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ABCA4 p.Arg2139Gln

c.6416G>A · rs761867791 · VCV1477198

Likely pathogenic Expert panel
Classification
Likely pathogenic
ClinVar
Review
Expert panel ★★★☆
ClinVar · 3 submitters
AlphaMissense
ambiguous
0.416 · ACMG-weighted
gnomAD v4.1
Rare
ultra-rare (popmax 0.09%, sas)
Missense predictors
2/2 damaging
REVEL, SaProt · AlphaMissense no call
Conditions
1
ABCA4-related retinopathy

ClinGen expert panel — ABCA4 VCEP

Likely Pathogenic for ABCA4-related retinopathy. Applied ACMG criteria (verbatim):

PP3_Moderate PM2_Supporting PM3 PM5

Curation rationale (ClinGen, verbatim)

The NM_000350.3(ABCA4):c.6416G>A variant in ABCA4 is a missense variant predicted to cause substitution of arginine by glutamine at amino acid 2139; p.Arg2139Gln. The total minor allele frequency in gnomAD v4.1.0 is 0.00008054 (130/1614074 alleles), which is lower than the ClinGen ABCA4 VCEP’s threshold for PM2_Supporting (<0.0001). The computational predictor REVEL gives a score of 0.964 which is above the threshold of >0.772 meeting PP3_Moderate. This variant has been detected in at least 1 individual with ABCA4-related retinopathy who was compound heterozygous for the variant confirmed in trans with a pathogenic variant (c.6445C>T, p.Arg2149Ter) (PM3; PMID: 37705246). Another missense variant, c.6416G>C; p.Arg2139Pro, in the same codon has been classified as pathogenic for ABCA4-related retinopathy by the ClinGen ABCA4 VCEP, and Splice AI revealed no expected effects on splicing (PM5). In summary, this variant meets the criteria to be classified as likely pathogenic for ABCA4-related retinopathy based on the ACMG/AMP criteria applied, as specified by the ClinGen ABCA4 VCEP (Specification Version 1.0.0): PM3, PP3_Moderate, PM5, PM2_Supporting.

ClinGen Evidence Repository → · reported verbatim, not re-tallied by Sugi Variant.

Computational evidence

Protein change
AlphaMissense0.416ambiguous
REVEL0.964strongly pathogenic-leaning
SaProtLLR -12.24damaging
⇒ REVEL and SaProt both call this damaging; AlphaMissense makes no call.
Splicing
SpliceAI—not assessed · no allele here is in the release
Constraint at this position
ConservationphyloP 3.9GERP 1.8, phastCons 1
Regional constrainto/e 0.98unconstrained · MANE · 128 kb · p 0.24 · regional, not allelic
Overall
CADD32.0PHRED · no single calibrated threshold — expert panels disagree

AlphaMissense carries the ACMG weight for missense; REVEL and SaProt are independent agreement signals.

Population frequency

gnomAD v4.1 · exomes + genomes
Grpmax group 0.09% South Asian · 82/91,088 alleles
Filtering AF 0.0743% ClinGen BA1/BS1 input FAF95, joint · FAF99 0.0685%
Overall 0.00805% 130/1,614,074 alleles · ultra-rare exomes 126/1,461,890 · genomes 4/152,184 · joint denominator
Ancestry group Frequency 1 in
South Asiangrpmax 0.09% 1,111
Admixed American 0.005% 20,003
Remaining individualsnot grpmax-eligible 0.0048% 20,829
European (non-Finnish) 0.00339% 29,501
Finnishnot grpmax-eligible 0.00156% 64,036
African / African-American 0.00133% 74,916

Rarity supports pathogenicity (ACMG PM2); frequency above a disease-specific BA1/BS1 threshold argues against it. A variant frequent in one ancestry group can be near-absent in others, so a single global figure can mislead.

Variant & gene context

Gene
ABCA4
Protein
p.Arg2139Gln
Coding
c.6416G>A
MANE Select
NM_000350
dbSNP
rs761867791
Type
single nucleotide variant
Location
chr1:94000899 (GRCh38)
Gene constraint
LOEUF 0.786 · pLI <0.01 (gnomAD)
Structure
AlphaFold pLDDT 75.96 · 8 PDB
Residue 2139
a UniProt-annotated variant site (in cord3; uncertain significance); a UniProt-annotated variant site (in stgd1; uncertain significance); a UniProt-annotated variant site (found in a patient with chorioretinal atrophy; uncertain significance); a UniProt-annotated variant site (found in a patient with macular dystrophy; uncertain significance); the abc transporter 2 domain; a UniProt-annotated variant site (in stgd1 and cord3; uncertain significance); a UniProt-annotated variant site (sequence variant); a UniProt-annotated variant site (in stgd1 and ffm; uncertain significance); a UniProt-annotated variant site (in stgd1; uncertain significance; also found in a patient with chorioretinal atrophy; uncertain significance); a UniProt-annotated variant site (in stgd1); a β-strand
Full ABCA4 gene report on Sugi Atlas → Gene function, pathways, protein structure, interactions & more

Similar variants

Built on 18 open, versioned datasets — ClinVar, gnomAD, AlphaMissense, REVEL, ClinGen & more — plus Sugi Variant's own cross-source analysis. Source data 2026-01–2026-10, ClinVar 2026-10. Full sources & versions →

Cite Sugi Variant

Gür T. Sugi Variant: A Deterministic Per-Variant Germline Reference from a Knowledge Graph for Humans and AI Agents. 2026. doi:10.5281/zenodo.21509445. This variant: https://sugi.bio/variant/abca4-p-arg2139gln (accessed [today's date]).

Preprint & method: sugi.bio/variant/method Machine-readable: this page as Markdown