rs886043590
Variant summary
Our verdict is Pathogenic. Variant got 18 ACMG points: 18P and 0B. PVS1PM2PP5_Very_Strong
The NM_002335.4(LRP5):c.2737dupT(p.Cys913LeufsTer73) variant causes a frameshift change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.0000292 in 1,612,030 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Pathogenic (★★). Variant results in nonsense mediated mRNA decay.
Frequency
Consequence
NM_002335.4 frameshift
Scores
Clinical Significance
Conservation
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ACMG classification
Verdict is Pathogenic. Variant got 18 ACMG points.
Transcripts
RefSeq
Ensembl
Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | TSL | MANE | Protein | Appris | UniProt |
---|---|---|---|---|---|---|---|---|---|---|
LRP5 | ENST00000294304.12 | c.2737dupT | p.Cys913LeufsTer73 | frameshift_variant | Exon 12 of 23 | 1 | NM_002335.4 | ENSP00000294304.6 | ||
LRP5 | ENST00000529993.5 | n.*1343dupT | non_coding_transcript_exon_variant | Exon 12 of 23 | 1 | ENSP00000436652.1 | ||||
LRP5 | ENST00000529993.5 | n.*1343dupT | 3_prime_UTR_variant | Exon 12 of 23 | 1 | ENSP00000436652.1 |
Frequencies
GnomAD3 genomes AF: 0.0000131 AC: 2AN: 152236Hom.: 0 Cov.: 32
GnomAD3 exomes AF: 0.00000401 AC: 1AN: 249404Hom.: 0 AF XY: 0.00 AC XY: 0AN XY: 135170
GnomAD4 exome AF: 0.0000308 AC: 45AN: 1459794Hom.: 0 Cov.: 33 AF XY: 0.0000289 AC XY: 21AN XY: 726320
GnomAD4 genome AF: 0.0000131 AC: 2AN: 152236Hom.: 0 Cov.: 32 AF XY: 0.0000134 AC XY: 1AN XY: 74370
ClinVar
Submissions by phenotype
not provided Pathogenic:3
This sequence change creates a premature translational stop signal (p.Cys913Leufs*73) in the LRP5 gene. It is expected to result in an absent or disrupted protein product. Loss-of-function variants in LRP5 are known to be pathogenic (PMID: 11719191, 16252235, 25711638). This variant is present in population databases (no rsID available, gnomAD 0.0009%). This premature translational stop signal has been observed in individual(s) with autosomal dominant osteoporosis with familial exudative vitreoretinopathy and autosomal recessive osteoporosis pseudoglioma (PMID: 16252235, 25711638). ClinVar contains an entry for this variant (Variation ID: 287187). For these reasons, this variant has been classified as Pathogenic. -
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Has been reported with a second pathogenic variant in a patient with pseudoglioma; however phase of the two variants was not determined in this study (Ai et al., 2005); Has also been reported as a single heterozygous variant in a patient with recurrent fractures, and in a second patient with a diagnosis of FEVR (Bardai et al., 2017; Salvo et al., 2015); Published functional studies suggest a damaging effect with this variant resulting in a protein with lower activity compared to wild-type protein (Korvala et al., 2012); Frameshift variant predicted to result in protein truncation or nonsense mediated decay in a gene for which loss-of-function is a known mechanism of disease; Not observed at a significant frequency in large population cohorts (gnomAD); This variant is associated with the following publications: (PMID: 28378289, 16252235, 22487062, 25711638, 35328049, 35753512) -
Osteoporosis with pseudoglioma;C0432273:Worth disease;C1843330:Autosomal dominant osteopetrosis 1;C1866079:Bone mineral density quantitative trait locus 1;C1866176:Exudative vitreoretinopathy 4;C4693479:Polycystic liver disease 4 with or without kidney cysts Pathogenic:1
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Osteoporosis with pseudoglioma Pathogenic:1
Based on the classification scheme VCGS_Germline_v1.3.4, this variant is classified as Pathogenic. Following criteria are met: 0103 - Loss of function and gain of function are known mechanisms of disease in this gene and are associated with exudative vitreoretinopathy 4 (FEVR; MIM#601813) and osteoporosis-pseudoglioma syndrome (OPPG; MIM#259770); and autosomal dominant osteopetrosis (MIM#607634), respectively (PMID: 31827910, 23744590). (I) 0108 - This gene is associated with both recessive and dominant disease. Exudative vitreoretinopathy 4 (MIM#601813) can be both autosomal dominant or recessive and is considered to be part of the spectrum of autosomal recessive osteoporosis-pseudoglioma syndrome (MIM#259770). There is currently no clear genotype-phenotype correlation distinguishing these two conditions. Instead, the functional severity of the variant determines the phenotypic consequences (PMID: 31827910). Missense variants clustered within the first b-propeller extracellular domain are associated with autosomal dominant osteopetrosis (MIM#607634; PMID: 23744590). (I) 0115 - Variants in this gene are known to have variable expressivity. Intra-familial variability has been reported for gain of function variants (PMID 23744590) and FEVR (PMID: 25323851). Patients may appear asymptomatic for osteoporosis (PMID: 15824851). (I) 0201 - Variant is predicted to cause nonsense-mediated decay (NMD) and loss of protein (premature termination codon is located at least 54 nucleotides upstream of the final exon-exon junction). (SP) 0251 - This variant is heterozygous. (I) 0304 - Variant is present in gnomAD (v2) <0.01 for the condition (2 heterozygotes, 0 homozygotes). (SP) 0701 - Many other NMD variants comparable to the one identified in this case have very strong previous evidence for pathogenicity (DECIPHER). (SP) 0801 - This variant has strong previous evidence of pathogenicity in unrelated individuals. This variant has been classified as pathogenic by multiple clinical laboratories in ClinVar, and has been observed in individuals with FEVR, OPPG, and osteoporosis in the literature (PMIDs: 16252235, 25711638, 35328049, 15824851). (SP) 1206 - This variant has been shown to be paternally inherited by trio analysis. (I) Legend: (SP) - Supporting pathogenic, (I) - Information, (SB) - Supporting benign -
Exudative vitreoretinopathy 4 Pathogenic:1
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Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at