rs8177988

Variant summary

Our verdict is Benign. Variant got -8 ACMG points: 0P and 8B. BP4_StrongBS2

The NM_000298.6(PKLR):​c.1516G>A​(p.Val506Ile) variant causes a missense change. The variant allele was found at a frequency of 0.00547 in 1,614,046 control chromosomes in the GnomAD database, including 43 homozygotes. In-silico tool predicts a benign outcome for this variant. 12/21 in silico tools predict a benign outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars).

Frequency

Genomes: 𝑓 0.0041 ( 2 hom., cov: 31)
Exomes 𝑓: 0.0056 ( 41 hom. )

Consequence

PKLR
NM_000298.6 missense

Scores

6
12

Clinical Significance

Conflicting classifications of pathogenicity criteria provided, conflicting classifications U:7B:4

Conservation

PhyloP100: 3.97
Variant links:
Genes affected
PKLR (HGNC:9020): (pyruvate kinase L/R) The protein encoded by this gene is a pyruvate kinase that catalyzes the transphosphorylation of phohsphoenolpyruvate into pyruvate and ATP, which is the rate-limiting step of glycolysis. Defects in this enzyme, due to gene mutations or genetic variations, are the common cause of chronic hereditary nonspherocytic hemolytic anemia (CNSHA or HNSHA). Multiple transcript variants encoding different isoforms have been found for this gene. [provided by RefSeq, Jul 2008]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Benign. Variant got -8 ACMG points.

BP4
Computational evidence support a benign effect (MetaRNN=0.010544926).
BS2
High Homozygotes in GnomAd4 at 2 AR gene

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE Protein UniProt
PKLRNM_000298.6 linkuse as main transcriptc.1516G>A p.Val506Ile missense_variant 10/11 ENST00000342741.6 NP_000289.1

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Protein Appris UniProt
PKLRENST00000342741.6 linkuse as main transcriptc.1516G>A p.Val506Ile missense_variant 10/111 NM_000298.6 ENSP00000339933 P3P30613-1
PKLRENST00000392414.7 linkuse as main transcriptc.1423G>A p.Val475Ile missense_variant 10/111 ENSP00000376214 A1P30613-2

Frequencies

GnomAD3 genomes
AF:
0.00413
AC:
629
AN:
152136
Hom.:
2
Cov.:
31
show subpopulations
Gnomad AFR
AF:
0.00109
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00537
Gnomad ASJ
AF:
0.00115
Gnomad EAS
AF:
0.00
Gnomad SAS
AF:
0.00498
Gnomad FIN
AF:
0.00132
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.00653
Gnomad OTH
AF:
0.00765
GnomAD3 exomes
AF:
0.00436
AC:
1096
AN:
251476
Hom.:
5
AF XY:
0.00493
AC XY:
670
AN XY:
135912
show subpopulations
Gnomad AFR exome
AF:
0.000984
Gnomad AMR exome
AF:
0.00266
Gnomad ASJ exome
AF:
0.00179
Gnomad EAS exome
AF:
0.00
Gnomad SAS exome
AF:
0.00722
Gnomad FIN exome
AF:
0.00120
Gnomad NFE exome
AF:
0.00606
Gnomad OTH exome
AF:
0.00554
GnomAD4 exome
AF:
0.00561
AC:
8195
AN:
1461792
Hom.:
41
Cov.:
33
AF XY:
0.00561
AC XY:
4083
AN XY:
727196
show subpopulations
Gnomad4 AFR exome
AF:
0.000986
Gnomad4 AMR exome
AF:
0.00271
Gnomad4 ASJ exome
AF:
0.00134
Gnomad4 EAS exome
AF:
0.00
Gnomad4 SAS exome
AF:
0.00681
Gnomad4 FIN exome
AF:
0.00140
Gnomad4 NFE exome
AF:
0.00636
Gnomad4 OTH exome
AF:
0.00392
GnomAD4 genome
AF:
0.00413
AC:
629
AN:
152254
Hom.:
2
Cov.:
31
AF XY:
0.00394
AC XY:
293
AN XY:
74442
show subpopulations
Gnomad4 AFR
AF:
0.00108
Gnomad4 AMR
AF:
0.00536
Gnomad4 ASJ
AF:
0.00115
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.00499
Gnomad4 FIN
AF:
0.00132
Gnomad4 NFE
AF:
0.00653
Gnomad4 OTH
AF:
0.00757
Alfa
AF:
0.00558
Hom.:
4
Bravo
AF:
0.00434
TwinsUK
AF:
0.00674
AC:
25
ALSPAC
AF:
0.00519
AC:
20
ESP6500AA
AF:
0.00159
AC:
7
ESP6500EA
AF:
0.00512
AC:
44
ExAC
AF:
0.00419
AC:
509
Asia WGS
AF:
0.000577
AC:
2
AN:
3478
EpiCase
AF:
0.00676
EpiControl
AF:
0.00747

ClinVar

Significance: Conflicting classifications of pathogenicity
Submissions summary: Uncertain:7Benign:4
Revision: criteria provided, conflicting classifications
LINK: link

Submissions by phenotype

not provided Uncertain:5Benign:2
Uncertain significance, criteria provided, single submitterclinical testingMayo Clinic Laboratories, Mayo ClinicNov 01, 2022BP4_strong -
Uncertain significance, criteria provided, single submitterclinical testingCenter for Pediatric Genomic Medicine, Children's Mercy Hospital and ClinicsFeb 06, 2015- -
Uncertain significance, criteria provided, single submitterclinical testingGeneDxOct 03, 2017The V506I variant in the PKLR gene, also called PK Mallorca, has been reported previously in the heterozygous state with a second PKLR variant in a patient with PK deficiency (Pissard et al., 2006). The V506I variant was also identified in the heterozygous state in a child with concomitant hereditary spherocytosis and chronic hemolytic anemia who harbored V506I in trans with variants in hereditary spherocytosis genes; this individual's mother with V506I in the heterozygous state was asymptomatic (Zarza et al., 2000). The V506I variant is observed in 217/30782 (0.7%) alleles from individuals of South African background, including five homozygous individuals, in the ExAC dataset (Lek et al., 2016). The V506I variant is a conservative amino acid substitution, which is not likely to impact secondary protein structure as these residues share similar properties. This substitution occurs at a position where amino acids with similar properties to Valine are tolerated across species. In silico analysis is inconsistent in its predictions as to whether or not the variant is damaging to the protein structure/function. We interpret V506I as a variant of uncertain significance. -
Uncertain significance, no assertion criteria providedclinical testingDepartment of Pathology and Laboratory Medicine, Sinai Health System-The PKLR p.Val475Ile variant was identified in 1 of 112 proband chromosomes (frequency: 0.0089) from individuals or families with pyruvate-kinase deficiency (Pissard_2006_PMID:16704447). The variant was also identified in the heterozygous state in a patient with partial red blood cell pyruvate-kinase deficiency concomitant hereditary spherocytosis and chronic hemolytic anemia; the patient's unaffected mother also carried the V475I variant (Zarza_2000_PMID:10702808). The variant was identified in dbSNP (ID: rs8177988), ClinVar (classified as a VUS by ARUP Laboratories, GeneDx, Fulgent Genetics and Center for Pediatric Genomic Medicine, Children's Mercy Hospital and Clinics) and LOVD 3.0 (classified as a VUS and pathogenic). The variant was identified in control databases in 1201 of 282864 chromosomes (5 homozygous) at a frequency of 0.004246 increasing the likelihood this could be a low frequency benign variant (Genome Aggregation Database Feb 27, 2017). The variant was observed in the following populations: South Asian in 221 of 30616 chromosomes (freq: 0.007218), European (non-Finnish) in 769 of 129180 chromosomes (freq: 0.005953), Other in 37 of 7224 chromosomes (freq: 0.005122), Latino in 93 of 35436 chromosomes (freq: 0.002624), Ashkenazi Jewish in 21 of 10368 chromosomes (freq: 0.002025), European (Finnish) in 31 of 25120 chromosomes (freq: 0.001234) and African in 29 of 24966 chromosomes (freq: 0.001162); it was not observed in the East Asian population. The p.Val475 residue is not conserved in mammals and computational analyses (PolyPhen-2, SIFT, AlignGVGD, BLOSUM, MutationTaster) do not suggest a high likelihood of impact to the protein; however, this information is not predictive enough to rule out pathogenicity. The variant occurs outside of the splicing consensus sequence and 3 of 4 in silico or computational prediction software programs (SpliceSiteFinder, MaxEntScan, GeneSplicer) do not predict a difference in splicing. In summary, based on the above information the clinical significance of this variant cannot be determined with certainty at this time. This variant is classified as a variant of uncertain significance. -
Likely benign, criteria provided, single submitterclinical testingLabcorp Genetics (formerly Invitae), LabcorpDec 18, 2023- -
Uncertain significance, criteria provided, single submitterclinical testingARUP Laboratories, Molecular Genetics and Genomics, ARUP LaboratoriesApr 06, 2023- -
Likely benign, criteria provided, single submitterclinical testingCeGaT Center for Human Genetics TuebingenOct 01, 2023PKLR: BS2 -
Pyruvate kinase deficiency of red cells Uncertain:1Benign:1
Likely benign, criteria provided, single submitterclinical testingIllumina Laboratory Services, IlluminaApr 27, 2017This variant was observed as part of a predisposition screen in an ostensibly healthy population. A literature search was performed for the gene, cDNA change, and amino acid change (where applicable). No publications were found based on this search. Allele frequency data from public databases allowed determination this variant is unlikely to cause disease. Therefore, this variant is classified as likely benign. -
Uncertain significance, criteria provided, single submitterclinical testingCenter for Genomic Medicine, King Faisal Specialist Hospital and Research CenterSep 22, 2024- -
Pyruvate kinase deficiency of red cells;C1863224:Pyruvate kinase hyperactivity Uncertain:1
Uncertain significance, criteria provided, single submitterclinical testingFulgent Genetics, Fulgent GeneticsOct 31, 2018- -
PKLR-related disorder Benign:1
Likely benign, no assertion criteria providedclinical testingPreventionGenetics, part of Exact SciencesFeb 15, 2023This variant is classified as likely benign based on ACMG/AMP sequence variant interpretation guidelines (Richards et al. 2015 PMID: 25741868, with internal and published modifications). -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.088
BayesDel_addAF
Benign
-0.096
T
BayesDel_noAF
Uncertain
0.090
CADD
Benign
19
DANN
Uncertain
0.99
DEOGEN2
Uncertain
0.64
D;.
Eigen
Benign
-0.25
Eigen_PC
Benign
-0.067
FATHMM_MKL
Uncertain
0.94
D
M_CAP
Benign
0.022
T
MetaRNN
Benign
0.011
T;T
MetaSVM
Uncertain
0.36
D
MutationAssessor
Benign
0.78
N;.
MutationTaster
Benign
0.53
D;N
PrimateAI
Benign
0.33
T
PROVEAN
Benign
-0.34
N;N
REVEL
Uncertain
0.53
Sift
Benign
0.15
T;T
Sift4G
Benign
0.43
T;T
Polyphen
0.0
B;.
Vest4
0.098
MVP
0.79
MPC
0.34
ClinPred
0.0060
T
GERP RS
3.9
RBP_binding_hub_radar
0.0
RBP_regulation_power_radar
1.7
Varity_R
0.18
gMVP
0.77

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.

Other links and lift over

dbSNP: rs8177988; hg19: chr1-155261649; COSMIC: COSV99048047; COSMIC: COSV99048047; API