# NM_005787.6(ALG3):c.1188dup (p.Asn397fs)

https://sugi.bio/variant/alg3-p-asn397fs

## Summary

**ALG3 p.Asn397fs (c.1188dup)** is classified **Pathogenic** in ALG3 (ClinVar, Single submitter, 1 submitter; last evaluated 2024-04-22). No gnomAD frequency available for this variant; Associated with ALG3-congenital disorder of glycosylation.

**At a glance:** Pathogenic · review: Single submitter · rsID rs2473846363 · 1 submitter · 1 linked condition · no gnomAD frequency available for this variant

## For patients & families {#patients}

This is a change in the ALG3 gene that is reported as disease-causing, but on limited review, submitted by 1 submitter, and is linked to ALG3-congenital disorder of glycosylation.

*Reference information, not medical advice, and not a prediction for any individual. A genetic counselor or clinician can interpret what it means for you and your family.*

|  |  |
| --- | --- |
| Typical inheritance (of this condition) | Autosomal recessive |
| Age of onset (of this condition) | Infancy, Neonatal |
| Diagnostic panels | ALG3 is a diagnostic-grade gene on 14 Genomics England panels |

**Commonly reported features of ALG3-CDG** (across patients with this condition; presentation varies — frequencies from Orphanet):

- Abnormal enzyme/coenzyme activity — Obligate (100%)
- Hypotonia — Very frequent (99-80%)
- Global developmental delay — Very frequent (99-80%)
- Abnormal cerebral morphology — Very frequent (99-80%)
- Recurrent infections — Very frequent (99-80%)
- Abnormality of the gastrointestinal tract — Very frequent (99-80%)
- Feeding difficulties — Very frequent (99-80%)
- Abnormality of the genitourinary system — Frequent (79-30%)

**Support & next steps:** [Condition overview & support (NIH GARD)](https://rarediseases.info.nih.gov/diseases/0009827/index) · [Find a genetic counselor (NSGC)](https://findageneticcounselor.nsgc.org/).

## Identity {#identity}

| Field | Value |
| --- | --- |
| Gene | [ALG3](https://sugi.bio/atlas/gene/ALG3/) |
| Protein change (HGVS p.) | p.Asn397fs |
| Coding change (HGVS c.) | c.1188dup |
| MANE Select transcript | [NM_005787](https://www.ncbi.nlm.nih.gov/nuccore/NM_005787) |
| dbSNP | [rs2473846363](https://www.ncbi.nlm.nih.gov/snp/rs2473846363/) |
| Variant type | Duplication |
| Location | chr3:184242642-184242643 (GRCh38) |
| ClinVar | [VCV2000151](https://www.ncbi.nlm.nih.gov/clinvar/variation/2000151/) |

**All HGVS expressions:** `NC_000003.11:g.183960432dup`, `NC_000003.12:g.184242644dup`, `NG_008924.2:g.11870dup`, `NM_001006941.2:c.1044dup`, `NM_001006942.1:c.1082dup`, `NM_005787.6:c.1188dup`, `NR_024533.1:n.1119dup`, `NR_024534.1:n.1182dup`

## Computational & population evidence {#evidence}

**Concordance:** 1 independent predictor **concordant** with the ClinVar classification.

- **Missense predictors (AlphaMissense/REVEL/SaProt) do not apply** to this variant type — they score amino-acid substitutions only. For non-missense variants the computational signal comes from conservation (below), not from a missing predictor score.
- Conservation: phyloP 6.163, GERP 1.72, phastCons 1 — highly conserved position (PP3-type support)
- Molecular consequence: **frameshift** — a predicted loss-of-function variant. Gene population constraint: LOEUF 0.972, pLI 1.7952e-10. *Descriptive; not an applied PVS1 code.*
- Nonsense-mediated decay: the premature termination codon is **in the last exon (9 of 9)** — predicted to **escape NMD**, so the truncated protein is likely expressed. An input to PVS1, not an applied code.
- SpliceAI: **not assessed** — the release is built from a substitutions-only source, so it holds no duplication variants. That is a property of the dataset, not of the variant, and is not evidence against a splicing effect.
- Population frequency: **no gnomAD frequency available for this variant** — rarity (ACMG PM2) and BA1/BS1 cannot be assessed for this variant.

*Computational predictors are not independent (ClinGen Variant Classification guidance): AlphaMissense (Cheng et al. 2023) carries the ACMG weight for missense and conservation (phyloP/GERP/phastCons) for non-missense; REVEL (Pejaver-2022 calibrated strength bands) and SaProt (Su et al. 2023, structure-aware, ClinVar-independent protein language model, raw LLR) are shown as orthogonal agreement signals, not additive. For frequency, the gnomAD v4.1 grpmax filtering allele frequency (FAF95) is ClinGen's designated BA1/BS1 input (gnomAD v4 guidance v3.0, June 2025); BA1/BS1 thresholds are disease-specific, not a blanket 5%. Predictions, not a clinical determination.*

## Gene constraint & dosage {#gene-context}

**ALG3** population constraint: LOEUF 0.972, pLI 1.7952e-10, missense-Z 0.75767. *Lower LOEUF and higher pLI indicate a gene that tolerates loss-of-function poorly; ClinGen dosage is the curated haploinsufficiency call.*

Curated gene–disease validity (ClinGen):

- **ALG3-congenital disorder of glycosylation** — Definitive (AR)

## Protein context {#protein}


AlphaFold model confidence (whole protein): pLDDT 89.05, 71% of residues very-high.

## What this gene does {#gene-function}

*Describes the biological roles of ALG3 (the gene this variant disrupts) — not effects measured for this specific variant. A damaging variant is expected to affect these functions and pathways; the degree depends on the variant.*

**How this variant is thought to act:** ALG3's established molecular role includes dol-P-Man:Man(5)GlcNAc(2)-PP-Dol alpha-1,3-mannosyltransferase activity. In Reactome, ALG3 is annotated in disease pathway(s) including **Defective ALG3 causes CDG-1d**.

**Disease mechanism (Reactome):** ALG3 loss or alteration is curated in [Defective ALG3 causes CDG-1d](https://reactome.org/content/detail/R-HSA-4720475).

### Pathways affected {#pathways}

ALG3 participates in **2 Reactome pathways** (⚕ = disease pathway):

| Pathway (Reactome) | Evidence |
| --- | --- |
| ⚕ [Defective ALG3 causes CDG-1d](https://reactome.org/content/detail/R-HSA-4720475) | curated |
| [Biosynthesis of the N-glycan precursor (dolichol lipid-linked oligosaccharide, LLO) and transfer to a nascent protein](https://reactome.org/content/detail/R-HSA-446193) | curated |

### Molecular function & processes (GO — experimentally supported) {#go}

**Molecular function:** dol-P-Man:Man(5)GlcNAc(2)-PP-Dol alpha-1,3-mannosyltransferase activity.

**Biological process:** protein N-linked glycosylation, dolichol-linked oligosaccharide biosynthetic process.

## Clinical significance {#significance}

**Pathogenic** — review status Single submitter *(criteria provided, single submitter)*, last evaluated 2024-04-22.

**Submitter consensus:** unanimous (1/1 Pathogenic).

### Submitter classifications {#submitters}

| Submitter | Classification | Review | Method | Date |
| --- | --- | --- | --- | --- |
| Labcorp Genetics (formerly Invitae), Labcorp | Pathogenic | criteria provided, single submitter | clinical testing | 2024-04-22 |

## Associated conditions {#conditions}

[ALG3-congenital disorder of glycosylation](https://sugi.bio/atlas/disease/alg3-congenital-disorder-of-glycosylation/).

**Reported phenotype names (ClinVar):** ALG3-congenital disorder of glycosylation, ALG3-CDG, CARBOHYDRATE-DEFICIENT GLYCOPROTEIN SYNDROME, TYPE IV, CDGS, TYPE IV, CDG Id, CONGENITAL DISORDER OF GLYCOSYLATION, TYPE Id.

## Similar variants {#similar}

Related ALG3 variant pages (same residue, condition, or type): [ALG3 p.Gln16fs](/variant/alg3-p-gln16fs), [ALG3 c.444+1G>T](/variant/alg3-c-444-plus-1g-t), [ALG3 p.Arg171Gln](/variant/alg3-p-arg171gln), [ALG3 p.Arg266Cys](/variant/alg3-p-arg266cys), [ALG3 p.Arg354Cys](/variant/alg3-p-arg354cys), [ALG3 p.Arg354His](/variant/alg3-p-arg354his), [ALG3 p.Asn174Ser](/variant/alg3-p-asn174ser), [ALG3 p.Gly55=](/variant/alg3-p-gly55).

### Data sources & attribution {#sources}

ClinVar (NCBI — public domain, built 2026-10-11); gnomAD v4.1 (Broad Institute, built 2026-10-06); AlphaMissense (Cheng et al. 2023, © Google DeepMind — CC BY 4.0, built 2026-01-27); REVEL (Ioannidis et al. 2016 — ODbL, built 2026-07-13); SaProt (Su et al. 2023 — MIT, built 2026-07-14); SpliceAI (Illumina — free for non-commercial use, built 2026-10-13); CADD (Rentzsch et al. 2019, University of Washington — free for non-commercial use, built 2026-10-10); Conservation (phyloP/phastCons/GERP) (UCSC hg38 470-way mammal (Hiller Lab) + Ensembl Compara, built 2026-07-12); gnomAD Non-coding Constraint (Gnocchi) (Chen et al. 2024, Broad Institute — CC0, built 2026-10-11); gnomAD Regional Missense Constraint (Broad Institute — CC0, built 2026-10-13); Pangolin (Zeng & Li 2022 — CC BY 4.0, built 2026-10-11); Repeat regions (UCSC — RepeatMasker, TRF, segmental duplications, built 2026-10-11); ClinGen (ClinGen, built 2026-09-22); UniProt (CC BY 4.0); Reactome / GO (CC BY 4.0, built 2026-09-23); MaveDB (per-record license, built 2026-10-11); CIViC (CC0, built 2026-09-22); Orphanet (Orphanet, built 2026-06-12)

*Primary record: NCBI ClinVar (variation 2000151). Classifications reflect these databases as of the page's build date and may change. Free reference use — not medical advice; consult the primary submitters and a clinician.*