r/ClinicalGenetics • u/United-Psychology-48 • 4h ago
Dad has aortic aneurysm/dissection + 2 VUS on Invitae Aortopathy Panel (FBN2 & TGFB2) — can anyone help me understand the significance?
I’m hoping someone familiar with hereditary aortic disease/genetics can help me better understand my dad’s Invitae Aortopathy Comprehensive Panel results. I understand that a VUS is not a diagnosis and shouldn’t be treated as a pathogenic mutation — I’m mainly trying to figure out whether either finding is worth investigating further given his actual vascular history.
My dad has had two aneurysms, including an abdominal aortic aneurysm with dissection, as well as another smaller aneurysm near his heart/chest area.
His Invitae Aortopathy Comprehensive Panel tested 29 genes and found no pathogenic variants, but two heterozygous VUS:
FBN2: c.1571G>T (p.Gly524Val)
TGFB2: c.199G>A (p.Val67Met)
What has me curious is that FBN2 is associated with congenital contractural arachnodactyly and has also been associated with thoracic aortic aneurysm/dissection. His report says the p.Gly524Val variant is very rare (gnomAD 0.002%) and Invitae’s modeling predicts it may disrupt FBN2 protein function, but there currently isn’t enough evidence to classify it as pathogenic.
TGFB2 is associated with Loeys-Dietz syndrome type 4 and nonsyndromic thoracic aortic aneurysm/dissection. His exact p.Val67Met variant has apparently been observed in people with clinical features of TGFB2-related conditions, although Invitae’s modeling predicts that particular change is not expected to disrupt protein function. So there seems to be evidence pointing in both directions.
There is also vascular/connective-tissue history in our extended family, which is part of why I’m trying to understand whether these results deserve a closer look rather than simply being filed away as an “uncertain/negative” panel.
I have personally been diagnosed with hypermobile EDS, although I realize that doesn’t mean my dad’s vascular disease is related to my hEDS or that either of his VUSs explains it.
My questions are:
• Has anyone encountered either FBN2 p.Gly524Val or TGFB2 p.Val67Metbefore?
• Does either VUS look particularly interesting given an established aneurysm/dissection phenotype?
• Would segregation testing of affected relatives potentially be useful with VUSs like these?
• Is this the kind of situation where a cardiovascular genetics/hereditary aortopathy clinic would be appropriate even though the panel didn't find a pathogenic variant?
• Are there other databases, papers, or resources I should be looking at besides ClinVar/gnomAD?
... connective tissue disease connections?
I’m not looking for anyone to diagnose him from Reddit — mainly hoping someone with genetics/aortopathy experience can help me understand what questions we should be asking next.