rs869025541
Variant summary
Our verdict is Pathogenic. Variant got 14 ACMG points: 14P and 0B. PM2PM5PP3_ModeratePP5_Very_Strong
The NM_004621.6(TRPC6):c.523C>T(p.Arg175Trp) variant causes a missense change. The variant was absent in control chromosomes in GnomAD project. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Likely pathogenic (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. R175Q) has been classified as Likely pathogenic.
Frequency
Consequence
NM_004621.6 missense
Scores
Clinical Significance
Conservation
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ACMG classification
Verdict is Pathogenic. Variant got 14 ACMG points.
Transcripts
RefSeq
Ensembl
Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | TSL | MANE | Protein | Appris | UniProt |
---|---|---|---|---|---|---|---|---|---|---|
TRPC6 | ENST00000344327.8 | c.523C>T | p.Arg175Trp | missense_variant | Exon 2 of 13 | 1 | NM_004621.6 | ENSP00000340913.3 | ||
TRPC6 | ENST00000360497.4 | c.523C>T | p.Arg175Trp | missense_variant | Exon 2 of 12 | 1 | ENSP00000353687.4 | |||
TRPC6 | ENST00000348423.8 | c.523C>T | p.Arg175Trp | missense_variant | Exon 2 of 11 | 1 | ENSP00000343672.4 | |||
TRPC6 | ENST00000532133.5 | c.523C>T | p.Arg175Trp | missense_variant | Exon 2 of 12 | 5 | ENSP00000435574.1 |
Frequencies
GnomAD3 genomes Cov.: 32
GnomAD4 exome Cov.: 31
GnomAD4 genome Cov.: 32
ClinVar
Submissions by phenotype
Focal segmental glomerulosclerosis 2 Pathogenic:3
The c.523C>T (p.Arg175Trp) TRPC6 variant has been reported in our laboratory in a 9-year-old girl with suspected focal segmental glomerulosclerosis associated with hypertensive crisis, requiring daily dialysis. Previous episode of 3 months of progressive decline with the last 3 weeks of refusal to eat and vomiting. Negative autoimmune study, proteinuria in the nephrotic range, hypocalcemia and hyperphosphatemia. Her father received a kidney transplant at 9 and 37 years of age. This variant is a de novo change in her father (healthy grandparents, aunt, and 15-year-old brother do not have the variant) and it has been previously reported as a de novo change in a patient with focal segmental glomerulosclerosis [PMID 28204945] and in two patients with steroid resistant nephrotic syndrome [PMID 28117080, 26668027]. In summary, c.523C>T TRPC6 variant meets our criteria to be classified as pathogenic based upon its absence from controls (gnomAD no frequency), computational evidence of pathogenicity (CADD, MutationTaster, SIFT, PolyPhen2), de novo occurrence in this family and specific patient´s phenotype. -
This variant was determined to be pathogenic according to ACMG Guidelines, 2015 [PMID:25741868]. This variant has been previously reported as a de novo change in a patient with focal segmental glomerulosclerosis [PMID 28204945] -
PS2,PM2_p,PP3 -
Nephrotic syndrome Pathogenic:2Uncertain:1
This individual is heterozygous for the c.523C>T p.(Arg175Trp) variant in the TRPC6 gene. To our knowledge, this variant has not been reported in any population databases (i.e. gnomAD, ExAC, ESP or dbSNP). This variant has been reported in three patients with steroid resistant nephrotic syndrome (Bierzynska et al 2017 Kidney Int 91:937-947 PMID: 28117080; Wang et al 2017 Pediatr Nephrol 32:1181-1192 PMID:28204945; Buscher et al 2016 Clin J Am Soc Nephrol 11:245-253 PMID: 26668027). The first two papers reported the variant as de novo/sporadic in the patient. In silico analysis (through Alamut Visual v2.8.1) using PolyPhen2, SIFT and MutationTaster all predict this variant to be a likely pathogenic variant. This variant is considered to be likely pathogenic according to the ACMG guidelines. -
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not provided Pathogenic:2
This sequence change replaces arginine, which is basic and polar, with tryptophan, which is neutral and slightly polar, at codon 175 of the TRPC6 protein (p.Arg175Trp). This variant is not present in population databases (gnomAD no frequency). This missense change has been observed in individual(s) with focal segmental glomerulosclerosis (PMID: 28204945, 33884742). In at least one individual the variant was observed to be de novo. ClinVar contains an entry for this variant (Variation ID: 222850). Invitae Evidence Modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) indicates that this missense variant is expected to disrupt TRPC6 protein function with a positive predictive value of 95%. For these reasons, this variant has been classified as Pathogenic. -
This variant was not reported in large, multi-ethnic, general populations (http://gnomad.broadinstitute.org). This variant has been identified in multiple unrelated individuals with clinical features associated with this gene, including multiple apparent de novo cases. At least one other missense variant at this codon is considered to be pathogenic or likely pathogenic, suggesting this variant may also cause disease. Computational tools predict that this variant is damaging. -
TRPC6-related disorder Pathogenic:1
The TRPC6 c.523C>T variant is predicted to result in the amino acid substitution p.Arg175Trp. This variant has been reported in multiple individuals with focal segmental glomerulosclerosis (de novo in Wang et al. 2017. PubMed ID: 28204945; Bierzynska et al. 2017. PubMed ID: 28117080; de novo in Nagano et al. 2020. PubMed ID: 31937884; de novo in Hanafusa et al. 2021. PubMed ID: 33884742). This variant has not been reported in a large population database (http://gnomad.broadinstitute.org), indicating this variant is rare. Of note, different substitutions at the same codon (p.Arg175Gln and p.Arg175Gly) have been reported to be pathogenic for focal segmental glomerulosclerosis (Hofstra et al. 2013. PubMed ID: 23291369; Table S2, Park et al. 2020. PubMed ID: 32604935 ). The c.523C>T (p.Arg175Trp) variant is interpreted as pathogenic. -
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at