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PAH p.Leu348Pro

c.1043T>C · rs1874733519 · VCV932253

Likely pathogenic Expert panel
Classification
Likely pathogenic
ClinVar
Review
Expert panel ★★★☆
ClinVar · 1 submitter
AlphaMissense
likely pathogenic
0.9912 · ACMG-weighted
gnomAD v4.1
Rare
very rare (popmax 0.0022%, sas)
Missense predictors
3/3 damaging
AlphaMissense, REVEL, SaProt
Conditions
1
phenylketonuria

ClinGen expert panel — Phenylketonuria VCEP

Likely Pathogenic for phenylketonuria. Applied ACMG criteria (verbatim):

PM2 PP4_Moderate PP3 PM5

Curation rationale (ClinGen, verbatim)

The c.1043T>C (p.Leu348Pro) variant in PAH has been reported in a Chinese patient with PAH deficiency (BH4 deficiency excluded) (PMID: 23932990) This variant is absent from population databases. A deleterious effect is predicted in SIFT, Polyphen-2, MutationTaster, and REVEL=0.981. Another missense change at the same amino acid is pathogenic: p.Leu348Val Pathogenic by 7 submitters. In summary, this variant meets criteria to be classified as likely pathogenic for PAH. PAH-specific ACMG/AMP criteria applied: PP4_Moderate, PM2, PM5, PP3.

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

Computational evidence

Protein change
AlphaMissense0.9912likely pathogenic ✓ concordant with ClinVar · top 4% in PAH
REVEL0.981strongly pathogenic-leaning
SaProtLLR -15.21damaging
⇒ AlphaMissense, REVEL and SaProt all call this damaging.
Splicing
SpliceAI—not assessed · no allele here is in the release
Constraint at this position
ConservationphyloP 11GERP 2.1, phastCons 1
Regional constrainto/e 1.07unconstrained · MANE · 78 kb · p 0.12 · regional, not allelic
Overall
CADD29.6PHRED · 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 0.0022% South Asian · 2/91,062 alleles
Filtering AF 0.000365% ClinGen BA1/BS1 input FAF95, joint · FAF99 0.000137%
Overall 0.000137% 2/1,460,834 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
PAH
Protein
p.Leu348Pro
Coding
c.1043T>C
MANE Select
NM_000277
dbSNP
rs1874733519
Type
single nucleotide variant
Location
chr12:102844358 (GRCh38)
Gene constraint
LOEUF 1.265 · pLI <0.01 · ClinGen HI gene assoc. with recessive phenotype (gnomAD)
Structure
AlphaFold pLDDT 89.04 · 21 PDB
Residue 348
a UniProt-annotated variant site (in pah deficiency; mild); an α-helix
Full PAH gene report on Sugi Atlas → Gene function, pathways, protein structure, interactions & more

Disease context

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

For Phenylketonuria (Orphanet):

Inheritance
Autosomal recessive
Onset
Infancy
Prevalence
1-9 / 100 000 (France)

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/pah-p-leu348pro (accessed [today's date]).

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