Is AGXT p.Arg233His (c.698G>A) pathogenic?

AGXT p.Arg233His (c.698G>A) is classified Pathogenic/Likely pathogenic in AGXT (ClinVar, Multiple submitters, 8 submitters; last evaluated 2025-12-23). AlphaMissense: ambiguous (0.5495); Ultra-rare (popmax 0.01%, amr); Associated with primary hyperoxaluria type 1.

What condition is associated with AGXT p.Arg233His (c.698G>A)?

AGXT p.Arg233His (c.698G>A) is associated with primary hyperoxaluria type 1 (ClinVar).

How common is AGXT p.Arg233His (c.698G>A) in the general population?

AGXT p.Arg233His (c.698G>A) is ultra-rare (popmax 0.01%, amr) (gnomAD).

How is Primary hyperoxaluria inherited?

Typically Autosomal recessive (Orphanet). A genetic counselor can assess individual risk for a family.

What do computational predictors say about AGXT p.Arg233His (c.698G>A)?

AlphaMissense predicts ambiguous (score 0.5495) — an in-silico prediction, not a clinical call.

AGXT p.Arg233His

c.698G>A · rs121908527 · VCV5648

Pathogenic/Likely pathogenic Multiple submitters

Classification

Pathogenic/Likely pathogenic

ClinVar

Review

Multiple submitters ★★☆☆

ClinVar · 8 submitters

AlphaMissense

ambiguous

0.5495 · ACMG-weighted

gnomAD v4.1

Rare

ultra-rare (popmax 0.01%, amr)

Missense predictors

2/2 damaging

REVEL, SaProt · AlphaMissense no call

Conditions

primary hyperoxaluria type 1

Computational evidence

Protein change
AlphaMissense	0.5495	ambiguous
REVEL	0.905	moderately pathogenic-leaning
SaProt	LLR -14.10	damaging
⇒ 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
Conservation	phyloP 11	GERP 0.84, phastCons 1
Regional constraint	o/e 1.00	unconstrained · MANE · 9,952 bp · p 0.92 · regional, not allelic
Overall
CADD	27.5	PHRED · 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 0.01% Admixed American · 6/59,998 alleles

Filtering AF 0.00428% ClinGen BA1/BS1 input FAF95, joint · FAF99 0.00295%

Overall 0.00211% 34/1,613,286 alleles · ultra-rare

Ancestry group	Frequency	1 in
Admixed Americangrpmax	0.01%	10,000
African / African-American	0.00534%	18,732
Remaining individualsnot grpmax-eligible	0.0032%	31,227
East Asian	0.00223%	44,890
European (non-Finnish)	0.0017%	58,967
South Asian	0.0011%	91,066

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: AGXT
Protein: p.Arg233His
Coding: c.698G>A
MANE Select: NM_000030
dbSNP: rs121908527
Type: single nucleotide variant
Location: chr2:240875126 (GRCh38)
Gene constraint: LOEUF 1.251 · pLI <0.01 · ClinGen HI gene assoc. with recessive phenotype (gnomAD)
Structure: AlphaFold pLDDT 98.30 · 17 PDB
Residue 233: a UniProt-annotated variant site (in hp1; associated in cis with l-11 and m-340; results in loss of alanine--glyoxylate aminotransferase activity); a UniProt-annotated variant site (in hp1)

Full AGXT gene report on Sugi Atlas → Gene function, pathways, protein structure, interactions & more

Disease context

primary hyperoxaluria type 1 — disease report on Sugi Atlas → Associated genes, phenotypes, clinical trials & treatments

For Primary hyperoxaluria (Orphanet):

Inheritance: Autosomal recessive
Onset: All ages
Prevalence: 1-9 / 1 000 000 (Germany)

Similar variants

AGXT p.Arg233Cys Pathogenic/Likely pathogenic ★★ ⚠ same residue
AGXT p.Arg233Leu Likely pathogenic ★ same residue
AGXT c.358+1G>A Pathogenic ★★ same condition
AGXT c.359-2A>G Likely pathogenic ★★ same condition
AGXT c.423+1G>A Pathogenic/Likely pathogenic ★★ same condition
AGXT c.524+2T>A Likely pathogenic ★★ same condition
AGXT c.525-1G>A Pathogenic ★★ same condition
AGXT c.525-2A>T Pathogenic/Likely pathogenic ★★ same condition

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/agxt-p-arg233his (accessed [today's date]).

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