Is F9 p.Arg191Cys (c.571C>T) pathogenic?

F9 p.Arg191Cys (c.571C>T) is classified Pathogenic/Likely pathogenic in F9 (ClinVar, Multiple submitters, 10 submitters; last evaluated 2024-10-31). AlphaMissense: ambiguous (0.46); Absent from gnomAD v4.1; Associated with hemophilia B.

What condition is associated with F9 p.Arg191Cys (c.571C>T)?

F9 p.Arg191Cys (c.571C>T) is associated with hemophilia B, thrombophilia, X-linked, due to factor 9 defect (ClinVar).

How common is F9 p.Arg191Cys (c.571C>T) in the general population?

F9 p.Arg191Cys (c.571C>T) is absent from gnomAD v4.1 (gnomAD).

How is Hemophilia B inherited?

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

What do computational predictors say about F9 p.Arg191Cys (c.571C>T)?

AlphaMissense predicts ambiguous (score 0.46) — an in-silico prediction, not a clinical call.

F9 p.Arg191Cys

c.571C>T · rs137852237 · VCV10584

Pathogenic/Likely pathogenic Multiple submitters

Classification

Pathogenic/Likely pathogenic

ClinVar

Review

Multiple submitters ★★☆☆

ClinVar · 10 submitters

AlphaMissense

ambiguous

0.46 · ACMG-weighted

gnomAD v4.1

Absent

absent from gnomAD v4.1

Missense predictors

1/2 damaging

REVEL, SaProt · AlphaMissense no call

Conditions

hemophilia B

Computational evidence

Protein change
AlphaMissense	0.46	ambiguous
REVEL	0.808	moderately pathogenic-leaning
SaProt	LLR -9.95	tolerated
⇒ REVEL calls this damaging; SaProt does not; AlphaMissense makes no call.
Splicing
SpliceAI	—	not assessed · no allele here is in the release
Constraint at this position
Conservation	phyloP 4.9	GERP 4.6, phastCons 1
Regional constraint	o/e 0.57	unconstrained · MANE · 25 kb · p 2.3e-14 · regional, not allelic
Overall
CADD	22.3	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

Absent from gnomAD v4.1. Not observed in any sequenced alleles — a rarity signal (ACMG PM2-supporting), not evidence of pathogenicity on its own.

Variant & gene context

Gene: F9
Protein: p.Arg191Cys
Coding: c.571C>T
MANE Select: NM_000133
dbSNP: rs137852237
Type: single nucleotide variant
Location: chrX:139551112 (GRCh38)
Structure: AlphaFold pLDDT 80.45 · 57 PDB
Residue 191: a UniProt-annotated variant site (in hemb; moderate; albuquerque, cardiff-1); a UniProt-annotated variant site (in hemb; moderate; chapel-hill, chicago-2); a functional site (cleavage; by factor xia); a disulfide bond

Full F9 gene report on Sugi Atlas → Gene function, pathways, protein structure, interactions & more

Disease context

hemophilia B — disease report on Sugi Atlas → Associated genes, phenotypes, clinical trials & treatments

Also linked: thrombophilia, X-linked, due to factor 9 defect

For Hemophilia B (Orphanet):

Inheritance: X-linked recessive
Onset: Childhood, Infancy, Neonatal
Prevalence: 1-9 / 100 000 (Europe)

Similar variants

F9 p.Arg191His Pathogenic ★★★ ⚠ same residue
F9 p.Arg191= Likely benign ★ same residue
F9 c.520+13A>G Pathogenic ★★★ same condition
F9 c.88+1G>A Pathogenic ★★★ same condition
F9 c.88+5G>T Likely pathogenic ★★★ same condition
F9 p.Ala279Thr Pathogenic ★★★ ⚠ same condition
F9 p.Ala337Pro Likely pathogenic ★★★ same condition
F9 p.Ala337Thr 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/f9-p-arg191cys (accessed [today's date]).

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