The ClinGen Evidence Repository is an FDA-recognized human genetic variant database containing expert-curated assertions regarding variants' pathogenicity and supporting evidence summaries. [Disclaimer]
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Variant: NM_000536.4(RAG2):c.1309G>A (p.Glu437Lys)

CA214215

36718 (ClinVar)

Gene: RAG2
Condition: recombinase activating gene 2 deficiency
Inheritance Mode: Autosomal recessive inheritance
UUID: c73eaa18-0afd-4242-a122-df3de55dc8ce

HGVS expressions

NM_000536.4:c.1309G>A
NM_000536.4(RAG2):c.1309G>A (p.Glu437Lys)
NC_000011.10:g.36592860C>T
CM000673.2:g.36592860C>T
NC_000011.9:g.36614410C>T
CM000673.1:g.36614410C>T
NC_000011.8:g.36570986C>T
NG_007573.1:g.10377G>A
NG_033154.1:g.3368C>T
ENST00000527033.6:c.1309G>A
ENST00000529083.2:c.1309G>A
ENST00000532616.2:c.1309G>A
ENST00000311485.8:c.1309G>A
ENST00000311485.7:c.1309G>A
ENST00000524423.1:n.131+5242G>A
ENST00000534663.1:c.*86-107C>T
ENST00000618712.4:c.1309G>A
NM_000536.3:c.1309G>A
NM_001243785.1:c.1309G>A
NM_001243786.1:c.1309G>A
NM_001243785.2:c.1309G>A
NM_001243786.2:c.1309G>A

Likely Pathogenic

Met criteria codes 5
PP4 PS3_Moderate PM3 PM1 PM2_Supporting

Evidence Links 0

Expert Panel

Criteria Specification Information

Criteria Specification: ClinGen Severe Combined Immunodeficiency Disease Expert Panel Specifications to the ACMG/AMP Variant Interpretation Guidelines for RAG2 Version 1.0.0

Criteria Specification Approval History
Criteria Specifications for this VCEP
Evidence submitted by expert panel
Severe Combined Immunodeficiency Disease VCEP
The c.1309G>A (NM_000536.4) variant in RAG2 is a missense variant predicted to cause the substitution of Glutamic Acid by Lysine at amino acid 437 (p.Glu437Lys). The filtering allele frequency (the upper threshold of the 95% CI of 9/63722 alleles) of the c.1309G>A variant in RAG2 is 0.000001910 for European (non-Finnish) chromosomes by gnomAD v.4, which is lower than the ClinGen SCID VCEP threshold (<0.0000588) for PM2_Supporting, and therefore meets this criterion (PM2_Supporting). No homozygotes have been observed in gnomAD. This variant is located in the PHD domain, amino acids 414-487 of RAG2, which is defined as a critical functional domain by the ClinGen SCID VCEP (PMID: 26996199); PM1. The recombination activity assay showed activity of this variant compared to wildtype RAG2 is 0.9% (SEM 0.2), which is lower than the SCID VCEP threshold (<25%) for PS3_Moderate, meeting this criterion (PS3_Moderate, PMID 29772310). The patient presents: Diagnostic criteria for SCID/Leaky SCID/Omenn syndrome met 0.5 pts + T-B-NK+ lymphocyte subset profile 0.5 pts, total is 1 point, PP4 (PMID: 29772310). The same patient is a compound heterozygous for his variant and G35A, a pathogenic variant according to SCID VCEP specifications; 1 point, PM3. In summary, this variant meets the criteria to be classified as Likely Pathogenic for autosomal recessive recombinase activating gene 2 deficiency based on the ACMG/AMP criteria applied, as specified by the ClinGen SCID VCEP. Criteria applied: PM2_Supporting, PM1, PS3_Moderate, PP4, and PM3 (VCEP specifications version 1.0).
Met criteria codes
PP4
The patient presents: Diagnostic criteria for SCID/Leaky SCID/Omenn syndrome met 0.5 pts + T-B-NK+ lymphocyte subset profile 0.5 pts, total is 1 point, PP4_Supporting (PMID: 29772310).
PS3_Moderate
The recombination activity assay showed activity of this variant compared to wildtype RAG2 is 0.9% (SEM 0.2), which is lower than the SCID VCEP threshold (<25%) for PS3_Moderate, meeting this criterion (PS3_Moderate, PMID 29772310).
PM3
The patient reported in PMID: 29772310, P9, is a compound heterozygous for this variant and G35A, a pathogenic variant according to SCID VCEP specifications; 1 point, PM3_Moderate.
PM1
This variant is located in the PHD domain, amino acids 414-487 of RAG2, which is defined as a critical functional domain by the ClinGen SCID VCEP (PMID: 26996199); PM1_Moderate.
PM2_Supporting
The filtering allele frequency (the upper threshold of the 95% CI of 3/418126 alleles) of the c.1309G>A variant in RAG2 is 0.000001910 for European (non-Finnish) chromosomes by gnomAD v.4, which is lower than the ClinGen SCID VCEP threshold (<0.0000588) for PM2_Supporting, and therefore meets this criterion (PM2_Supporting). No homozygotes have been observed in gnomAD.
Approved on: 2024-04-01
Published on: 2024-04-01
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