KCNH2 Variant D821E Detail

We estimate the penetrance of LQTS for KCNH2 D821E is 22%. This variant was found in a total of 1 carriers in 0 papers or gnomAD, 0 had LQTS. D821E is present in 1 alleles in gnomAD. D821E has not been functionally characterized. This residue is located in a Mild_Hotspot region for LQT2. In silico predictions, functional data (if available), and location in structure are equivalent to observing 2 individuals with LQT2 and 8 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 D821E around 22% (2/11).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-3.355 0.563 2 0.586 38
PROVEAN scores less than -2 are considered deleterious. REVEL scores higher than 0.5 or 0.75 are considered likely pathogenic (higher sensitivity with the former cutoff, higher specificity with the latter cutoff). A PolyPhen-2 score of 0.85 or greater is considered likely pathogenic. BLAST-PSSM reflects the evolutionary conservation of residue substitutions, more negative numbers indicate fewer observations of the specific substitution than is expected. Penetrance density is our previously published method to calculate the average LQTS probability density in a shell of residues surrounding a residue of interest (Kroncke et al. 2019).

Reported Carrier Data

PubMed ID Year Carriers Unaffected LQT2 Other Disease
LITERATURE, COHORT, AND GNOMAD: - 1 1 0 -
VARIANT FEATURES ALONE: - 10 8 2 -
Summary totals might not agree with the literature table because of duplicate patients, which were excluded from the total counts. We do not distinguish here between multiple missense codons. Missense variants are combined across degenerate codon substitutions since codon-level data were not consistently available for curation.

D821E has 61 previously observed neighbors within 15 angstroms

A residue within a folded protein on average has nearest neighbors that fall roughly into two shells: a "nearest" neighbor around 5-6 angstroms and a second shell around 11 angstroms. NOTE: some residues appear multiple times at different distances since the functional KV11.1 channel (protein product of KCNH2/hERG) is a homotetramer and occasionally the same residue from multiple subunits is present within the 15A window. All variants shown in the rightmost column have been observed in at least one individual in the literature or gnomAD.

Neighbor Distance (Angstroms) Variants Observed in Individuals
821 0 D821E, D821E,
820 4 G820R, G820R,
771 5 H771fsX, H771R,
822 5 V822M, V822L, V822L,
790 5
772 6
770 6
823 6 R823T, R823Q, R823W, R823fsX,
789 7
768 7
791 8 R791W, R791Q,
819 8 N819K, N819K,
792 8
818 8 S818A, S818L, S818W,
769 9
774 9 D774X, D774Y,
773 9
793 9 D793N,
794 10 V794D, V794I,
748 10
788 10 E788D, E788D, E788K,
862 10 L862P,
796 10 V796L, V796L, V796Del,
797 11 A797T,
795 11 V795I,
824 11
749 11
767 11 D767X,
787 11
723 11 C723G, C723R, C723X,
766 11
752 11 R752W, R752P, R752Q,
860 12
805 12 F805C, F805S,
776 12 L776I, L776P,
747 12
806 13 G806R, G806R,
817 13
780 13
12 13 N12D,
799 13 L799sp,
775 13
825 14
863 14 R863X, R863P,
798 14 I798fsX,
11 14 Q11H, Q11L, Q11H,
750 14 C750X,
861 14 N861I, N861H,
727 14
778 14 A778T,
726 15
816 15 G816V,
763 15
10 15
724 15 L724X,
696 15 R696C, R696H,
751 15 L751V,
42 15 I42N,
722 15
807 15 E807X,
786 15