MBD4 NM_001276270.2:c.1382A>G (p.Asn461Ser) is a missense variant in exon 5 encoding a non-conservative amino acid substitution from asparagine to serine at codon 461. This variant is present in gnomAD v4.1 at an allele frequency of 0.202% (3,262/1,614,054 alleles, including 8 homozygotes) and in gnomAD v2.1 at 0.169% (479/282,746 alleles, including 2 homozygotes), indicating it is not a rare variant in the general population.1 Multiple lines of in silico evidence suggest no significant impact on the gene product: BayesDel scores -0.063 (benign) and SpliceAI predicts no splicing impact (max delta score 0.15). REVEL scores 0.54 (borderline deleterious) but does not overcome the preponderance of benign computational evidence (BP4 supporting).2 No variant-specific functional studies, segregation data, de novo observations, or case-control studies were identified in the literature or ClinVar submissions.3 ClinVar classifies this variant as Likely benign based on submissions from multiple clinical laboratories (4 Likely benign, 2 Uncertain significance), though the aggregate review status remains single-submitter level.4 Overall, the only criterion met is BP4 at supporting strength. No pathogenic criteria are met. Insufficient evidence exists to classify this variant as either pathogenic or likely pathogenic; the classification is Uncertain Significance (VUS). The population frequency data and clinical laboratory consensus lean toward a benign interpretation but do not meet formal benign classification thresholds.