Is TRPM4 p.Pro4Arg (c.11C>G) pathogenic?

TRPM4 p.Pro4Arg (c.11C>G) is classified Uncertain significance in TRPM4 (ClinVar, Multiple submitters, 3 submitters; last evaluated 2023-06-02). AlphaMissense: likely benign (0.115); Very rare (popmax 0.00489%, eas); Associated with progressive familial heart block type IB.

What condition is associated with TRPM4 p.Pro4Arg (c.11C>G)?

TRPM4 p.Pro4Arg (c.11C>G) is associated with progressive familial heart block type IB, erythrokeratodermia variabilis et progressiva 6 (ClinVar).

How common is TRPM4 p.Pro4Arg (c.11C>G) in the general population?

TRPM4 p.Pro4Arg (c.11C>G) is very rare (popmax 0.00489%, eas) (gnomAD).

What do computational predictors say about TRPM4 p.Pro4Arg (c.11C>G)?

AlphaMissense predicts likely benign (score 0.115) — an in-silico prediction, not a clinical call.

TRPM4 p.Pro4Arg

Q: How is Hereditary progressive cardiac conduction defect inherited?

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

c.11C>G · rs1318656879 · VCV577534

Uncertain significance Multiple submitters

Classification

Uncertain significance

ClinVar

Review

Multiple submitters ★★☆☆

ClinVar · 3 submitters

AlphaMissense

likely benign

0.115 · ACMG-weighted

gnomAD v4.1

Rare

very rare (popmax 0.00489%, eas)

Missense predictors

0/3 damaging

AlphaMissense, REVEL, SaProt

Conditions

progressive familial heart block type IB

Computational evidence

Protein change
AlphaMissense	0.115	likely benign
REVEL	0.118	moderately benign-leaning
SaProt	LLR -6.72	tolerated
⇒ AlphaMissense, REVEL and SaProt all call this tolerated.
Splicing
SpliceAI	—	not assessed · no allele here is in the release
Constraint at this position
Conservation	phyloP 1.3	phastCons 0.001
Regional constraint	o/e 1.00	unconstrained · MANE · 10 kb · p 0.94 · regional, not allelic
Overall
CADD	21.3	PHRED · no single calibrated threshold — expert panels disagree

ClinVar classifies this uncertain; the computational predictors unanimously lean tolerated — 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 0.00489% East Asian · 2/40,912 alleles

Filtering AF 0.00081% ClinGen BA1/BS1 input FAF95, joint · FAF99 0.000303%

Overall 0.000912% 14/1,534,798 alleles · very rare exomes 13/1,382,666 · genomes 1/152,132 · joint denominator

Ancestry group	Frequency	1 in
East Asiangrpmax	0.00489%	20,456
Ashkenazi Jewishnot grpmax-eligible	0.00349%	28,618
South Asian	0.00238%	41,989
European (non-Finnish)	0.000785%	127,380

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: TRPM4
Protein: p.Pro4Arg
Coding: c.11C>G
MANE Select: NM_017636
dbSNP: rs1318656879
Type: single nucleotide variant
Location: chr19:49157877 (GRCh38)
Gene constraint: LOEUF 1.084 · pLI <0.01 (gnomAD)
Structure: AlphaFold pLDDT 78.51 · 42 PDB

Full TRPM4 gene report on Sugi Atlas → Gene function, pathways, protein structure, interactions & more

Disease context

progressive familial heart block type IB — disease report on Sugi Atlas → Associated genes, phenotypes, clinical trials & treatments

Also linked: erythrokeratodermia variabilis et progressiva 6

For Hereditary progressive cardiac conduction defect (Orphanet):

Inheritance: Autosomal dominant
Onset: Adult

Similar variants

TRPM4 p.Pro4Ser Conflicting classifications of pathogenicity ★ ⚠ same residue
TRPM4 p.Pro4= Likely benign ★ same residue
TRPM4 p.Ile1040Thr Pathogenic/Likely pathogenic ★★ same condition
TRPM4 p.Ile376Thr Pathogenic/Likely pathogenic ★★ ⚠ same condition
TRPM4 c.1050+1G>A Uncertain significance ★★ same condition
TRPM4 c.1150+5A>T Uncertain significance ★★ same condition
TRPM4 c.1150+6A>G Uncertain significance ★★ same condition
TRPM4 c.1263+1G>A Uncertain significance ★★ 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/trpm4-p-pro4arg (accessed [today's date]).

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