Our verdict is Pathogenic. Variant got 10 ACMG points: 10P and 0B. PVS1PM2
The ENST00000252034.12(ELN):c.670_671insTGAGG(p.Gly224GlufsTer95) variant causes a frameshift change. The variant was absent in control chromosomes in GnomAD project. Variant has been reported in ClinVar as Uncertain significance (★). Variant results in nonsense mediated mRNA decay.
ELN (HGNC:3327): (elastin) This gene encodes a protein that is one of the two components of elastic fibers. Elastic fibers comprise part of the extracellular matrix and confer elasticity to organs and tissues including the heart, skin, lungs, ligaments, and blood vessels. The encoded protein is rich in hydrophobic amino acids such as glycine and proline, which form mobile hydrophobic regions bounded by crosslinks between lysine residues. Degradation products of the encoded protein, known as elastin-derived peptides or elastokines, bind the elastin receptor complex and other receptors and stimulate migration and proliferation of monocytes and skin fibroblasts. Elastokines can also contribute to cancer progression. Deletions and mutations in this gene are associated with supravalvular aortic stenosis (SVAS) and autosomal dominant cutis laxa. [provided by RefSeq, Aug 2017]
Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing
Variant classified as Uncertain Significance - Favor Pathogenic. The c.685+1_685 +5dup variant in ELN has not been previously reported in individuals with congen ital heart defects or in large population studies. This variant is a duplication of 5 bases and is located in the 5' splice region. Computational tools suggest an impact to splicing and splice-site alterations in the ELN gene have been asso ciated with SVAS (Human Genome Mutation Database, HGMD). However, information fo r this variant is insufficient to establish pathogenicity. In summary, while th ere is some suspicion for a pathogenic role, the clinical significance of the c. 685+1_685+5dup variant is uncertain. -