Description
Note this variant was found in clinical genetic testing performed by one or more labs who may also submit to ClinVar. Thus any internal case data may overlap with the internal case data of other labs. The interpretation reviewed below is that of the Stanford Center for Inherited Cardiovascular Disease. p.Arg238Trp (R238W; c.712 C>T) in exon 8 of the TPM1 gene The testing lab refered to it as “published” because after being seen at LMM it was added to a DCM sequencing chip in a publication by Zimmerman et al. (2010) as a “pathogenic variant” (this is the group from LMM and Partners Healthcare; see the paper’s supplementary material). Because of this same reference, it is listed in HGMD. There is no segregation data available. This is a non-conservative amino acid change, resulting in the replacement of a positively-charged Arginine with a nonpolar Tryptophan. The Arginine at this location is highly conserved across 10 vertebrate species for which information is available. Several adjacent residues on either side are also highly conserved. Variation at nearby residues has been associated with cardiomyopathy, which supports the functional importance of this region of the protein: Asp230Asn, Ala239Thr (HGMD professional version as of January 17, 2014). In silico analysis with PolyPhen-2 (http://genetics.bwh.harvard.edu/pph2/) predicts the variant to be “probably damaging” with a score of 1.0. In total the variant has not been seen in ~6500 individuals from publicly available population datasets. This variant is not listed in the NHLBI Exome Sequencing Project dataset (http://evs.gs.washington.edu/EVS/), which currently includes variant calls on ~4300 Caucasian and ~2200 African American individuals. However, these individuals are not ancestry-matched to our patient, who is of Mexican descent. The phenotype of the ESP individuals is not publicly available, however the cohorts that were merged to create this dataset were all either general population samples or samples recruited for common cardiovascular disease such as hypertension. There is also no variation at this codon listed in dbSNP (http://www.ncbi.nlm.nih.gov/projects/SNP) or 1000 genomes (http://browser.1000genomes.org/index.htm) as of April 15, 2014.
# | Sample | Method | Observation |
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Origin | Affected | Number tested | Tissue | Purpose | Method | Individuals | Allele frequency | Families | Co-occurrences |
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1 | germline | not provided | not provided | not provided | not provided | | 2 | not provided | not provided | not provided |