FAH

Chr 15AR

fumarylacetoacetate hydrolase

Fumarylacetoacetase catalyzes the final step in tyrosine catabolism, converting fumarylacetoacetate to fumarate and acetoacetate. Mutations cause tyrosinemia type I, an autosomal recessive disorder presenting in infancy with hepatomegaly, failure to thrive, and a characteristic cabbage-like odor, progressing to liver failure, renal tubular dysfunction, and neurologic crises if untreated. Early diagnosis and treatment with nitisinone (NTBC) and dietary restriction can prevent the severe complications of this metabolic disorder.

GeneReviewsOMIMResearchSummary from RefSeq, OMIM
LOFmechanismARLOEUF 1.411 OMIM phenotype
Clinical SummaryFAH
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Gene-Disease Validity (ClinGen)
tyrosinemia type I · ARDefinitive

Definitive — sufficient evidence for diagnostic panels

Population Constraint (gnomAD)
Low constraint (pLI 0.00) — loss-of-function variants are relatively tolerated in the population.
📋
ClinVar Variants
80 unique Pathogenic / Likely Pathogenic· 132 VUS of 400 total submissions
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Clinical Trials
6 active or recruiting trials — potential therapeutic options may be available
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GeneReview available — FAH
Authoritative clinical overview · Recommended first read
Open GeneReview ↗

Population Genetics & Constraint

gnomAD v4 — loss-of-function & missense intolerance

Tolerant — LoF & missense variants common in population
LoF Constraint
1.41LOEUF
pLI 0.000
Z-score -0.06
OE 1.01 (0.741.41)
Tolerant

Highly tolerant — LoF variants common in population

Missense Constraint
-0.03Z-score
OE missense 1.01 (0.911.12)
244 obs / 242.6 exp
Tolerant

Tolerant to missense variation

Observed / Expected Ratios
LoF OE1.01 (0.741.41)
00.351.4
Missense OE1.01 (0.911.12)
00.61.4
Synonymous OE1.08
01.21.6
LoF obs/exp: 25 / 24.7Missense obs/exp: 244 / 242.6Syn Z: -0.61

ClinVar Variant Classifications

400 submitted variants in ClinVar

Classification Summary

Pathogenic19
Likely Pathogenic61
VUS132
Likely Benign168
Benign1
Conflicting5
19
Pathogenic
61
Likely Pathogenic
132
VUS
168
Likely Benign
1
Benign
5
Conflicting

Curated Variants Distribution

Classified variants from ClinVar · 5 ACMG categories

ClassificationLoFMissense + InframeNon-codingSynonymousTotal
Pathogenic
12
0
7
0
19
Likely Pathogenic
47
10
4
0
61
VUS
2
110
13
7
132
Likely Benign
0
0
117
51
168
Benign
0
0
1
0
1
Conflicting
5
Total6112014258386

LoF = frameshift, stop gained/lost, canonical splice · Counts from ClinVar esearch · Updated hourly

View in ClinVar →

Protein Context — Lollipop Plot

FAH · protein map & ClinVar variants

Showing all ClinVar variants across the protein. Search a specific variant to highlight its position.

3D Protein StructureAlphaFold
Clinical Literature
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