ClinVar Miner

Submissions for variant NM_002834.4(PTPN11):c.166A>G (p.Ile56Val) (rs397507504)

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Total submissions: 6
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Submitter RCV SCV Clinical significance Condition Last evaluated Review status Method Comment
Blueprint Genetics, RCV000518841 SCV000927861 likely pathogenic not provided 2018-08-17 criteria provided, single submitter clinical testing
ClinGen RASopathy Variant Curation Expert Panel RCV000788006 SCV000927038 pathogenic Noonan syndrome and Noonan-related syndrome 2019-05-10 reviewed by expert panel curation The c.166A>G (p.Ile56Val) variant in PTPN11 has been reported as a confirmed de novo occurrence in a patient with clinical features of a RASopathy (PS2; Invitae internal data; GTR Lab ID: 500031; ClinVar SCV000659037.2). The p.Ile56Val variant has been identified in at least 5 independent occurrences in patients with clinical features of a RASopathy (PS4; GeneDx, Partners LMM, Invitae, LabCorp internal data; GTR Lab IDs: 26957, 21766, 500031, 500026; ClinVar SCV SCV000057358.13, SCV000204234.4, SCV000659037.2, SCV000698061.1). This variant was absent from large population studies (PM2; gnomAD, Computational prediction tools and conservation analysis suggest that the p.Ile56Val variant may impact the protein (PP3). The variant is located in the PTPN11 gene, which has been defined by the ClinGen RASopathy Expert Panel as a gene with a low rate of benign missense variants and pathogenic missense variants are common (PP2; PMID: 29493581). In summary, this variant meets criteria to be classified as pathogenic for RASopathies in an autosomal dominant manner. Rasopathy-specific ACMG/AMP criteria applied (PMID:29493581): PS2, PS4, PM2, PP3, PP2.
GeneDx RCV000518841 SCV000057358 likely pathogenic not provided 2017-07-26 criteria provided, single submitter clinical testing The I56V missense substitution has been observed previously in a patient with suspected Noonan syndrome (Atik et al., 2016). The variant is not observed in large population cohorts (Lek et al., 2016; 1000 Genomes Consortium et al., 2015; Exome Variant Server). I56V is a conservative amino acid substitution, which is not likely to impact secondary protein structure as these residues share similar properties. This substitution occurs at a position within the SH2 domain that is conserved across species. In silico analysis is inconsistent in its predictions as to whether or not the variant is damaging to the protein structure/function. Missense variants in nearby residues (T52I, N58H/D/K, T59A, G60C/S/A, D61H/N/G/A) have been reported in the Human Gene Mutation Database in association with Noonan syndrome (Stenson et al., 2014), supporting the functional importance of this region of the protein. In summary, this variant is likely pathogenic; however, the possibility that it is benign cannot be excluded.
Integrated Genetics/Laboratory Corporation of America RCV000518841 SCV000698061 uncertain significance not provided 2017-02-06 criteria provided, single submitter clinical testing Variant summary: The PTPN11 c.166A>G (p.Ile56Val) variant involves the alteration of a conserved nucleotide and is located in SH2 domain of the protein which is known to be functionally important. 3/4 in silico tools predict a damaging outcome for this variant (SNPs&GO not captured due to low reliability index). In addition, missense variants in this gene are predicted to be less tolerant (z-score for missense is 3.43 in ExAC). This variant is absent in 121560 control chromosomes from ExAC. This variant has been reported in one patient with congenital heart defect (Smith_2009) and two patients with clinical features of NSRD (Atik_2016 and LMM-PH unpublished findings). In one NSRD patient, this variant was maternally inherited (however whether mother also had clinical features of Noonan's syndrome is not specified) (Atik_2016). In addition, this variant was identified in one internal pediatric case who presented with pulmonary stenosis and ASD; however no additional phenotypic information was provided. Several mutations in neighboring codons (N58K, N58H, and N58D) have been published in association with Noonan Syndrome, emphasizing the functional importance of this residue and/or SH2 region. Multiple clinical laboratories have classified it as VUS-Likely Pathogenic variant. Taken together, this variant was classified as VUS-Possibly Pathogenic until more information becomes available.
Invitae RCV000557839 SCV000659037 pathogenic Rasopathy 2018-05-18 criteria provided, single submitter clinical testing This sequence change replaces isoleucine with valine at codon 56 of the PTPN11 protein (p.Ile56Val). The isoleucine residue is moderately conserved and there is a small physicochemical difference between isoleucine and valine. This variant is not present in population databases (ExAC no frequency). This variant has been observed in a single family affected with Noonan syndrome (NS) (PMID: 26817465) and has also been observed to be de novo in an individual affected with NS (Invitae). ClinVar contains an entry for this variant (Variation ID: 40485). Algorithms developed to predict the effect of missense changes on protein structure and function do not agree on the potential impact of this missense change (SIFT: "Tolerated"; PolyPhen-2: "Possibly Damaging"; Align-GVGD: "Class C0"). Algorithms developed to predict the effect of sequence changes on RNA splicing suggest that this variant may create or strengthen a splice site, but this prediction has not been confirmed by published transcriptional studies. For these reasons, this variant has been classified as Pathogenic.
Laboratory for Molecular Medicine,Partners HealthCare Personalized Medicine RCV000154561 SCV000204234 likely pathogenic Noonan syndrome 2018-02-27 criteria provided, single submitter clinical testing proposed classification - variant undergoing re-assessment, contact laboratory

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