may disrupt the consensus splice site. ClinVar contains an entry for this variant (Variation ID: 201438). This premature translational stop signal has been observed in individual(s) with Brugada syndrome (PMID: 19716085, 26173111, 26467377, 27287068). This variant is not present in population databases (gnomAD no frequency). This sequence change creates a premature translational stop signal (p.Arg222*) in the SCN5A gene. It is expected to result in an absent or disrupted protein product. Loss-of-function variants in SCN5A are known to be pathogenic (PMID: 20129283, 22789973). -
Brugada syndrome Pathogenic:2
Pathogenic, criteria provided, single submitterclinical testingAll of Us Research Program, National Institutes of HealthSep 18, 2023This variant changes 1 nucleotide in exon 6 of the SCN5A gene, creating a premature translation stop signal. This variant is expected to result in an absent or non-functional protein product. A functional study has shown that this variant causes a large reduction of sodium current amplitudes when expressed in Xenopus oocytes (PMID 27287068). This variant has been reported in at least five families affected with Brugada syndrome (PMID: 22277643, 26173111, 26467377, 27232914, 27287068, 32893267, 34546463). Asymptomatic carriers were also reported in a few families (PMID: 22277643, 26467377). This variant has not been identified in the general population by the Genome Aggregation Database (gnomAD). Loss of SCN5A function is a known mechanism of disease (clinicalgenome.org). Based on the available evidence, this variant is classified as Pathogenic. -
Pathogenic, criteria provided, single submitterclinical testingHuman Genome Sequencing Center Clinical Lab, Baylor College of MedicineDec 17, 2019This c.664C>T (p.Arg222*) variant in the SCN5A gene introduces a premature translation termination codon. This variant has been observed in multiple individuals with Brugada syndrome as well as one individual tested for Long QT syndrome (PMID 26173111, 20129283, 27287068, 27232914, and 26467377). Based on the current evidence, this variant in the SCN5A gene is classified as pathogenic. -
SUDDEN INFANT DEATH SYNDROME;C1832680:Dilated cardiomyopathy 1E;C1837845:Sick sinus syndrome 1;C1859062:Long QT syndrome 3;C1879286:Progressive familial heart block, type 1A;C2751898:Ventricular fibrillation, paroxysmal familial, type 1;C3151464:Atrial fibrillation, familial, 10;C4551804:Brugada syndrome 1 Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingFulgent Genetics, Fulgent GeneticsNov 17, 2021- -
Long QT syndrome 3 Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingHuman Genome Sequencing Center Clinical Lab, Baylor College of MedicineApr 27, 2018This c.664C>T (p.Arg222*) variant in the SCN5A gene introduces a premature translation termination codon. This variant has been observed in multiple individuals with Brugada syndrome as well as one individual tested for Long QT syndrome (PMID 26173111, 20129283, 27287068, 27232914, and 26467377). Based on the current evidence, this variant in the SCN5A gene is classified as pathogenic. -
Cardiovascular phenotype Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingAmbry GeneticsOct 11, 2021The p.R222* pathogenic mutation (also known as c.664C>T), located in coding exon 5 of the SCN5A gene, results from a C to T substitution at nucleotide position 664. This changes the amino acid from an arginine to a stop codon within coding exon 5. This mutation has been detected in several unrelated individuals with diagnosed or suspected Brugada syndrome and has shown some segregation with disease features in families (Kapplinger JD et al. Heart Rhythm, 2010 Jan;7:33-46; Santos LF et al. Europace, 2012 Jun;14:882-8; Ortiz-Bonnin B et al. Pflugers Arch, 2016 08;468:1375-87; Asadi M et al. Anatol J Cardiol, 2016 Mar;16:170-4; Berthome P et al. Heart Rhythm, 2019 02;16:260-267; Selga E et al. PLoS One, 2015 Jul;10:e0132888). This mutation has also been detected in a long QT syndrome genetic testing cohort and in cohorts not selected for the presence of arrhythmia; however, details were limited (Kapplinger JD et al. Heart Rhythm, 2009 Sep;6:1297-303; Zouk et al. Am J Hum Genet, 2019 09;105:588-605; Diebold I et al. Hum Mutat, 2020 05;41:1025-103). One in vitro functional study reported this variant to produce no detectable sodium current (Ortiz-Bonnin B et al. Pflugers Arch, 2016 08;468:1375-87). This variant is considered to be rare based on population cohorts in the Genome Aggregation Database (gnomAD). In addition to the clinical data presented in the literature, this alteration is expected to result in loss of function by premature protein truncation or nonsense-mediated mRNA decay. As such, this alteration is interpreted as a disease-causing mutation. -
Cardiac arrhythmia Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingColor Diagnostics, LLC DBA Color HealthJul 24, 2023This variant changes 1 nucleotide in exon 6 of the SCN5A gene, creating a premature translation stop signal. This variant is expected to result in an absent or non-functional protein product. A functional study has shown that this variant causes a large reduction of sodium current amplitudes when expressed in Xenopus oocytes (PMID 27287068). This variant has been reported in at least five families affected with Brugada syndrome (PMID: 22277643, 26173111, 26467377, 27232914, 27287068, 32893267, 34546463). Asymptomatic carriers were also reported in a few families (PMID: 22277643, 26467377). This variant has not been identified in the general population by the Genome Aggregation Database (gnomAD). Loss of SCN5A function is a known mechanism of disease (clinicalgenome.org). Based on the available evidence, this variant is classified as Pathogenic. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
BayesDel_addAF
Uncertain
0.049
T
BayesDel_noAF
Benign
-0.17
CADD
Pathogenic
45
DANN
Uncertain
1.0
Eigen
Benign
0.11
Eigen_PC
Benign
0.19
FATHMM_MKL
Uncertain
0.91
D
MutationTaster
Benign
1.0
A;A;A;A;D;D;D;D;D;D
Vest4
0.89
GERP RS
4.3

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.36
Details are displayed if max score is > 0.2
DS_DL_spliceai
0.36
Position offset: -39

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: rs794728849; hg19: chr3-38655273; COSMIC: COSV61140413; COSMIC: COSV61140413; API