Total submissions: 5
| Submitter | RCV | SCV | Clinical significance | Condition | Last evaluated | Review status | Method | Comment |
|---|---|---|---|---|---|---|---|---|
| Women's Health and Genetics/Laboratory Corporation of America, |
RCV000002326 | SCV000697523 | pathogenic | Von Hippel-Lindau syndrome | 2021-01-19 | criteria provided, single submitter | clinical testing | Variant summary: VHL c.491A>G (p.Gln164Arg) results in a conservative amino acid change located in the alpha domain, which is known to interact with Elongin C (IPR024048). Three of five in-silico tools predict a damaging effect of the variant on protein function. The variant was absent in 251444 control chromosomes (gnomAD). c.491A>G has been reported in the literature in multiple patients/families affected with Von Hippel-Lindau Syndrome (VHL) or with VHL-related tumors, including at least one individual with de novo occurrence (e.g. Chen_1995, Zbar_1996, Webster_1999, Mattocks_2000, Ong_2007, Sovinz_2010, de Cubas_2013, Neumann_2019). These data indicate that the variant is very likely to be associated with disease. Publications also reported experimental evidence evaluating an impact on protein function, and demonstrated that while this variant didn't affect elongin B and C binding in an in vitro peptide-binding assay, the Q164R mutant full-length protein had reduced binding ability to elongin B and Cul2 in transiently transfected renal carcinoma cells (Ohh_1999). In addition, another study also reported that though the variant protein had retained elongin C binding, the variant significantly reduced the intracellular stability of VHL protein (Park_2015). Three other clinical diagnostic laboratories have submitted clinical-significance assessments for this variant to ClinVar after 2014 without evidence for independent evaluation, and all of them classified the variant as pathogenic. Based on the evidence outlined above, the variant was classified as pathogenic. |
| Genomic Diagnostic Laboratory, |
RCV000002326 | SCV000897835 | pathogenic | Von Hippel-Lindau syndrome | 2018-08-01 | criteria provided, single submitter | clinical testing | |
| Ambry Genetics | RCV001023261 | SCV001185112 | pathogenic | Hereditary cancer-predisposing syndrome | 2020-09-24 | criteria provided, single submitter | clinical testing | The p.Q164R (also known as c.491A>G) pathogenic mutation, located in coding exon 3 of the VHL gene, results from an A to G substitution at nucleotide position 491. The glutamine at codon 164 is replaced by arginine, an amino acid with highly similar properties. This variant has been reported in patients with clinical diagnoses of von Hippel-Lindau syndrome (VHL), or VHL related tumors (Chen F et al. Hum. Mutat. 1995;5:66-75; Webster AR et al. Arch. Ophthalmol. 1999 Mar;117:371-8; Ong KR et al. Hum. Mutat. 2007 Feb;28:143-9; Sovinz P et al. Am. J. Med. Genet. A. 2010 Jul;152A:1752-5; de Cubas AA et al. Endocr. Relat. Cancer. 2013 Aug;20:477-93; Fallon SC et al. J. Pediatr. Surg. 2013 Jun;48:1422-5; Krauss T et al. Endocr. Relat. Cancer. 2018 Sep;25:783-793). In one case, this variant was identified in a 2-year-old child with pheochromocytoma. It was found to be de novo in the patient's father, who also had pheochromocytoma, retinal angioma, and an adrenal adenoma (Sovinz P et al. Am. J. Med. Genet. A. 2010 Jul;152A:1752-5). In vitro functional studies do not show specific impaired functions, including elongin C binding, however, one study showed a shorter protein half-life than wild type leading the authors to speculate that the protein may be unstable (Ohh M et al. J. Clin. Invest. 1999 Dec;104:1583-91; Maynard MA et al. J. Biol. Chem. 2003 Mar;278:11032-40; Park KS et al. BMC Cancer. 2015 Oct;15:800). Another alteration at the same codon, p.Q164H (c.492G>C) , has been reported in a family diagnosed with PGLs and PCCs (Bauters C et al. J. Med. Genet. 2003 Jun;40:e75), and internal structural analysis indicated the alteration disrupts the fold of the elongin binding domain of VHL (Ambry internal data; Van Molle I et al. Chem. Biol. 2012 Oct;19:1300-12). In addition, the p.Q164R variant was not reported in population-based cohorts in the Genome Aggregation Database (gnomAD). Based on the supporting evidence, this alteration is interpreted as a disease-causing mutation. |
| Labcorp Genetics |
RCV001052383 | SCV001216592 | pathogenic | Chuvash polycythemia; Von Hippel-Lindau syndrome | 2023-03-26 | criteria provided, single submitter | clinical testing | For these reasons, this variant has been classified as Pathogenic. This variant disrupts the p.Gln164 amino acid residue in VHL. Other variant(s) that disrupt this residue have been determined to be pathogenic (PMID: 12807974, 19215943, 22517557, 24102379; Invitae). This suggests that this residue is clinically significant, and that variants that disrupt this residue are likely to be disease-causing. 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 VHL protein function. ClinVar contains an entry for this variant (Variation ID: 2238). This missense change has been observed in individual(s) with von Hippel-Lindau disease (PMID: 7728151, 17024664, 20583150). In at least one individual the variant was observed to be de novo. This variant is not present in population databases (gnomAD no frequency). This sequence change replaces glutamine, which is neutral and polar, with arginine, which is basic and polar, at codon 164 of the VHL protein (p.Gln164Arg). |
| OMIM | RCV000002326 | SCV000022484 | pathogenic | Von Hippel-Lindau syndrome | 2010-07-01 | no assertion criteria provided | literature only |