PVS1
This variant is a frameshift in exon 6, the last exon of PPM1D, and is predicted to truncate the protein at p.Ala481ProfsTer2 rather than create a typical loss-of-function allele subject to nonsense-mediated decay.
PS2
No confirmed de novo occurrence with verified parentage was identified, so PS2 could not be assessed.
PS3
Available studies show that truncating variants in exon 6 of PPM1D can increase protein stability and phosphatase activity, which is consistent with an abnormal functional effect for this variant class.
PS4
This variant has been observed in somatic cancers, but no germline case-control enrichment or statistically increased prevalence in affected individuals compared with controls was identified.
PM1
Published data indicate that pathogenic truncating PPM1D variants often cluster in exon 6, but this specific variant was not shown to lie in a statistically significant hotspot in Cancer Hotspots and no critical benign-variation-depleted domain threshold was established for applying PM1 here.
PM6
No assumed de novo occurrence without full parental confirmation was identified, so PM6 could not be assessed.
PP1
No segregation data were identified for this variant, so PP1 could not be assessed.
PP4
No phenotype or family-history data specific enough to assess a highly specific PPM1D-related clinical presentation were identified, so PP4 could not be assessed.
PP5
No pathogenic classification from a reputable source without available supporting evidence was identified.