# NM_000036.3(AMPD1):c.1192A>G (p.Ile398Val)

https://sugi.bio/variant/ampd1-p-ile398val

## Summary

**AMPD1 p.Ile398Val (c.1192A>G)** is classified **Uncertain significance** in AMPD1 (ClinVar, Multiple submitters, 3 submitters; last evaluated 2025-03-20). AlphaMissense: likely benign (0.0957); Very rare (popmax 0.00834%, amr); Associated with myopathy due to myoadenylate deaminase deficiency.

**At a glance:** Uncertain significance · review: Multiple submitters · rsID rs1263217341 · 3 submitters · 1 linked condition · AlphaMissense likely benign · very rare (popmax 0.00834%, amr)

## For patients & families {#patients}

This is a change in the AMPD1 gene that is currently of uncertain significance — a definitive interpretation has not yet been established, submitted by 3 submitters, and is linked to myopathy due to myoadenylate deaminase deficiency.

*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.*

**Support & next steps:** [Condition overview & support (NIH GARD)](https://rarediseases.info.nih.gov/diseases/0015248/index) · [Find a genetic counselor (NSGC)](https://findageneticcounselor.nsgc.org/).

## Identity {#identity}

| Field | Value |
| --- | --- |
| Gene | [AMPD1](https://sugi.bio/atlas/gene/AMPD1/) |
| Protein change (HGVS p.) | p.Ile398Val |
| Coding change (HGVS c.) | c.1192A>G |
| MANE Select transcript | [NM_000036](https://www.ncbi.nlm.nih.gov/nuccore/NM_000036) |
| dbSNP | [rs1263217341](https://www.ncbi.nlm.nih.gov/snp/rs1263217341/) |
| Variant type | single nucleotide variant |
| Location | chr1:114677942-114677942 (GRCh38) |
| ClinVar | [VCV1410658](https://www.ncbi.nlm.nih.gov/clinvar/variation/1410658/) |

**All HGVS expressions:** `NC_000001.10:g.115220563T>C`, `NC_000001.11:g.114677942T>C`, `NG_008012.1:g.22614A>G`, `NM_000036.2:c.1291A>G`, `NM_000036.3:c.1192A>G`, `NM_001172626.2:c.1180A>G`

## Computational & population evidence {#evidence}

**Concordance:** Mixed / partial computational evidence (see below).

- AlphaMissense **likely benign** (0.0957)
- REVEL 0.388 (indeterminate)
- Conservation: phyloP 6.224, GERP -1.2, phastCons 1 — highly conserved (differs from AlphaMissense)
- ⚠ **Isoform check:** AlphaMissense is numbered on a different transcript (AM **I431V** vs ClinVar **I398V**) — the AlphaMissense read here may be for a different residue; verify against the ClinVar transcript.
- CADD: **PHRED 22.6**. No single ClinGen-calibrated threshold exists and the expert panels that use CADD disagree — GUCY2D/AIPL1 require ≥ 20.0 for an untranslated-region variant, ABCA4 ≥ 28.1 for a synonymous or indel variant, the Pulmonary Hypertension panel imports Pejaver 2022's missense-calibrated numbers, and the Antibody Deficiencies panel declines CADD entirely for PIK3CD. CADD v1.7 also incorporates Zoonomia phyloP, so it partly re-expresses the conservation above. *Descriptive; no threshold applied.*
- Regional missense constraint: **o/e 1.00** across the covering region of the MANE Select transcript (114,673,980–114,695,471), spanning 21,491 bp. Chi-square p 0.9. Describes the region, not this allele; gnomAD v4.1.1's own constrained determination. *Descriptive; no ACMG code applied.*
- SpliceAI: **not assessed** — no allele at this position is in our SpliceAI release, either because it lies outside the scored MANE transcript scope or because every allele is below Δ0.2. We cannot tell which, so this claims neither; absence is not evidence against a splicing effect.
- Population frequency (gnomAD v4.1): grpmax **0.00834%** (amr) · FAF95 0.00324% · FAF99 0.00207% · 5/59,944 in the highest group · 10/1,613,784 alleles overall — very rare (popmax 0.00834%, amr).

| Ancestry group | Allele frequency | 1 in |
| --- | --- | --- |
| Admixed American (grpmax) | 0.00834% | 11,989 |
| Remaining individuals (not grpmax-eligible) | 0.0016% | 62,482 |
| European (non-Finnish) | 0.000339% | 294,995 |

*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}

**AMPD1** population constraint: LOEUF 1.036, pLI 7.1588e-21, missense-Z 1.0985. *Lower LOEUF and higher pLI indicate a gene that tolerates loss-of-function poorly; ClinGen dosage is the curated haploinsufficiency call.*

## Protein context {#protein}


AlphaFold model confidence (whole protein): pLDDT 86.84, 73% of residues very-high.

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

*Describes the biological roles of AMPD1 (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:** AMPD1's established molecular role includes AMP deaminase activity.


### Pathways affected {#pathways}

AMPD1 participates in **1 Reactome pathway** (⚕ = disease pathway):

| Pathway (Reactome) | Evidence |
| --- | --- |
| [Purine salvage](https://reactome.org/content/detail/R-HSA-74217) | curated |

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

**Molecular function:** AMP deaminase activity, identical protein binding.

**Biological process:** GMP salvage.

## Clinical significance {#significance}

**Uncertain significance** — review status Multiple submitters *(criteria provided, multiple submitters, no conflicts)*, last evaluated 2025-03-20.

**Submitter consensus:** unanimous (3/3 Uncertain significance).

**Submission history:** 3 submissions (2019–2025); classifications have been stable.

### Submitter classifications {#submitters}

| Submitter | Classification | Review | Method | Date |
| --- | --- | --- | --- | --- |
| Labcorp Genetics (formerly Invitae), Labcorp | Uncertain significance | criteria provided, single submitter | clinical testing | 2024-01-04 |
| Ambry Genetics | Uncertain significance | criteria provided, single submitter | clinical testing | 2025-03-20 |
| Revvity Omics, Revvity | Uncertain significance | criteria provided, single submitter | clinical testing | 2019-12-19 |

## Associated conditions {#conditions}

[myopathy due to myoadenylate deaminase deficiency](https://sugi.bio/atlas/disease/myopathy-due-to-myoadenylate-deaminase-deficiency/).

**Reported phenotype names (ClinVar):** Muscle AMP deaminase deficiency, Inborn genetic diseases, Myoadenylate deaminase deficiency, myopathy due to, Adenosine monophosphate deaminase 1 deficiency, AMP deaminase 1 deficiency, Adenosine Monophosphate Deaminase 1, ADENOSINE MONOPHOSPHATE DEAMINASE-1 DEFICIENCY, MYOPATHY DUE TO, AMPD1 DEFICIENCY.

## Similar variants {#similar}

Related AMPD1 variant pages (same residue, condition, or type): [AMPD1 p.Gln653Ter](/variant/ampd1-p-gln653ter), [AMPD1 c.1388+5G>A](/variant/ampd1-c-1388-plus-5g-a), [AMPD1 c.1974+1G>A](/variant/ampd1-c-1974-plus-1g-a), [AMPD1 c.-42C>T](/variant/ampd1-c-minus-42c-t), [AMPD1 p.Ala308Thr](/variant/ampd1-p-ala308thr), [AMPD1 p.Ala489Thr](/variant/ampd1-p-ala489thr), [AMPD1 p.Ala578Thr](/variant/ampd1-p-ala578thr), [AMPD1 p.Ala616Thr](/variant/ampd1-p-ala616thr).

### 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 1410658). 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.*