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Variant: NM_000277.2(PAH):c.1357_*2delTAAAG (p.Ter453Profs)

194161 (ClinVar)

Gene: PAH
Condition: phenylketonuria
Inheritance Mode: Autosomal recessive inheritance
UUID: dd07cd11-a480-4024-b568-1aabf10c6428
Approved on: 2023-07-23
Published on: 2023-07-23

HGVS expressions

NM_000277.2:c.1357_*2delTAAAG
NM_000277.2(PAH):c.1357_*2delTAAAG (p.Ter453Profs)
NM_000277.3(PAH):c.1357_*2del (p.Ter453ProextTer?)

Likely Pathogenic

Met criteria codes 4
PP4_Moderate PM2_Supporting PM4 PM3_Strong

Evidence Links 0

Expert Panel

Criteria Specification Information

Criteria Specifications for this VCEP
Evidence submitted by expert panel
Phenylketonuria VCEP
The c.1357_*2delTAAAG (p.Ter453Profs) variant in PAH has been reported in multiple individuals with PAH deficiency; one with other causes of hyperphenylalninemia ruled out with panel sequencing. (PP4_Moderate; PMID: 10679941, data share with Invitae). This variant is at low frequency in population databases (TopMed AF=0.00001). This variant was detected with known pathogenic/likely pathogenic variants: p.L48 (unknown phase, PMID: 10679941); c.1066-11G>A, p.Arg408Trp, p.Arg155Pro, (unknown phase, PMID: 32668217); and Leu348Val (in trans, data share with Invitae). The deletion p.Ter453Profs is predicted to abolish the stop codon and causes an elongation of the polypeptide by 35 amino acids (PM4). In summary, this variant meets criteria to be classified as likely pathogenic for PAH. PAH-specific ACMG/AMP criteria applied: PP4_moderate, PM2-supporting, PM3_strong, PM4.
Met criteria codes
PP4_Moderate
Detected in a Patient with Mild PKU. Cofactor deficiency was excluded by the BH4 test. c.1357-1361del (Ter452del5bp). PMID: 10679941. Detected in patient with Phe 308 umol/L, panel performed: DNAJC12, GCH1, PCBD1, PTS, QDPR, SLC25A13, SPR (Invitae)
PM2_Supporting
TopMed: delCTTTA=0.00001 (Sample size 125568)
PM4
The deletion Ter452del5bp affects the translation termination codon and causes an elongation of the polypeptide by 35 amino acids.
PM3_Strong
Detected with known pathogenic variant p.L48S, "in trans" (PMID: 10679941). c.1066-11G>A (P), p.Arg408Trp (P), and p.Arg155Pro (LP) (unknown phase, PMID: 32668217); Leu348Val in trans (P by 15 submitters); Arg241Leu, unknown phase (P, Invitae). Parental confirmation not reported. 3.25 points
Curation History
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