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NM_018129.4(PNPO):c.685C>T (p.Arg229Trp) AND Pyridoxal phosphate-responsive seizures

Germline classification:
Likely pathogenic (2 submissions)
Last evaluated:
Mar 14, 2023
Review status:
1 star out of maximum of 4 stars
criteria provided, single submitter
Somatic classification
of clinical impact:
None
Review status:
(0/4) 0 stars out of maximum of 4 stars
no assertion criteria provided
Somatic classification
of oncogenicity:
None
Review status:
(0/4) 0 stars out of maximum of 4 stars
no assertion criteria provided
Record status:
current
Accession:
RCV000006896.8

Allele description [Variation Report for NM_018129.4(PNPO):c.685C>T (p.Arg229Trp)]

NM_018129.4(PNPO):c.685C>T (p.Arg229Trp)

Gene:
PNPO:pyridoxamine 5'-phosphate oxidase [Gene - OMIM - HGNC]
Variant type:
single nucleotide variant
Cytogenetic location:
17q21.32
Genomic location:
Preferred name:
NM_018129.4(PNPO):c.685C>T (p.Arg229Trp)
HGVS:
  • NC_000017.11:g.47946681C>T
  • NG_008744.1:g.10159C>T
  • NM_018129.3:c.685C>T
  • NM_018129.4:c.685C>TMANE SELECT
  • NP_060599.1:p.Arg229Trp
  • NC_000017.10:g.46024047C>T
  • Q9NVS9:p.Arg229Trp
Protein change:
R229W; ARG229TRP
Links:
UniProtKB: Q9NVS9#VAR_029360; OMIM: 603287.0001; dbSNP: rs104894629
NCBI 1000 Genomes Browser:
rs104894629
Molecular consequence:
  • NM_018129.4:c.685C>T - missense variant - [Sequence Ontology: SO:0001583]

Condition(s)

Name:
Pyridoxal phosphate-responsive seizures (PNPOD)
Synonyms:
EPILEPTIC ENCEPHALOPATHY, NEONATAL, PNPO-RELATED; SEIZURES, PYRIDOXINE-RESISTANT, PLP-SENSITIVE; Pyridoxal 5'-phosphate-dependent epilepsy; See all synonyms [MedGen]
Identifiers:
MONDO: MONDO:0012407; MedGen: C1864723; Orphanet: 79096; OMIM: 610090

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Assertion and evidence details

Submission AccessionSubmitterReview Status
(Assertion method)
Clinical Significance
(Last evaluated)
OriginMethodCitations
SCV000027092OMIM
no assertion criteria provided
Pathogenic
(Apr 15, 2005)
germlineliterature only

PubMed (1)
[See all records that cite this PMID]

Brautigam, C., Hyland, K., Wevers, R., Sharma, R., Wagner, L., Stock, G.-J., Heitmann, F., Hoffmann, G. F. Clinical and laboratory findings in twins with neonatal epileptic encephalopathy mimicking aromatic L-amino acid decarboxylase deficiency. Neuropediatrics 33: 113-117, 2002.,

SCV002304198Labcorp Genetics (formerly Invitae), Labcorp
criteria provided, single submitter

(Invitae Variant Classification Sherloc (09022015))
Likely pathogenic
(Mar 14, 2023)
germlineclinical testing

PubMed (9)
[See all records that cite these PMIDs]

Summary from all submissions

EthnicityOriginAffectedIndividualsFamiliesChromosomes testedNumber TestedFamily historyMethod
not providedgermlinenot providednot providednot providednot providednot providednot providedliterature only
not providedgermlineunknownnot providednot providednot providednot providednot providedclinical testing

Citations

PubMed

Targeted resequencing in epileptic encephalopathies identifies de novo mutations in CHD2 and SYNGAP1.

Carvill GL, Heavin SB, Yendle SC, McMahon JM, O'Roak BJ, Cook J, Khan A, Dorschner MO, Weaver M, Calvert S, Malone S, Wallace G, Stanley T, Bye AM, Bleasel A, Howell KB, Kivity S, Mackay MT, Rodriguez-Casero V, Webster R, Korczyn A, Afawi Z, et al.

Nat Genet. 2013 Jul;45(7):825-30. doi: 10.1038/ng.2646. Epub 2013 May 26.

PubMed [citation]
PMID:
23708187
PMCID:
PMC3704157

Typical and atypical phenotypes of PNPO deficiency with elevated CSF and plasma pyridoxamine on treatment.

Ware TL, Earl J, Salomons GS, Struys EA, Peters HL, Howell KB, Pitt JJ, Freeman JL.

Dev Med Child Neurol. 2014 May;56(5):498-502. doi: 10.1111/dmcn.12346. Epub 2013 Nov 23.

PubMed [citation]
PMID:
24266778
See all PubMed Citations (9)

Details of each submission

From OMIM, SCV000027092.3

#EthnicityIndividualsChromosomes TestedFamily HistoryMethodCitations
1not providednot providednot providednot providedliterature only PubMed (1)

Description

In twin boys, the children of consanguineous Turkish parents, with PNPO deficiency (PNPOD; 610090), Mills et al. (2005) detected a homozygous C-to-T transition in exon 7 of the PNPO gene, resulting in a substitution of tryptophan for the conserved arginine-229 residue (R229W). At least 4 and possibly 6 sibs from this family, including the twins, died from the same disorder. Brautigam et al. (2002) had described the clinical and laboratory findings in these patients.

#SampleMethodObservation
OriginAffectedNumber testedTissuePurposeMethodIndividualsAllele frequencyFamiliesCo-occurrences
1germlinenot providednot providednot providednot providednot providednot providednot providednot provided

From Labcorp Genetics (formerly Invitae), Labcorp, SCV002304198.3

#EthnicityIndividualsChromosomes TestedFamily HistoryMethodCitations
1not providednot providednot providednot providedclinical testing PubMed (9)

Description

In summary, the currently available evidence indicates that the variant is pathogenic, but additional data are needed to prove that conclusively. Therefore, this variant has been classified as Likely Pathogenic. This variant disrupts the p.Arg229 amino acid residue in PNPO. Other variant(s) that disrupt this residue have been determined to be pathogenic (PMID: 23708187, 24266778, 28133863, 28985901). This suggests that this residue is clinically significant, and that variants that disrupt this residue are likely to be disease-causing. Experimental studies have shown that this missense change affects PNPO function (PMID: 15772097, 19759001, 24645144, 27419045). 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 PNPO protein function. ClinVar contains an entry for this variant (Variation ID: 6523). This missense change has been observed in individual(s) with epileptic encephalopathy (PMID: 15772097). This variant is present in population databases (rs104894629, gnomAD 0.004%). This sequence change replaces arginine, which is basic and polar, with tryptophan, which is neutral and slightly polar, at codon 229 of the PNPO protein (p.Arg229Trp).

#SampleMethodObservation
OriginAffectedNumber testedTissuePurposeMethodIndividualsAllele frequencyFamiliesCo-occurrences
1germlineunknownnot providednot providednot providednot providednot providednot providednot provided

Last Updated: Sep 29, 2024