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Variant: NM_000277.3(PAH):c.707-1G>A

CA229703

102793 (ClinVar)

Gene: PAH
Condition: phenylketonuria
Inheritance Mode: Autosomal recessive inheritance
UUID: 67f31c92-6ecb-4dbf-8209-0b49d4c1f7f1

HGVS expressions

NM_000277.3:c.707-1G>A
NM_000277.3(PAH):c.707-1G>A
NM_000277.1:c.707-1G>A
NM_000277.2:c.707-1G>A
NM_001354304.1:c.707-1G>A
NM_001354304.2:c.707-1G>A
ENST00000307000.7:c.692-1G>A
ENST00000549247.6:n.465G>A
ENST00000553106.5:c.707-1G>A
NC_000012.12:g.102852951C>T
CM000674.2:g.102852951C>T
NC_000012.11:g.103246729C>T
CM000674.1:g.103246729C>T
NC_000012.10:g.101770859C>T
NG_008690.1:g.69652G>A
NG_008690.2:g.110460G>A

Pathogenic

Met criteria codes 4
PM2 PM3_Supporting PP4_Moderate PVS1

Evidence Links 2

Expert Panel

Criteria Specification Information

Criteria Specifications for this VCEP
Evidence submitted by expert panel
Phenylketonuria VCEP
The PAH variant c.707-1G>A (IVS6-1G>A) is a null variant (acceptor site) located in exon number 7 of the PAH gene. Loss of function in the PAH gene is a known mechanism of disease. Eleven null variants in exon 7 of the PAH gene have been reported. This variant causes exon skipping that results in the removal of more than 10% of the transcript. This variant is predicted to disrupt the reading frame, altering regions critical to protein function (63 pathogenic non-nonsense variants in skipped exons have been reported). The mRNA transcript is predicted to undergo NMD. According to TraP in silico splicing prediction, this alteration is probably damaging (TraP score 0.572). HSF (-31.55% variation) and MaxEnt (-114.25% variation) agree that this alteration of the WT acceptor site most probably affects splicing. The PAH variant c.707-1G>A (IVS6-1G>A) was identified in three alleles from Chinese patients with classical PKU. The patients had a plasma Phe level above 120 μmol/L. DHPR activity, biopterin, and/or pteridine analysis was performed to rule out other causes of hyperphenylalaninemia (PMID: 28754886, 30747360). The PAH variant c.707-1G>A (IVS6-1G>A) was detected in two Chinese patients with classic PKU (cPKU Phe more than 1200 μmol/L). These two patients were identified with the likely pathogenic PAH variant c.1285C>A (p.Gln429Lys) (ClinVar ID: 551555) and with the pathogenic PAH variant c.526C>T (p.Arg176Ter) (ClinVar ID: 102723) Pathogenic PM3 Points: 0.75 (Supporting) (PMID: 28754886) This variant is absent in the gnomAD, ExAC , and PAGE population databases. In summary, this variant meets the criteria to be classified as pathogenic. PAH-specific ACMG/AMP criteria applied: PM2, PM3_Supporting, PP4_Moderate, PVS1.
Met criteria codes
PM2
This variant is absent in the gnomAD, ExAC , and PAGE population databases.
PM3_Supporting
The PAH variant c.707-1G>A (IVS6-1G>A) was detected in two Chinese patients with classic PKU (cPKU Phe more than 1200 μmol/L). These two patients were identified with another pathogenic variant in the PAH gene: c.1285C>A (p.Gln429Lys) (ClinVar ID: 551555) Likely Pathogenic (1*0.25=0.25) c.526C>T (p.Arg176Ter) (ClinVar ID: 102723) Pathogenic (PMID: 28754886) (1*0.5=0.5)

PP4_Moderate
The PAH variant c.707-1G>A (IVS6-1G>A) was identified in three alleles from Chinese patients with classical PKU. The patients had a plasma Phe cutoff level of 120 μmol/L and had normal urinary pterins and normal dihydropteridine reductase (DHPR) activity (PMID: 28754886, 30747360).

PVS1
The PAH variant c.707-1G>A (IVS6-1G>A) is a null variant (acceptor site) located in exon number 7 of the PAH gene. Loss of function in the PAH gene is a known mechanism of disease. Eleven null variants in exon 7 of the PAH gene have been reported. This variant causes exon skipping that results in the removal of more than 10% of the transcript . This variant is predicted to disrupt the reading frame, altering regions critical to protein function (63 pathogenic non-nonsense variants in skipped exons have been reported). The mRNA transcript is predicted to undergo NMD. According to TraP in silico splicing prediction, this alteration is probably damaging (TraP score 0.572). HSF (-31.55% variation) and MaxEnt (-114.25% variation) agree that this alteration of the WT acceptor site most probably affects splicing.
Approved on: 2020-05-09
Published on: 2020-05-09
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