ClinVar Miner

Submissions for variant NC_012920.1(MT-TI):m.4284G>A

dbSNP: rs121434468
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Total submissions: 5
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Submitter RCV SCV Clinical significance Condition Last evaluated Review status Method Comment
ClinGen Mitochondrial Disease Nuclear and Mitochondrial Variant Curation Expert Panel, ClinGen RCV003985254 SCV004801737 uncertain significance Mitochondrial disease 2023-11-28 reviewed by expert panel curation The m.4284G>A variant in MT-TI has been reported in one family to date (PMID: 11782991). The proband had isolated spastic paraparesis and normal muscle biopsy including normal respiratory chain enzyme activities. The variant was present at 55% muscle, 50% in hair, 40% in urine, 30% in skin, 20% in buccal, and 20% in blood. His mother had truncal ataxia, dysarthria, severe hearing loss, mental regression, ptosis, ophthalmoparesis, and diabetes. Her brain MRI showed cortical and subcortical diffuse atrophy and muscle biopsy showed reduced activities of complex I and complex IV. The variant was present at 80% in muscle, 20% in urine, and 30% in blood. The proband had one brother with a multisystem progressive disorder who ultimately died of cardiomyopathy. His brain imaging showed marked cortical and subcortical atrophy. His muscle biopsy showed reductions in complex I, complex IV, and complex V. The variant was present at 90% in muscle. As this is the only family reported to date, PS4 could not be applied. The proband had another brother who was healthy and had undetectable levels of the variant in blood and urine. Therefore, this variant segregated with disease in multiple affected family members and a healthy family member had undetectable levels of the variant (PP1; PMID: 11782991). In silico predictions are inconsistent as MitoTIP suggests this variant is benign (35th percentile) and HmtVAR predicts it to be deleterious (0.55). This variant is present in population databases (Mitomap's 61,168 sequences: AF=0.003%; Helix's 195,983 sequences: AF=0.001%; and gnomAD v3.1.2: AF=0.007% as this is homoplasmic in four individuals and heteroplasmic in two individual). Given the frequency of this variant, it does not meet PM2 criterion. Cybrid studies showed that the homoplasmic mutant clones had decreases in COX activity and oxygen consumption rates compared to controls (PS3_supporting, PMID: 11782991). In summary, this variant meets criteria to be classified as uncertain significance for primary mitochondrial disease inherited in a mitochondrial manner. This classification was approved by the NICHD/NINDS U24 ClinGen Mitochondrial Disease Variant Curation Expert Panel on November 28, 2023. Mitochondrial DNA-specific ACMG/AMP criteria applied (PMID: 32906214): PP1, PS3_supporting.
Wong Mito Lab, Molecular and Human Genetics, Baylor College of Medicine RCV000850716 SCV000992949 likely pathogenic MELAS syndrome 2019-07-12 criteria provided, single submitter clinical testing The NC_012920.1:m.4284G>A variant in MT-TI gene is interpreted to be a Likely Pathogenic variant based on the modified ACMG guidelines (unpublished). This variant meets the following evidence codes reported in the guidelines: PM8, PM9, PM10
New York Genome Center RCV001838978 SCV002099168 uncertain significance not provided 2021-05-07 criteria provided, single submitter clinical testing The variant has 0.000106 frequency in the gnomAD(v3) database (56,426 total allele number, 4 homoplasmic alleles, 2 heteroplasmic alleles). The m.4284G>A variant has been reported as likely pathogenic in ClinVar [variation ID: 9604, variant also described in PMID:31965079]. Given the low level of heteroplasmy in detected here, the lack of information on heteroplasmy levels of this variant in different tissues of this proband and its inheritance from a reportedly unaffected mother, the m.4284G>A variant identified in the mitochondrial genome is reported as a variant of uncertain significance.
Mendelics RCV002247292 SCV002517696 pathogenic MERRF syndrome 2022-05-04 criteria provided, single submitter clinical testing
OMIM RCV000010227 SCV000030451 pathogenic Multisystem disorder 2002-01-01 no assertion criteria provided literature only

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