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LDLR p.Pro84Leu

c.251C>T · rs875989892 · VCV226310

Uncertain significance Expert panel
Classification
Uncertain significance
ClinVar
Review
Expert panel ★★★☆
ClinVar · 10 submitters
AlphaMissense
likely pathogenic
0.7346 · ACMG-weighted
gnomAD v4.1
Rare
very rare (popmax 0.00017%, nfe)
Missense predictors
3/3 damaging
AlphaMissense, REVEL, SaProt
Conditions
2
hypercholesterolemia, familial, 1

ClinGen expert panel — Familial Hypercholesterolemia VCEP

Uncertain Significance for hypercholesterolemia, familial. Applied ACMG criteria (verbatim):

PM2 PP1_Moderate PP4

Curation rationale (ClinGen, verbatim)

The NM_000527.5(LDLR):c.251C>T (p.Pro84Leu) variant is classified as Uncertain significance - insufficient evidence for Familial Hypercholesterolemia by applying evidence code PM2, PP1_Moderate and PP4 as defined by the ClinGen Familial Hypercholesterolemia Expert Panel LDLR-specific variant curation guidelines (https://doi.org/10.1016/j.gim.2021.09.012). The supporting evidence is as follows: PM2 - This variant is absent from gnomAD (gnomAD v2.1.1) PP1_Moderate - Variant segregates with FH phenotype in at least 4 informative meiosis from 2 families from Cardiovascular Genetics Laboratory (PathWest Laboratory Medicine WA). In one family 2 family members positive for variant with LDL > 75th percentile, in the other 2 family members negative for variantwith LDL < 50th percentile. PP4 - Variant meets PM2 and is identified in one index case who fulfill FH/DLCN>=6 criteria for FH from Cardiovascular Genetics Laboratory (PathWest Laboratory Medicine WA) after alternative causes of high cholesterol were excluded.

ClinGen Evidence Repository → · reported verbatim, not re-tallied by Sugi Variant.

Computational evidence

Protein change
AlphaMissense0.7346likely pathogenic
REVEL0.666pathogenic-leaning
SaProtLLR -10.64damaging
⇒ AlphaMissense, REVEL and SaProt all call this damaging.
Splicing
SpliceAI—not assessed · no allele here is in the release
Constraint at this position
ConservationphyloP 5.8GERP 2.5, phastCons 0.75
Regional constrainto/e 1.00unconstrained · MANE · 42 kb · p 0.91 · regional, not allelic
Overall
CADD25.5PHRED · no single calibrated threshold — expert panels disagree

ClinVar classifies this uncertain; the computational predictors unanimously lean damaging — a triage signal, not a reclassification

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

Population frequency

gnomAD v4.1 · exomes + genomes
Grpmax group 0.00017% European (non-Finnish) · 2/1,179,944 alleles
Filtering AF 2.8e-05% ClinGen BA1/BS1 input FAF95, joint · FAF99 1.1e-05%
Overall 0.000137% 2/1,461,744 alleles · very rare

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
LDLR
Protein
p.Pro84Leu
Coding
c.251C>T
MANE Select
NM_000527
dbSNP
rs875989892
Type
single nucleotide variant
Location
chr19:11102724 (GRCh38)
Gene constraint
LOEUF 1.091 · pLI <0.01 · ClinGen HI 3/3 (gnomAD)
Structure
AlphaFold pLDDT 75.81 · 36 PDB
Residue 84
a disulfide bond; the ldl-receptor class a 2 domain
Full LDLR gene report on Sugi Atlas → Gene function, pathways, protein structure, interactions & more

Similar variants

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/ldlr-p-pro84leu (accessed [today's date]).

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