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IDH2
Final classification
VUS
IDH2 c.413C>A · p.Thr138Asn
IDH2

PM2 (Supporting): absent from all population databases — gnomAD v2.1 exomes, v4.1 exomes, and gnomAD-Canada v1.0 genomes (observed AF = 0).

Gene
IDH2
Transcript
NM_002168.3
HGVS · transcript:coding
NM_002168.3:c.413C>A
Consequence
N/A
GRCh38
chr15:90088708 G>T
GRCh37
chr15:90631940 G>T
Basis VUS: no ClinGen CSPEC/VCEP framework exists for IDH2, so generic ACMG/AMP 2015 rules apply; the combination of PM2 (supporting) plus PP3 (moderate) meets no Pathogenic or Benign threshold.
VUS: no ClinGen CSPEC/VCEP framework exists for IDH2, so generic ACMG/AMP 2015 rules apply; the combination of PM2 (supporting) plus PP3 (moderate) meets no Pathogenic or Benign threshold.
Classification rationale
PM2PP3 VUS
IDH2 c.413C>A

PM2 (Supporting): absent from all population databases — gnomAD v2.1 exomes, v4.1 exomes, and gnomAD-Canada v1.0 genomes (observed AF = 0). PP3 (Moderate): REVEL 0.736 falls within the ClinGen SVI-calibrated moderate band (0.644–0.773). Overall: VUS — the 1 moderate + 1 supporting combination satisfies no Pathogenic, Likely Pathogenic, Benign, or Likely Benign threshold in the generic ACMG/AMP 2015 rules.

PM2 + PP3 VUS
Gene diagram · NM_002168.3 · variants mapped to exon structure
IDH2 NM_002168.3
Fetching transcript structure from UCSC…
Applied criteria · 2 applied · 22 assessed
Applied · 2
Strength Supporting Moderate Strong Very strong
PM2 supporting Pathogenic
Met (supporting): absent from all population databases — gnomAD v2.1 exomes, v4.1 exomes, and gnomAD-Canada v1.0 genomes (observed AF = 0).
gnomad_v2: c.413C>A absent (AF=0) in gnomAD v2.1 exomes (125,748 exomes; Karczewski et al. 2020, PMID:32461654)gnomad_v4: c.413C>A absent (AF=0) in gnomAD v4.1 exomes (dataset gnomad_r4)gnomad_canada: c.413C>A absent in gnomAD-Canada v1.0 (HostSeq genomes)
PP3 moderate Pathogenic
Met (moderate): REVEL 0.736 falls within the ClinGen SVI-calibrated PP3 moderate band (0.644–0.773).
REVEL score = 0.736 for NM_002168.3:c.413C>A (p.Thr138Asn); ClinGen SVI missense calibration, Pejaver et al. 2022, Am J Hum Genet 109(12):2163-2177, PMID 36413997, assigns REVEL scores 0.644-0.773 to PP3 at moderate strength.SpliceAI (Jaganathan et al. 2019, Cell 176(3):535-548, PMID 30661751) max delta = 0.00 with DS_AG/DS_AL/DS_DG/DS_DL all 0.0 — no predicted splice impact; does not support PP3 via the splice-impact path.BayesDel noAF score = -0.037745 (local lookup BayesDel_170824_noAF_chr15.gz) — treated as insufficiently calibrated for PP3 per pipeline policy because no verified published threshold is available.
Assessed · not applied
Pathogenic
PS1 Not assessed: no established pathogenic variant producing the same amino-acid change (p.Thr138Asn) exists; this is the only single-nucleotide change that yields Asn at codon 138.
PS2 Not assessed: no proband, parental, or de novo occurrence data were available to evaluate.
PS3 Not assessed: no validated variant-specific functional assay data were available; in silico predictions do not qualify as functional studies.
PS4 Not assessed: no case-control or cohort enrichment data exist for this variant.
PM1 Not assessed: position 138 is not a known IDH2 hotspot (R140/R172 are), and no protein-domain annotation was available to evaluate the critical-domain arm.
PM3 Not assessed: no second pathogenic allele or phase (trans/cis) information was available, and no recessive germline disorder applies.
PM5 Not assessed: no different missense change at residue 138 has been established as pathogenic.
PM6 Not assessed: no de novo occurrence data, confirmed or unconfirmed, were available.
PP1 Not assessed: no segregation or pedigree data were available, and IDH2's germline disease association is not established.
PP2 Not assessed: missense is a common disease mechanism for IDH2, but no gene-level missense constraint metric was available.
PP4 Not assessed: no proband phenotype or family-history data were available to evaluate.
PP5 Not met: this variant is absent from ClinVar, so no expert-panel pathogenic classification exists to apply.
Benign
BA1 Not met: allele frequency is 0 in all population datasets, far below the >5% BA1 threshold.
BS1 Not met: allele frequency 0 cannot exceed the expected frequency for an ultra-rare IDH2 germline disorder.
BS2 Not met: no carriers or homozygotes were observed in any consulted cohort.
BS3 Not assessed: no functional study data were available to demonstrate absence of a damaging effect.
BS4 Not assessed: no family testing data were available to evaluate non-segregation.
BP1 Not met: IDH2 disease is mediated by missense variants, so the truncating-only mechanism does not apply.
BP2 Not assessed: no trans or cis co-occurrence with a second variant was observed.
BP4 Not met: REVEL 0.736 is far above the ClinGen-calibrated BP4 supporting threshold (≤0.016).
BP5 Not assessed: no proband-level data were available to identify an alternative molecular basis.
BP6 Not met: this variant is absent from ClinVar, so no expert-panel benign classification exists to apply.
N/A · 4 PVS1 · PM4 · BP3 · BP7
Research & evidence
Population frequency
gnomAD v4.1 screenshot
gnomAD v4.1
gnomAD v2.1 screenshot
gnomAD v2.1
v4.1
Absent from gnomAD v4.1.
v2.1
Absent from gnomAD v2.1.
🇨🇦 CA
Absent from gnomAD-Canada v1.0.
Allele frequency by ancestry
three datasets · side by side
gnomAD v4.1
Absent · 0 / ?
0 hom
Not observed in any ancestry group.
gnomAD v2.1
Absent · 0 / ?
0 hom
Not observed in any ancestry group.
gnomAD Canada 🇨🇦
Absent · 0 / ?
0 hom
Not observed in any ancestry group.
ClinVar screenshot
ClinVar
This variant is absent from ClinVar.
SpliceAI screenshot
In silico
SpliceAI predicts no significant splice impact for this variant (max delta score = 0.00). REVEL score = 0.736. BayesDel score = -0.037745.
Functional / OncoKB screenshot
Functional Unknown Oncogenic Effect
OncoKB did not identify variant-specific reviewed functional evidence for this variant; gene-level curated context is available for reviewer follow-up. IDH2, a cell metabolism enzyme, is recurrently mutated in various cancer types including acute myeloid leukemia, glioblastoma, and cholangiocarcinoma.
OncoKB ↗
COSMIC screenshot
COSMIC
Cancer hotspots screenshot
Cancer hotspots
Somatic evidence Not in COSMIC / hotspots
COSMIC
This variant does not lie in a statistically significant hotspot. This variant has previously been reported in somatic cancers (COSMIC; COSV100344117, n = 1 times).
Hotspots
This variant does not lie in a statistically significant hotspot.
Sources & reference links
8Sources
ClinVar
gnomAD v2.1
gnomAD v4.1
gnomAD-Canada
SpliceAI
OncoKB
COSMIC
Cancer hotspots