About FH
No gene-level summary was recorded for this case.
No variant summary was recorded for this case.
Five-step scale from benign to pathogenic. This variant is uncertain. Select a step to read what it means.
Uncertain.The recorded classification is uncertain significance.
Gene-level background from the recorded interpretation.
Words with a dotted underline have a short definition. Hover or tap them.No gene-level summary was recorded for this case.
The recorded framework is Not recorded. The criteria and strengths shown below come from the saved assessment; this page does not recalculate the classification.
The applied criteria and their strengths are shown as assessed under the stated framework.
NM_000143.4:c.1127A>C was identified as a novel pathogenic mutation in the fumarase gene by Remes et al. (2004, PMID:15221078). The abstract confirms the variant was directly studied; however, full-text functional assay data are not available for independent confirmation. A single publication with abstract-level variant-specific evidence supports PS3 at supporting strength.
NM_000143.4:c.1127A>C (p.Gln376Pro) is located in the fumarate lyase domain of FH, a critical functional domain where pathogenic missense variants cluster. Large-scale profiling studies confirm exons 5-7 in this domain as predominant mutational hotspots in hereditary FH-deficient disease.
This variant is absent from gnomAD-Canada and present at very low frequency: gnomAD v2.1 AF=0.00601% (17/282,834 alleles, 0 homozygotes) and gnomAD v4.1 AF=0.00465% (75/1,614,038 alleles, 0 homozygotes), both well below the 0.1% PM2 threshold.
Multiple in silico predictors support a deleterious effect: REVEL score 0.97 (strongly pathogenic) and BayesDel score 0.565 (damaging prediction). SpliceAI predicts no splice impact (max delta 0.00).
No benign criterion marked as applied in the recorded assessment.
gene-specific framework lacked a usable explicit final combination framework, so generic ACMG/AMP 2015 final-combination rules were applied as fallback; applied criteria: PS3 supporting, PM1 supporting, PM2 supporting, PP3 supporting; combination = 4 supporting, which maps to VUS.
Evidence summaries and captured source records, where available. Missing entries should not be interpreted as negative findings.
gnomAD v4.1: 75 / 1,614,038 alleles. Recorded AF 4.64673e-05. Recorded homozygote count 0.
This variant is present in gnomAD v2.1 (AF= 6.01059e-05; MAF= 0.00601%, 17/282834 alleles, homozygotes = 0) and has highest observed frequency in the European (non-Finnish) population (AF= 0.000108389; MAF= 0.01084%, 14/129164 alleles, homozygotes = 0); grpmax FAF= 6.663e-05.
Absent from gnomAD-Canada v1.0.
Recorded SpliceAI maximum delta score: 0.000. Refer to the recorded PP3/BP4 rationale for interpretation.
7 Pathogenic · 2 Likely pathogenic · 2 Uncertain significance · 1 likely pathogenic. ClinVar API review status: criteria provided, conflicting classifications.
OncoKB did not identify variant-specific reviewed functional evidence for this variant; gene-level curated context is available for reviewer follow-up. FH, an enzyme that converts fumarate to malate in the TCA cycle, is infrequently altered in cancer.
This variant has previously been reported in somatic cancers (COSMIC; COSV105921172, n = 1 times).
This variant does not lie in a statistically significant hotspot.
ACMG/AMP criteria under Not recorded, with the data and sources behind each one.
29 criteria with recorded statuses: 4 met · 9 not met · 7 not assessed · 9 not applicable. Open any row for the full reasoning, the rule and the evidence behind it.
NM_000143.4:c.1127A>C (p.Gln376Pro) is a missense variant in the fumarate lyase domain of FH, a critical catalytic region where pathogenic missense variants cluster.
This variant is absent from gnomAD-Canada and present at very low frequency in gnomAD v2.1 (AF=0.00601%, 17/282,834 alleles) and v4.1 (AF=0.00465%, 75/1,614,038 alleles), with no homozygotes observed.
REVEL (0.97) and BayesDel (0.565) in silico predictors support a deleterious effect; SpliceAI predicts no splicing impact (max delta 0.00).
Remes et al. (2004) identified c.1127A>C as a novel pathogenic mutation in a family with autosomal recessive fumarase deficiency, confirming variant-specific functional relevance.
ClinVar classifies this variant as Pathogenic (2-star, criteria provided by single submitter) with 7 clinical laboratories reporting Pathogenic, 2 Likely pathogenic, 2 VUS, and 1 likely pathogenic.
Met criteria: PM1 (supporting, fumarate lyase domain), PM2 (supporting, low population frequency), PP3 (supporting, in silico predictors), PS3 (supporting, functional study). Total: 4 supporting pathogenic criteria. No benign criteria met.
No criteria match.
No further detail was recorded.
No further detail was recorded.
No further detail was recorded.
No further detail was recorded.
No further detail was recorded.
Every interpreted variant in FH, mapped onto the exon structure of NM_000143.4. Select a row to find it on the plot.
| Protein | Location | Classification | Link |
|---|
| European (Finnish)10 / 64,034 | 0.00016 |
| European (non-Finnish)62 / 1,180,012 | 5.3e-05 |
| African/African American2 / 74,940 | 2.7e-05 |
| Remaining individuals1 / 62,488 | 1.6e-05 |
| European (non-Finnish)14 / 129,164 | 0.00011 |
| European (Finnish)2 / 25,124 | 8e-05 |
| African/African American1 / 24,972 | 4e-05 |
This variant is present in gnomAD v4.1 (AF= 4.64673e-05; MAF= 0.00465%, 75/1614038 alleles, homozygotes = 0) and has highest observed frequency in the European (Finnish) population (AF= 0.000156167; MAF= 0.01562%, 10/64034 alleles, homozygotes = 0); grpmax FAF= 4.182e-05.
This variant is present in gnomAD v2.1 (AF= 6.01059e-05; MAF= 0.00601%, 17/282834 alleles, homozygotes = 0) and has highest observed frequency in the European (non-Finnish) population (AF= 0.000108389; MAF= 0.01084%, 14/129164 alleles, homozygotes = 0); grpmax FAF= 6.663e-05.
Absent from gnomAD-Canada v1.0.
SpliceAI predicts no significant splice impact for this variant (max delta score = 0.00). REVEL score = 0.97. BayesDel score = 0.565222.
8 paper records listed. 1 cited in the classification.
We describe a novel mutation in nucleotide 1127A>C of the fumarase gene
Location Abstract
FH-deficient primary diploid fibroblasts from two patients carrying recessive defects of FH ('FH fibroblasts')
Methods: FH-deficient fibroblast lines from patients with recessive FH defects (line 143-144)
Gene testing in both revealed the following two mutations: Mutation #1 998 A to C aa Q333P, which is a glutamine to proline change; and Mutation #2 1078 C to T aa H360C, which is a histidine to cysteine change.
Case Report, gene testing results (line 118-124)
Screenshots represent source records captured during evidence collection. Select one to view the recorded source content.
The evidence statements recorded by the interpretation pipeline. They have not been reinterpreted by the page.
This variant is present in gnomAD v4.1 (AF= 4.64673e-05; MAF= 0.00465%, 75/1614038 alleles, homozygotes = 0) and has highest observed frequency in the European (Finnish) population (AF= 0.000156167; MAF= 0.01562%, 10/64034 alleles, homozygotes = 0); grpmax FAF= 4.182e-05.
This variant is present in gnomAD v2.1 (AF= 6.01059e-05; MAF= 0.00601%, 17/282834 alleles, homozygotes = 0) and has highest observed frequency in the European (non-Finnish) population (AF= 0.000108389; MAF= 0.01084%, 14/129164 alleles, homozygotes = 0); grpmax FAF= 6.663e-05.
Absent from gnomAD-Canada v1.0.
This variant has been reported in ClinVar as Pathogenic (7 clinical laboratories) and as Likely pathogenic (2 clinical laboratories) and as Uncertain significance (2 clinical laboratories) and as likely pathogenic (1 clinical laboratory). (ClinVarID = 42094)
SpliceAI predicts no significant splice impact for this variant (max delta score = 0.00). REVEL score = 0.97. BayesDel score = 0.565222.
OncoKB did not identify variant-specific reviewed functional evidence for this variant; gene-level curated context is available for reviewer follow-up. FH, an enzyme that converts fumarate to malate in the TCA cycle, is infrequently altered in cancer.
This variant does not lie in a statistically significant hotspot. This variant has previously been reported in somatic cancers (COSMIC; COSV105921172, n = 1 times).
This variant does not lie in a statistically significant hotspot.