Variant: m.14849T>C

CA120623

9685 (ClinVar)

Gene: MT-CYB

Condition: mitochondrial disease

Inheritance Mode: Mitochondrial inheritance

UUID: ad66692a-4abb-4760-8a67-05a175dc8ac7

Approved on: 2022-06-30

Published on: 2022-06-30

HGVS expressions

NC_012920.1:m.14849T>C
J01415.2:m.14849T>C
ENST00000361789.2:n.103T>C

Uncertain Significance

• Met criteria codes: PP3 PM2_Supporting

• Not Met criteria codes: PS3 PS2 PS4 PP1 PM6

Expert Panel

Mitochondrial Diseases VCEP

Criteria Specification Information

Criteria Specification: ClinGen Mitochondrial Disease Nuclear and Mitochondrial Expert Panel Specifications to the ACMG/AMP Variant Interpretation Guidelines Version 1_mtDNA

Evidence submitted by expert panel

Mitochondrial Diseases VCEP

The m.14849T>C (p.S35P) variant in MT-CYB has been reported in two unrelated men. The first reported individual had developmental delay, microcephaly, lactic acidosis and rhabdomyolysis with illness, short stature, dysdiadokinesia, ataxia, exercise intolerance, fatigue, Wolff-Parkinson-White, left ventricular hypertrophy, retinitis pigmentosa, septo-optic dysplasia, and cerebellar hypoplasia (PMID: 11891837) and the second reported individual had exercise intolerance, depressive episodes, and myopathy with ragged red fibers seen on muscle biopsy (PMID: 20544923). Both individuals had onset of features in childhood and heteroplasmy levels in various tissues ranged from 6-85%. Haplogroup information was not reported for all cases precluding consideration for PS4. The variant was reported de novo in the first case report as it was absent in mother’s blood (PMID: 11891837), however no additional tissues were tested and technology performed at the time of publication would not detect low heteroplasmy levels of the variant. There are no large families reported in the medical literature to consider for evidence of segregation. This variant is absent in the GenBank dataset, Helix dataset, and gnomAD v3.1.2 (PM2_supporting). There are no cybrid studies, single fiber studies, or other functional assays reported for this variant. The computational predictor APOGEE gives a consensus rating of pathogenic with a score of 0.74 (Min=0, Max=1), which predicts a damaging effect on gene function (PP3). In summary, this variant meets criteria to be classified as uncertain significance for primary mitochondrial disease inherited in a mitochondrial manner. This classification was approved by the NICHD/NINDS U24 Mitochondrial Disease Variant Curation Expert Panel on May 24, 2022. Mitochondrial DNA-specific ACMG/AMP criteria applied (PMID: 32906214): PM2_supporting, PP3.

Met criteria codes

• PP3: The computational predictor APOGEE gives a consensus rating of pathogenic with a score of 0.74 (Min=0, Max=1), which predicts a damaging effect on gene function (PP3).
• PM2_Supporting: This variant is absent in the GenBank dataset, Helix dataset, and gnomAD v3.1.2 (PM2_supporting).

Not Met criteria codes

• PS3: There are no cybrid studies, single fiber studies, or other functional assays reported for this variant.
• PS2: The variant was reported de novo in the first case report as it was absent in mother’s blood (PMID: 11891837), however no additional tissues were tested and technology performed at the time of publication would not detect low heteroplasmy levels of the variant.
• PS4: The m.14849T>C (p.S35P) variant in MT-CYB has been reported in two unrelated men. The first reported individual had developmental delay, microcephaly, lactic acidosis and rhabdomyolysis with illness, short stature, dysdiadokinesia, ataxia, exercise intolerance, fatigue, Wolff-Parkinson-White, left ventricular hypertrophy, retinitis pigmentosa, septo-optic dysplasia, and cerebellar hypoplasia (PMID: 11891837) and the second reported individual had exercise intolerance, depressive episodes, and myopathy with ragged red fibers seen on muscle biopsy (PMID: 20544923). Both individuals had onset of features in childhood and heteroplasmy levels in various tissues ranged from 6-85%. Haplogroup information was not reported for all cases precluding consideration for PS4.
• PP1: There are no large families reported in the medical literature to consider for evidence of segregation.
• PM6: The variant was reported de novo in the first case report as it was absent in mother’s blood (PMID: 11891837), however no additional tissues were tested and technology performed at the time of publication would not detect low heteroplasmy levels of the variant.