Is ARX p.Ala145Ser (c.433G>T) pathogenic?

ARX p.Ala145Ser (c.433G>T) is classified Conflicting classifications of pathogenicity in ARX (ClinVar, Conflicting submitters, 2 submitters; last evaluated 2024-02-07). AlphaMissense: likely benign (0.1051); Ultra-rare (popmax 0.0536%, sas); Associated with developmental and epileptic encephalopathy, 1.

What condition is associated with ARX p.Ala145Ser (c.433G>T)?

ARX p.Ala145Ser (c.433G>T) is associated with developmental and epileptic encephalopathy, 1, intellectual disability, X-linked, with or without seizures, ARX-related (ClinVar).

How common is ARX p.Ala145Ser (c.433G>T) in the general population?

ARX p.Ala145Ser (c.433G>T) is ultra-rare (popmax 0.0536%, sas) (gnomAD).

How is Infantile epileptic spasms syndrome inherited?

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

What do computational predictors say about ARX p.Ala145Ser (c.433G>T)?

AlphaMissense predicts likely benign (score 0.1051) — an in-silico prediction, not a clinical call.

ARX p.Ala145Ser

c.433G>T · rs1438576250 · VCV1631889

Conflicting classifications of pathogenicity Conflicting submitters

Classification

Conflicting classifications of pathogenicity

ClinVar

Review

Conflicting submitters ★☆☆☆

ClinVar · 2 submitters

AlphaMissense

likely benign

0.1051 · ACMG-weighted

gnomAD v4.1

Rare

ultra-rare (popmax 0.0536%, sas)

Missense predictors

0/3 damaging

AlphaMissense, REVEL, SaProt

Conditions

developmental and epileptic encephalopathy, 1

Computational evidence

Protein change
AlphaMissense	0.1051	likely benign
REVEL	0.177	moderately benign-leaning
SaProt	LLR -9.52	tolerated
⇒ AlphaMissense, REVEL and SaProt all call this tolerated.
Splicing
SpliceAI	—	not assessed · no allele here is in the release
Constraint at this position
Regional constraint	o/e 0.87	unconstrained · MANE · 2,633 bp · p 0.032 · regional, not allelic
Overall
CADD	14.79	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 0.0536% South Asian · 9/16,791 alleles

Filtering AF 0.0279% ClinGen BA1/BS1 input FAF95, joint · FAF99 0.0209%

Overall 0.00142% 11/776,845 alleles · ultra-rare exomes 10/672,008 · genomes 1/104,837 · joint denominator

Ancestry group	Frequency	1 in
South Asiangrpmax	0.0536%	1,866
European (non-Finnish)	0.000304%	329,483

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: ARX
Protein: p.Ala145Ser
Coding: c.433G>T
MANE Select: NM_139058
dbSNP: rs1438576250
Type: single nucleotide variant
Location: chrX:25013562 (GRCh38)
Structure: AlphaFold pLDDT 56.51
Residue 145: the 'disordered' region

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

Disease context

developmental and epileptic encephalopathy, 1 — disease report on Sugi Atlas → Associated genes, phenotypes, clinical trials & treatments

Also linked: intellectual disability, X-linked, with or without seizures, ARX-related

For Infantile epileptic spasms syndrome (Orphanet):

Inheritance: Autosomal dominant, Autosomal recessive, X-linked dominant

Similar variants

ARX p.Ala145Pro Uncertain significance ★ ⚠ same residue
ARX p.Ala145= Likely benign ★ same residue
ARX p.Ala145fs Likely pathogenic ★ same residue
ARX p.Ala145_Ala155del Uncertain significance ★ same residue
ARX p.Arg330His Likely pathogenic ★★ same condition
ARX p.Arg332Gly Pathogenic/Likely pathogenic ★★ same condition
ARX p.Arg332His Pathogenic ★★ same condition
ARX p.Arg371Gln 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/arx-p-ala145ser (accessed [today's date]).

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