Our verdict is Pathogenic. The variant received 12 ACMG points: 12P and 0B. PVS1PM2PP5_Moderate
The NM_144997.7(FLCN):c.828delTinsAGA(p.Ala277GlufsTer17) variant causes a frameshift, synonymous change involving the alteration of a non-conserved nucleotide. The variant was absent in control chromosomes in GnomAD project. Variant has been reported in ClinVar as Pathogenic (★). Synonymous variant affecting the same amino acid position (i.e. G276G) has been classified as Benign. Variant results in nonsense mediated mRNA decay.
FLCN (HGNC:27310): (folliculin) This gene is located within the Smith-Magenis syndrome region on chromosome 17. Mutations in this gene are associated with Birt-Hogg-Dube syndrome, which is characterized by fibrofolliculomas, renal tumors, lung cysts, and pneumothorax. Alternative splicing of this gene results in two transcript variants encoding different isoforms. [provided by RefSeq, Jul 2008]
FLCN Gene-Disease associations (from GenCC):
Birt-Hogg-Dube syndrome
Inheritance: AD Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Genomics England PanelApp, Labcorp Genetics (formerly Invitae), Orphanet, ClinGen
Birt-Hogg-Dube syndrome 1
Inheritance: AD Classification: DEFINITIVE Submitted by: G2P, Ambry Genetics
familial spontaneous pneumothorax
Inheritance: AD Classification: STRONG, MODERATE, SUPPORTIVE Submitted by: Genomics England PanelApp, Orphanet, Ambry Genetics
renal carcinoma
Inheritance: AD Classification: STRONG Submitted by: Genomics England PanelApp
colorectal cancer
Inheritance: AD Classification: LIMITED Submitted by: Ambry Genetics
Our verdict: Pathogenic. The variant received 12 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 17-17221580-A-TCT is Pathogenic according to our data. Variant chr17-17221580-A-TCT is described in CliVar as Pathogenic. Clinvar id is 241931.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr17-17221580-A-TCT is described in CliVar as Pathogenic. Clinvar id is 241931.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr17-17221580-A-TCT is described in CliVar as Pathogenic. Clinvar id is 241931.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr17-17221580-A-TCT is described in CliVar as Pathogenic. Clinvar id is 241931.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr17-17221580-A-TCT is described in CliVar as Pathogenic. Clinvar id is 241931.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr17-17221580-A-TCT is described in CliVar as Pathogenic. Clinvar id is 241931.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr17-17221580-A-TCT is described in CliVar as Pathogenic. Clinvar id is 241931.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr17-17221580-A-TCT is described in CliVar as Pathogenic. Clinvar id is 241931.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr17-17221580-A-TCT is described in CliVar as Pathogenic. Clinvar id is 241931.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr17-17221580-A-TCT is described in CliVar as Pathogenic. Clinvar id is 241931.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr17-17221580-A-TCT is described in CliVar as Pathogenic. Clinvar id is 241931.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr17-17221580-A-TCT is described in CliVar as Pathogenic. Clinvar id is 241931.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr17-17221580-A-TCT is described in CliVar as Pathogenic. Clinvar id is 241931.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr17-17221580-A-TCT is described in CliVar as Pathogenic. Clinvar id is 241931.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr17-17221580-A-TCT is described in CliVar as Pathogenic. Clinvar id is 241931.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr17-17221580-A-TCT is described in CliVar as Pathogenic. Clinvar id is 241931.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr17-17221580-A-TCT is described in CliVar as Pathogenic. Clinvar id is 241931.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr17-17221580-A-TCT is described in CliVar as Pathogenic. Clinvar id is 241931.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr17-17221580-A-TCT is described in CliVar as Pathogenic. Clinvar id is 241931.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr17-17221580-A-TCT is described in CliVar as Pathogenic. Clinvar id is 241931.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr17-17221580-A-TCT is described in CliVar as Pathogenic. Clinvar id is 241931.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr17-17221580-A-TCT is described in CliVar as Pathogenic. Clinvar id is 241931.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr17-17221580-A-TCT is described in CliVar as Pathogenic. Clinvar id is 241931.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr17-17221580-A-TCT is described in CliVar as Pathogenic. Clinvar id is 241931.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr17-17221580-A-TCT is described in CliVar as Pathogenic. Clinvar id is 241931.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr17-17221580-A-TCT is described in CliVar as Pathogenic. Clinvar id is 241931.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr17-17221580-A-TCT is described in CliVar as Pathogenic. Clinvar id is 241931.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr17-17221580-A-TCT is described in CliVar as Pathogenic. Clinvar id is 241931.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr17-17221580-A-TCT is described in CliVar as Pathogenic. Clinvar id is 241931.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr17-17221580-A-TCT is described in CliVar as Pathogenic. Clinvar id is 241931.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr17-17221580-A-TCT is described in CliVar as Pathogenic. Clinvar id is 241931.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr17-17221580-A-TCT is described in CliVar as Pathogenic. Clinvar id is 241931.Status of the report is criteria_provided_single_submitter, 1 stars. Variant chr17-17221580-A-TCT is described in CliVar as Pathogenic. Clinvar id is 241931.Status of the report is criteria_provided_single_submitter, 1 stars.
This sequence change creates a premature translational stop signal (p.Ala277Glufs*17) in the FLCN gene. It is expected to result in an absent or disrupted protein product. This variant is not present in population databases (ExAC no frequency). This variant has not been reported in the literature in individuals with FLCN-related conditions. ClinVar contains an entry for this variant (Variation ID: 241931). Loss-of-function variants in FLCN are known to be pathogenic (PMID: 15852235). For these reasons, this variant has been classified as Pathogenic. -