# NM_177986.5(DSG4):c.2523G>A (p.Arg841=)

https://sugi.bio/variant/dsg4-p-arg841

## Summary

**DSG4 p.Arg841= (c.2523G>A)** is classified **Conflicting classifications of pathogenicity** in DSG4 (ClinVar, Conflicting submitters, 2 submitters; last evaluated 2025-09-16). Ultra-rare (popmax 0.0819%, nfe); Associated with hypotrichosis 6.

**At a glance:** Conflicting classifications of pathogenicity · review: Conflicting submitters · rsID rs151048983 · 2 submitters · 1 linked condition · ultra-rare (popmax 0.0819%, nfe)

## For patients & families {#patients}

This is a change in the DSG4 gene that is of uncertain or conflicting significance (submitters disagree on it), submitted by 2 submitters, and is linked to hypotrichosis 6.

*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 dominant, Autosomal recessive |
| Age of onset (of this condition) | Childhood |

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

- Sparse eyelashes — Very frequent (99-80%)
- Alopecia — Very frequent (99-80%)
- Sparse scalp hair — Very frequent (99-80%)
- Sparse body hair — Very frequent (99-80%)
- Sparse eyebrow — Very frequent (99-80%)
- Sparse hair — Frequent (79-30%)

**Support & next steps:** [Condition overview & support (NIH GARD)](https://rarediseases.info.nih.gov/diseases/0015423/index) · [Find a genetic counselor (NSGC)](https://findageneticcounselor.nsgc.org/).

## Identity {#identity}

| Field | Value |
| --- | --- |
| Gene | [DSG4](https://sugi.bio/atlas/gene/DSG4/) |
| Protein change (HGVS p.) | p.Arg841= |
| Coding change (HGVS c.) | c.2523G>A |
| dbSNP | [rs151048983](https://www.ncbi.nlm.nih.gov/snp/rs151048983/) |
| Variant type | single nucleotide variant |
| Location | chr18:31412995-31412995 (GRCh38) |
| ClinVar | [VCV890046](https://www.ncbi.nlm.nih.gov/clinvar/variation/890046/) |

**All HGVS expressions:** `NC_000018.10:g.31412995G>A`, `NC_000018.9:g.28992958G>A`, `NG_013040.1:g.41219G>A`, `NM_001134453.3:c.2580G>A`, `NM_177986.5:c.2523G>A`

## Computational & population evidence {#evidence}

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

- **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 0.891, GERP -0.005, phastCons 0.999 — weakly conserved position
- CADD: **PHRED 5.463**. 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.*
- SpliceAI: **not looked up on this page** — it was served without the gene's SpliceAI index, so no lookup was made. This is a gap in this page, not in the data, and says nothing about whether a splicing effect is predicted.
- Population frequency (gnomAD v4.1): grpmax **0.0819%** (nfe) · FAF95 0.0776% · FAF99 0.0759% · 967/1,180,020 in the highest group · 1,043/1,613,980 alleles overall — ultra-rare (popmax 0.0819%, nfe).

| Ancestry group | Allele frequency | 1 in |
| --- | --- | --- |
| European (non-Finnish) (grpmax) | 0.0819% | 1,220 |
| Remaining individuals (not grpmax-eligible) | 0.0688% | 1,453 |
| Finnish (not grpmax-eligible) | 0.0375% | 2,668 |
| African / African-American | 0.00801% | 12,482 |
| Admixed American | 0.00333% | 30,000 |
| South Asian | 0.0011% | 91,084 |

*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.*

## Clinical significance {#significance}

**Conflicting classifications of pathogenicity** — review status Conflicting submitters *(criteria provided, conflicting classifications)*, last evaluated 2025-09-16.

**Submitter consensus:** conflicting (1 Uncertain significance, 1 Likely benign).

**Submission history:** 2 submissions (2018–2025); classifications have differed over time.

### Submitter classifications {#submitters}

| Submitter | Classification | Review | Method | Date |
| --- | --- | --- | --- | --- |
| Illumina Laboratory Services, Illumina | Uncertain significance | criteria provided, single submitter | clinical testing | 2018-01-12 |
| Labcorp Genetics (formerly Invitae), Labcorp | Likely benign | criteria provided, single submitter | clinical testing | 2025-09-16 |

## Associated conditions {#conditions}

[hypotrichosis 6](https://sugi.bio/atlas/disease/hypotrichosis-6/).

**Reported phenotype names (ClinVar):** Hypotrichosis 6, not provided, none provided, MONILETHRIX-LIKE HYPOTRICHOSIS, HYPOTRICHOSIS, LOCALIZED, AUTOSOMAL RECESSIVE 1.

### 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 890046). 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.*