rs80338898

Variant names:

Variant summary

Our verdict is Pathogenic. Variant got 12 ACMG points: 12P and 0B. PM2PP3_ModeratePP5_Very_Strong

The NM_000137.4(FAH):c.782C>T(p.Pro261Leu) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.000096 in 1,614,094 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 (★★).

Frequency

Genomes: 𝑓 0.000066 ( 0 hom., cov: 33)

Exomes 𝑓: 0.000099 ( 0 hom. )

Consequence

FAH
NM_000137.4 missense

Scores

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:12O:1

Conservation

PhyloP100: 7.22

Variant links:

Genes affected

FAH (HGNC:3579): (fumarylacetoacetate hydrolase) Predicted to enable fumarylacetoacetase activity. Predicted to be involved in L-phenylalanine catabolic process; homogentisate catabolic process; and tyrosine catabolic process. Predicted to act upstream of or within arginine catabolic process. Located in extracellular exosome. Implicated in tyrosinemia type I. [provided by Alliance of Genome Resources, Apr 2022]

FAH links:

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 12 ACMG points.

PM2

Very rare variant in population databases, with high coverage;

PP3

MetaRNN computational evidence supports a deleterious effect, 0.927

PP5

Variant 15-80173089-C-T is Pathogenic according to our data. Variant chr15-80173089-C-T is described in ClinVar as [Likely_pathogenic]. Clinvar id is 21058.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.

Transcripts

RefSeq

Gene	Transcript	HGVSc	HGVSp	Effect	Exon rank	MANE	Protein	UniProt
FAH	NM_000137.4 link	c.782C>T	p.Pro261Leu	missense_variant	Exon 9 of 14	ENST00000561421.6	NP_000128.1	P16930-1A0A384P5L6
FAH	NM_001374377.1 link	c.782C>T	p.Pro261Leu	missense_variant	Exon 10 of 15		NP_001361306.1
FAH	NM_001374380.1 link	c.782C>T	p.Pro261Leu	missense_variant	Exon 10 of 15		NP_001361309.1

Ensembl

Gene	Transcript	HGVSc	HGVSp	Effect	Exon rank	TSL	MANE	Protein	Appris	UniProt
FAH	ENST00000561421.6 link	c.782C>T	p.Pro261Leu	missense_variant	Exon 9 of 14	1	NM_000137.4	ENSP00000453347.2		P16930-1

Frequencies

GnomAD3 genomes

AF:

0.0000657

AC:

AN:

152224

Hom.:

Cov.:

show subpopulations

Gnomad AFR

AF:

0.0000241

Gnomad AMI

AF:

0.00

Gnomad AMR

AF:

0.00

Gnomad ASJ

AF:

0.00173

Gnomad EAS

AF:

0.000192

Gnomad SAS

AF:

0.00

Gnomad FIN

AF:

0.00

Gnomad MID

AF:

0.00

Gnomad NFE

AF:

0.0000294

Gnomad OTH

AF:

0.00

GnomAD3 exomes

AF:

0.000175

AC:

AN:

251484

Hom.:

AF XY:

0.000206

AC XY:

AN XY:

135912

show subpopulations

Gnomad AFR exome

AF:

0.00

Gnomad AMR exome

AF:

0.00

Gnomad ASJ exome

AF:

0.00377

Gnomad EAS exome

AF:

0.00

Gnomad SAS exome

AF:

0.00

Gnomad FIN exome

AF:

0.00

Gnomad NFE exome

AF:

0.0000264

Gnomad OTH exome

AF:

0.000489

GnomAD4 exome

AF:

0.0000992

AC:

145

AN:

1461870

Hom.:

Cov.:

AF XY:

0.000116

AC XY:

AN XY:

727238

show subpopulations

Gnomad4 AFR exome

AF:

0.0000896

Gnomad4 AMR exome

AF:

0.0000447

Gnomad4 ASJ exome

AF:

0.00341

Gnomad4 EAS exome

AF:

0.00

Gnomad4 SAS exome

AF:

0.0000116

Gnomad4 FIN exome

AF:

0.0000187

Gnomad4 NFE exome

AF:

0.0000297

Gnomad4 OTH exome

AF:

0.000265

GnomAD4 genome

AF:

0.0000657

AC:

AN:

152224

Hom.:

Cov.:

AF XY:

0.0000403

AC XY:

AN XY:

74370

show subpopulations

Gnomad4 AFR

AF:

0.0000241

Gnomad4 AMR

AF:

0.00

Gnomad4 ASJ

AF:

0.00173

Gnomad4 EAS

AF:

0.000192

Gnomad4 SAS

AF:

0.00

Gnomad4 FIN

AF:

0.00

Gnomad4 NFE

AF:

0.0000294

Gnomad4 OTH

AF:

0.00

Alfa

AF:

0.000369

Hom.:

Bravo

AF:

0.000147

ESP6500AA

AF:

0.00

AC:

ESP6500EA

AF:

0.000116

AC:

ExAC

AF:

0.000132

AC:

EpiCase

AF:

0.000164

EpiControl

AF:

0.00

ClinVar

Significance: Pathogenic/Likely pathogenic

Submissions summary: Pathogenic:12Other:1

Revision: criteria provided, multiple submitters, no conflicts

LINK: link

Submissions by phenotype

Tyrosinemia type I

Pathogenic:8Other:1

Oct 13, 2022

Revvity Omics, Revvity

Significance: Likely pathogenic

Review Status: criteria provided, single submitter

Collection Method: clinical testing

- -

Oct 18, 2019

Myriad Genetics, Inc.

Significance: Likely pathogenic

Review Status: criteria provided, single submitter

Collection Method: clinical testing

NM_000137.2(FAH):c.782C>T(P261L) is classified as likely pathogenic in the context of tyrosinemia type I. Sources cited for classification include the following: PMID 11754109, 9633815, 15187789, and 9633815. Classification of NM_000137.2(FAH):c.782C>T(P261L) is based on the following criteria: This variant has been observed more frequently in patients with clinical diagnoses than in healthy populations. Please note: this variant was assessed in the context of healthy population screening.â€šÃ„Ã¶âˆšÃ‘âˆšÂ£ -

GeneReviews

Significance: not provided

Review Status: no classification provided

Collection Method: literature only

Ashkenazi Jewish-specific pathogenic variant resulting from founder effect or genetic drift [Angileri et al 2015]. -

Mar 17, 2024

Genomic Medicine Center of Excellence, King Faisal Specialist Hospital and Research Centre

Significance: Pathogenic

Review Status: criteria provided, single submitter

Collection Method: research

- -

Mar 19, 2024

Labcorp Genetics (formerly Invitae), Labcorp

Significance: Pathogenic

Review Status: criteria provided, single submitter

Collection Method: clinical testing

This sequence change replaces proline, which is neutral and non-polar, with leucine, which is neutral and non-polar, at codon 261 of the FAH protein (p.Pro261Leu). This variant is present in population databases (rs80338898, gnomAD 0.4%). This missense change has been observed in individual(s) with tyrosinemia type 1 (PMID: 9633815, 11754109, 21764616, 31998365, 35800472). It has also been observed to segregate with disease in related individuals. ClinVar contains an entry for this variant (Variation ID: 21058). Advanced modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) performed at Invitae indicates that this missense variant is expected to disrupt FAH protein function with a positive predictive value of 80%. For these reasons, this variant has been classified as Pathogenic. -

Oct 06, 2016

Women's Health and Genetics/Laboratory Corporation of America, LabCorp

Significance: Pathogenic

Review Status: criteria provided, single submitter

Collection Method: clinical testing

Variant summary: The FAH c.782C>T (p.Pro261Leu) variant located in the fumarylacetoacestase, C-terminal-related domain (via InterPro) causes a missense change involving a conserved nucleotide with 5/5 in silico tools predict a damaging outcome, although these predictions have yet to be functionally assessed. The variant of interest was observed in the large, broad control population, ExAC, with allele frequency of 16/121404, predominantly in the European (Non-Finnish), 15/66732 (1/4448), which does not exceed the estimated maximal expected allele frequency for a pathogenic FAH variant of 1/400. The variant of interest has been reported in multiple affected individuals in a homozygous state via publications. In addition, multiple reputable databases/clinical diagnostic laboratories cite the variant as "pathogenic." Therefore, the variant of interest has been classified as Pathogenic. -

May 29, 2024

Fulgent Genetics, Fulgent Genetics

Significance: Pathogenic

Review Status: criteria provided, single submitter

Collection Method: clinical testing

- -

Mar 21, 2024

Baylor Genetics

Significance: Pathogenic

Review Status: criteria provided, single submitter

Collection Method: clinical testing

- -

Sep 13, 2017

Illumina Laboratory Services, Illumina

Significance: Pathogenic

Review Status: flagged submission

Collection Method: clinical testing

The FAH c.782C>T (p.Pro261Leu) variant is one of the four most common variants seen in patients with tyrosinemia type I, and is often observed in affected individuals of Ashkenazi Jewish descent (Sniderman King et al. 2017). The p.Pro261Leu variant has been reported in three studies in which it is found in a homozygous state in seven Israeli individuals with tyrosinemia type I (Bergman et al. 1998; Elpeleg et al. 2002; Korman and Gutman 2004). Control data are unavailable for this variant, which is reported at a frequency of 0.00374 in the Ashkenazi Jewish population of the Genome Aggregation Database. Based on the evidence, the p.Pro261Leu variant is classified as pathogenic for tyrosinemia. This variant was observed by ICSL as part of a predisposition screen in an ostensibly healthy population. -

not provided

Pathogenic:3

Feb 19, 2014

Eurofins Ntd Llc (ga)

Significance: Pathogenic

Review Status: criteria provided, single submitter

Collection Method: clinical testing

- -

Nov 16, 2022

Illumina Laboratory Services, Illumina

Significance: Pathogenic

Review Status: criteria provided, single submitter

Collection Method: clinical testing

The FAH c.782C>T (p.Pro261Leu) missense variant results in the substitution of proline at amino acid position 261 with leucine and is one of the common pathogenic variant in this gene (PMID: 20301688). Across a selection of the available literature, this variant has been identified in at least eleven individuals with tyrosinemia type 1, all in a homozygous state (PMID: 9633815; PMID: 11754109; PMID: 21764616). The highest frequency of this allele in the Genome Aggregation Database is 0.003664 in the Ashkenazi Jewish population (version 2.1.1). The variant accounts for more than 99% of the pathogenic variants in this population (PMID: 20301688). Site-directed mutagenesis, enzymatic assays, and molecular dynamics simulations with the variant protein revealed that the p.Pro261Leu variant protein results in destabilized protein with <10% of enzymatic activity compared to wild-type FAH (PMID: 31300554). Multiple lines of computational evidence suggest the variant may have a deleterious effect on the gene or gene product. Based on the available evidence, the c.782C>T (p.Pro261Leu) variant is classified as pathogenic for tyrosinemia type 1. -

May 07, 2021

GeneDx

Significance: Pathogenic

Review Status: criteria provided, single submitter

Collection Method: clinical testing

Functional studies found that this variant is associated with approximately 8% residual enzyme activity compared to wild-type and results in destabilization of the enzyme (Macias et al., 2019); 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: 25681080, 9633815, 11754109, 25087612, 27415407, 22975760, 21764616, 30414057, 31300554, 29625052, 31130284, 31998365, 31980526, 15187789, 31589614) -

FAH-related disorder

Pathogenic:1

May 22, 2024

PreventionGenetics, part of Exact Sciences

Significance: Pathogenic

Review Status: no assertion criteria provided

Collection Method: clinical testing

The FAH c.782C>T variant is predicted to result in the amino acid substitution p.Pro261Leu. This variant has previously been reported to be causative for autosomal recessive tyrosinemia type 1. It is one of the most common pathogenic variants in this gene, and functional studies support its pathogenicity (Bergman et al. 1998. PubMed ID: 9633815; Elpeleg et al. 2002. PubMed ID: 11754109; Angileri et al. 2015. PubMed ID: 25681080; Macias et al. 2019. PubMed ID: 31300554; OMIM #276700). This variant is reported in 0.37% of alleles in individuals of Ashkenazi Jewish descent in gnomAD. This variant is interpreted as pathogenic. -

Computational scores

Source: dbNSFP v4.3

Name

Calibrated prediction

Score

Prediction

AlphaMissense

Uncertain

0.41

BayesDel_addAF

Pathogenic

0.57

BayesDel_noAF

Pathogenic

0.59

CADD

Pathogenic

DANN

Uncertain

1.0

DEOGEN2

Pathogenic

0.98

D;D;D

Eigen

Pathogenic

0.80

Eigen_PC

Uncertain

0.60

FATHMM_MKL

Uncertain

0.91

LIST_S2

Pathogenic

0.99

.;.;D

M_CAP

Pathogenic

0.80

MetaRNN

Pathogenic

0.93

D;D;D

MetaSVM

Pathogenic

0.97

MutationAssessor

Pathogenic

4.7

H;H;H

PrimateAI

Uncertain

0.75

PROVEAN

Pathogenic

-9.4

D;D;D

REVEL

Pathogenic

0.94

Sift

Pathogenic

0.0

D;D;D

Sift4G

Pathogenic

0.0010

D;D;D

Polyphen

1.0

D;D;D

Vest4

0.99

MVP

0.98

MPC

0.85

ClinPred

1.0

GERP RS

4.6

RBP_binding_hub_radar

0.0

RBP_regulation_power_radar

1.7

Varity_R

0.94

gMVP

0.95

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

LitVar

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

Variant summary

Frequency

Consequence

Scores

Clinical Significance

Conservation

ACMG classification

Transcripts

RefSeq

Ensembl

Frequencies

ClinVar

Submissions by phenotype

Computational scores

Splicing

Publications

LitVar

Other links and lift over