Submissions for variant NM_000143.4(FH):c.1022A>G (p.Asp341Gly)

dbSNP: rs1060499640

Total submissions: 3

Submitter	RCV	SCV	Clinical significance	Condition	Last evaluated	Review status	Method	Comment
Genomic Diagnostic Laboratory, Division of Genomic Diagnostics, Children's Hospital of Philadelphia	RCV000445616	SCV000537252	uncertain significance	Hereditary leiomyomatosis and renal cell cancer	2017-01-17	criteria provided, single submitter	clinical testing
Labcorp Genetics (formerly Invitae), Labcorp	RCV002525530	SCV000816853	pathogenic	not provided	2023-04-24	criteria provided, single submitter	clinical testing	For these reasons, this variant has been classified as Pathogenic. This variant disrupts the p.Asp341 amino acid residue in FH. Other variant(s) that disrupt this residue have been determined to be pathogenic (PMID: 21051878, 21304509, 22528940, 24684806; Invitae). This suggests that this residue is clinically significant, and that variants that disrupt this residue are likely to be disease-causing. Algorithms developed to predict the effect of sequence changes on RNA splicing suggest that this variant may create or strengthen a splice site. Advanced modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) performed at Invitae indicates that this missense variant is expected to disrupt FH protein function. ClinVar contains an entry for this variant (Variation ID: 393575). This missense change has been observed in individual(s) with clinical features of hereditary leiomyomatosis and renal cell cancer (PMID: 21520333; Invitae). This variant is not present in population databases (gnomAD no frequency). This sequence change replaces aspartic acid, which is acidic and polar, with glycine, which is neutral and non-polar, at codon 341 of the FH protein (p.Asp341Gly).
PreventionGenetics, part of Exact Sciences	RCV004555576	SCV004109631	uncertain significance	FH-related disorder	2023-06-23	criteria provided, single submitter	clinical testing	The FH c.1022A>G variant is predicted to result in the amino acid substitution p.Asp341Gly. To our knowledge, this variant has not been reported in the literature or in a large population database (http://gnomad.broadinstitute.org), indicating this variant is rare. It has been reported as pathogenic in a single heterozygous individual documented in the LOVD FH gene-specific database (Fokkema et al. 2011. PubMed ID: 21520333). In ClinVar, this variant has conflicting classifications of uncertain significance and pathogenic (https://preview.ncbi.nlm.nih.gov/clinvar/variation/393575/). Two alternate missense changes at the same amino acid position have also been reported in individuals with renal cell carcinoma, and leiomyomatosis (Kuwada et al. 2014. PubMed ID: 24684806; Rongioletti et al. 2010. PubMed ID: 21051878). Although we suspect that this variant may be pathogenic, at this time, the clinical significance of this variant is uncertain due to the absence of conclusive functional and genetic evidence.