rs886039548

Variant summary

Our verdict is Pathogenic. The variant received 12 ACMG points: 12P and 0B. PVS1_ModeratePM2PP5_Very_Strong

The NM_001042492.3(NF1):​c.204+1G>A variant causes a splice donor, intron change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.000000684 in 1,461,364 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. 3/3 splice prediction tools predicting alterations to normal splicing. Variant has been reported in ClinVar as Likely pathogenic (★★).

Frequency

Genomes: not found (cov: 32)
Exomes 𝑓: 6.8e-7 ( 0 hom. )

Consequence

NF1
NM_001042492.3 splice_donor, intron

Scores

5
1
1
Splicing: ADA: 1.000
2

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:10

Conservation

PhyloP100: 9.38

Publications

6 publications found
Variant links:
Genes affected
NF1 (HGNC:7765): (neurofibromin 1) This gene product appears to function as a negative regulator of the ras signal transduction pathway. Mutations in this gene have been linked to neurofibromatosis type 1, juvenile myelomonocytic leukemia and Watson syndrome. The mRNA for this gene is subject to RNA editing (CGA>UGA->Arg1306Term) resulting in premature translation termination. Alternatively spliced transcript variants encoding different isoforms have also been described for this gene. [provided by RefSeq, Jul 2008]
NF1 Gene-Disease associations (from GenCC):
  • neurofibromatosis type 1
    Inheritance: AD Classification: DEFINITIVE, STRONG Submitted by: Labcorp Genetics (formerly Invitae), ClinGen, PanelApp Australia, G2P, Genomics England PanelApp
  • neurofibromatosis-Noonan syndrome
    Inheritance: AD Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Orphanet, Genomics England PanelApp, PanelApp Australia
  • Moyamoya disease
    Inheritance: AD Classification: MODERATE Submitted by: Genomics England PanelApp
  • hereditary pheochromocytoma-paraganglioma
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • familial ovarian cancer
    Inheritance: AD Classification: NO_KNOWN Submitted by: ClinGen

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Pathogenic. The variant received 12 ACMG points.

PVS1
Splicing +-2 bp (donor or acceptor) variant, product NOT destroyed by NMD, known LOF gene, truncates exone, which is 0.01690141 fraction of the gene. No cryptic splice site detected. Exon removal is inframe change.
PM2
Very rare variant in population databases, with high coverage;
PP5
Variant 17-31156127-G-A is Pathogenic according to our data. Variant chr17-31156127-G-A is described in ClinVar as Pathogenic/Likely_pathogenic. ClinVar VariationId is 265442.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
NF1NM_001042492.3 linkc.204+1G>A splice_donor_variant, intron_variant Intron 2 of 57 ENST00000358273.9 NP_001035957.1 P21359-1
NF1NM_000267.4 linkc.204+1G>A splice_donor_variant, intron_variant Intron 2 of 56 NP_000258.1 P21359-2
NF1NM_001128147.3 linkc.204+1G>A splice_donor_variant, intron_variant Intron 2 of 14 NP_001121619.1 P21359-5

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
NF1ENST00000358273.9 linkc.204+1G>A splice_donor_variant, intron_variant Intron 2 of 57 1 NM_001042492.3 ENSP00000351015.4 P21359-1

Frequencies

GnomAD3 genomes
Cov.:
32
GnomAD4 exome
AF:
6.84e-7
AC:
1
AN:
1461364
Hom.:
0
Cov.:
32
AF XY:
0.00000138
AC XY:
1
AN XY:
727020
show subpopulations
⚠️ The allele balance in gnomAD version 4 Exomes is significantly skewed from the expected value of 0.5.
African (AFR)
AF:
0.00
AC:
0
AN:
33462
American (AMR)
AF:
0.00
AC:
0
AN:
44722
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
26118
East Asian (EAS)
AF:
0.00
AC:
0
AN:
39604
South Asian (SAS)
AF:
0.00
AC:
0
AN:
86234
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
53404
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
5684
European-Non Finnish (NFE)
AF:
8.99e-7
AC:
1
AN:
1111768
Other (OTH)
AF:
0.00
AC:
0
AN:
60368
⚠️ The allele balance in gnomAD4 Exomes is highly skewed from 0.5 (p-value = 0), which strongly suggests a high chance of mosaicism in these individuals.
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.225
Heterozygous variant carriers
0
0
1
1
2
2
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome Het
Variant carriers
0
2
4
6
8
10
<30
30-35
35-40
40-45
45-50
50-55
55-60
60-65
65-70
70-75
75-80
>80
Age
GnomAD4 genome
Cov.:
32

ClinVar

Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:10
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Neurofibromatosis, type 1 Pathogenic:6
-
Neuberg Centre For Genomic Medicine, NCGM
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The splice site variant c.204+1G>A in NF1 gene has been reported in the literature in individuals affected with neurofibromatosis type 1 (Zhang J et.al.,2015). This variant has been reported to the ClinVar database as Pathogenic. The c.204+1G>A variant is novel (not in any individuals) in gnomAD Exomes and 1000 Genomes. The variant affects an invariant splice nucleotide and is expected to cause loss of function .Donor and acceptor splice site variants typically lead to a loss of protein function and loss-of-function variants in NF1 are known to be pathogenic (Fahsold R et.al.,2000). For these reasons, this variant has been classified as Pathogenic. -

Oct 26, 2020
Genome Diagnostics Laboratory, The Hospital for Sick Children
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Mar 15, 2022
Genome-Nilou Lab
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Jun 02, 2024
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This sequence change affects a donor splice site in intron 2 of the NF1 gene. RNA analysis indicates that disruption of this splice site induces altered splicing and likely results in the loss of 35 amino acid residue(s), but is expected to preserve the integrity of the reading-frame. This variant is not present in population databases (gnomAD no frequency). Disruption of this splice site has been observed in individual(s) with neurofibromatosis type 1 (NF1) (PMID: 12807981, 18546366, 21520333, 26056819). In at least one individual the variant was observed to be de novo. ClinVar contains an entry for this variant (Variation ID: 265442). Studies have shown that disruption of this splice site results in the activation of a cryptic splice site in exon 2 (Invitae). This variant disrupts a region of the NF1 protein in which other variant(s) (p.Leu43Pro) have been determined to be pathogenic (PMID: 28529006, 31370276; Invitae). This suggests that this is a clinically significant region of the protein, and that variants that disrupt it are likely to be disease-causing. For these reasons, this variant has been classified as Pathogenic. -

Nov 01, 2016
Center for Human Genetics, Inc, Center for Human Genetics, Inc
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Aug 24, 2022
Laboratorio de Genetica e Diagnostico Molecular, Hospital Israelita Albert Einstein
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

ACMG classification criteria: PVS1 strong, PS4 moderated, PM2 moderated, PM6 moderated -

not provided Pathogenic:2
May 23, 2025
GeneDx
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

Canonical splice site variant predicted to result in an in-frame loss of the adjacent exon in a gene for which loss of function is a known mechanism of disease; Not observed at significant frequency in large population cohorts (gnomAD); This variant is associated with the following publications: (PMID: 12807981, 25525159, 21354044, 18546366, 19061981, 26056819, 25541118, 29415745, 23913538, 30908848, 33877690, 33057194, 35982159) -

May 03, 2024
Mayo Clinic Laboratories, Mayo Clinic
Significance:Likely pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

PP4, PM2, PS4_moderate, PVS1_strong -

not specified Pathogenic:1
Apr 19, 2019
ARUP Laboratories, Molecular Genetics and Genomics, ARUP Laboratories
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The NF1 c.204+1G>A variant (rs886039548), also known as IVS2+1G>A, is reported in the literature in multiple individuals affected with neurofibromatosis type I (Ars 2003, Pros 2008, Zhang 2015). This variant is reported as pathogenic by multiple laboratories in ClinVar (Variation ID: 265442), and is absent from general population databases (Exome Variant Server, Genome Aggregation Database), indicating it is not a common polymorphism. This variant disrupts the canonical splice donor site of intron 2, which is likely to negatively impact gene function. Based on available information, this variant is considered to be pathogenic. References: Ars E et al. Recurrent mutations in the NF1 gene are common among neurofibromatosis type 1 patients. J Med Genet. 2003 40(6):e82. Pros E et al. Nature and mRNA effect of 282 different NF1 point mutations: focus on splicing alterations Hum Mutat. 2008 Sep;29(9):E173-93. Zhang J et al. Molecular Characterization of NF1 and Neurofibromatosis Type 1 Genotype-Phenotype Correlations in a Chinese Population. Sci Rep. 2015 5:11291. -

Hereditary cancer-predisposing syndrome;CN230736:Cardiovascular phenotype Pathogenic:1
Feb 13, 2025
Ambry Genetics
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The c.204+1G>A intronic pathogenic mutation results from a G to A substitution one nucleotide after coding exon 2 of the NF1 gene. This mutation has been identified in multiple individuals with a clinical diagnosis of neurofibromatosis type 1 (Zhang J et al. Sci Rep. 2015 Jun;5:11291; Leskel&auml; HV et al. Bone. 2009 Feb;44:243-50; Ambry internal data). In addition, RNA studies have demonstrated that this alteration results in abnormal splicing in the set of samples tested (Ambry internal data). Another alteration impacting the same donor site (c.204+1G>T) has been detected in multiple individuals with neurofibromatosis type 1 and reported to result in aberrant splicing (Fahsold R et al. Am J Hum Genet, 2000 Mar;66:790-818; Wimmer K et al. Hum Mutat, 2007 Jun;28:599-612; Pros E et al. Hum Mutat, 2008 Sep;29:E173-93). c.204+1G>A is considered to be rare based on population cohorts in the Genome Aggregation Database (gnomAD). Based on the supporting evidence, this alteration is interpreted as a disease-causing mutation. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
BayesDel_addAF
Pathogenic
0.43
D
BayesDel_noAF
Pathogenic
0.38
CADD
Pathogenic
34
DANN
Uncertain
0.99
Eigen
Pathogenic
1.2
Eigen_PC
Pathogenic
1.0
FATHMM_MKL
Pathogenic
1.0
D
PhyloP100
9.4
GERP RS
5.0
Mutation Taster
=0/100
disease causing (ClinVar)

Splicing

Name
Calibrated prediction
Score
Prediction
dbscSNV1_ADA
Pathogenic
1.0
dbscSNV1_RF
Pathogenic
0.94
SpliceAI score (max)
1.0
Details are displayed if max score is > 0.2
DS_DL_spliceai
1.0
Position offset: -1

Find out detailed SpliceAI scores and Pangolin per-transcript scores at spliceailookup.broadinstitute.org

Publications

Other links and lift over

dbSNP: rs886039548; hg19: chr17-29483145; COSMIC: COSV62206992; COSMIC: COSV62206992; API