Our verdict is Pathogenic. Variant got 18 ACMG points: 18P and 0B. PVS1PM2PP5_Very_Strong
The NM_001195248.2(APTX):c.875-2A>G variant causes a splice acceptor, intron change. The variant was absent in control chromosomes in GnomAD project. In-silico tool predicts a pathogenic outcome for this variant. 2/3 splice prediction tools predicting alterations to normal splicing. Variant has been reported in ClinVar as Likely pathogenic (★★).
APTX (HGNC:15984): (aprataxin) This gene encodes a member of the histidine triad (HIT) superfamily. The encoded protein may play a role in single-stranded DNA repair through its nucleotide-binding activity and its diadenosine polyphosphate hydrolase activity. Mutations in this gene have been associated with ataxia-ocular apraxia. Alternatively spliced transcript variants have been identified for this gene.[provided by RefSeq, Aug 2010]
Verdict is Pathogenic. Variant got 18 ACMG points.
PVS1
Splicing +-2 bp (donor or acceptor) variant, LoF is a know mechanism of disease,
PM2
Very rare variant in population databases, with high coverage;
PP5
Variant 9-32973654-T-C is Pathogenic according to our data. Variant chr9-32973654-T-C is described in ClinVar as [Likely_pathogenic]. Clinvar id is 434253.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr9-32973654-T-C is described in Lovd as [Likely_pathogenic].
Ataxia, early-onset, with oculomotor apraxia and hypoalbuminemia Pathogenic:2
Nov 23, 2015
Genetic Services Laboratory, University of Chicago
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing
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Neuberg Centre For Genomic Medicine, NCGM
Significance: Likely pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing
The observed invariant splice acceptor c.875-2A>G variant in APTX gene has been reported previously in compound heterozygous state in individual(s) affected with early-onset ataxia with oculomotor apraxia and hypoalbuminemia (Sun M, et al., 2019). The c.875-2A>G variant is absent in gnomAD Exomes. This variant has been submitted to the ClinVar database as Pathogenic. Loss of function variants have been previously reported to be disease causing. However, additional functional studies will be required to prove the pathogenicity of this variant. For these reasons, this variant has been classified as Likely Pathogenic. -