Is HLCS p.Pro803Ser (c.2407C>T) pathogenic?

HLCS p.Pro803Ser (c.2407C>T) is classified Uncertain significance in HLCS (ClinVar, Multiple submitters, 2 submitters; last evaluated 2022-03-10). AlphaMissense: likely benign (0.2636); Ultra-rare (popmax 0.0933%, sas); Associated with holocarboxylase synthetase deficiency.

What condition is associated with HLCS p.Pro803Ser (c.2407C>T)?

HLCS p.Pro803Ser (c.2407C>T) is associated with holocarboxylase synthetase deficiency (ClinVar).

How common is HLCS p.Pro803Ser (c.2407C>T) in the general population?

HLCS p.Pro803Ser (c.2407C>T) is ultra-rare (popmax 0.0933%, sas) (gnomAD).

How is Holocarboxylase synthetase deficiency inherited?

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

What do computational predictors say about HLCS p.Pro803Ser (c.2407C>T)?

AlphaMissense predicts likely benign (score 0.2636) — an in-silico prediction, not a clinical call.

HLCS p.Pro803Ser

c.2407C>T · rs538159086 · VCV1376621

Uncertain significance Multiple submitters

Classification

Uncertain significance

ClinVar

Review

Multiple submitters ★★☆☆

ClinVar · 2 submitters

AlphaMissense

likely benign

0.2636 · ACMG-weighted

gnomAD v4.1

Rare

ultra-rare (popmax 0.0933%, sas)

Missense predictors

1/3 damaging

AlphaMissense, REVEL, SaProt

Conditions

holocarboxylase synthetase deficiency

Computational evidence

Protein change
AlphaMissense	0.2636	likely benign
REVEL	0.659	pathogenic-leaning
SaProt	LLR -7.15	tolerated
⇒ REVEL calls this damaging; AlphaMissense and SaProt do not.
Splicing
SpliceAI	—	not assessed · no allele here is in the release
Constraint at this position
Conservation	phyloP 9.7	GERP 2.1, phastCons 1
Regional constraint	o/e 0.90	unconstrained · MANE · 212 kb · p 0.00098 · regional, not allelic
Overall
CADD	22.6	PHRED · no single calibrated threshold — expert panels disagree

AlphaMissense carries the ACMG weight for missense; REVEL and SaProt are independent agreement signals.

⚠ Isoform check: AlphaMissense numbered on a different transcript (AM P656S vs ClinVar P803S) — verify the residue.

Population frequency

gnomAD v4.1 · exomes + genomes

Grpmax group 0.0933% South Asian · 85/91,070 alleles

Filtering AF 0.0773% ClinGen BA1/BS1 input FAF95, joint · FAF99 0.0713%

Overall 0.00582% 94/1,613,902 alleles · ultra-rare

Ancestry group	Frequency	1 in
South Asiangrpmax	0.0933%	1,071
Middle Eastern	0.033%	3,029
Remaining individualsnot grpmax-eligible	0.0064%	15,624
European (non-Finnish)	0.000254%	393,307

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: HLCS
Protein: p.Pro803Ser
Coding: c.2407C>T
MANE Select: NM_001352514
dbSNP: rs538159086
Type: single nucleotide variant
Location: chr21:36756585 (GRCh38)
Gene constraint: LOEUF 0.883 · pLI <0.01 · ClinGen HI gene assoc. with recessive phenotype (gnomAD)
Structure: AlphaFold pLDDT 77.33

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

Disease context

holocarboxylase synthetase deficiency — disease report on Sugi Atlas → Associated genes, phenotypes, clinical trials & treatments

For Holocarboxylase synthetase deficiency (Orphanet):

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

Similar variants

HLCS p.Pro803= Likely benign ★ same residue
HLCS c.1620+2T>G Likely pathogenic ★★ same condition
HLCS c.1621-2A>G Likely pathogenic ★★ same condition
HLCS c.1892+1G>A Likely pathogenic ★★ same condition
HLCS c.1960+5G>A Pathogenic ★★ same condition
HLCS c.2121+1G>A Pathogenic/Likely pathogenic ★★ same condition
HLCS c.2237-2A>G Likely pathogenic ★★ same condition
HLCS c.2450+2T>A 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/hlcs-p-pro803ser (accessed [today's date]).

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