Summary Statistics:
ASD Reports: 11
Recent Reports: 1
Annotated variants: 71
Associated CNVs: 15
Evidence score: 4
Gene Score: 4S
Relevance to Autism
De novo damaging missense variants (defined by CADD score 25) in the CLCN4 gene were identified in two ASD probands from the Autism Sequencing Consortium (Kosmicki et al., 2017), while a third de novo damaging missense variant in this gene was observed in an ASD proband from the SPARK cohort (Feliciano et al., 2019). A meta-analysis of de novo variants in 4773 published ASD trios and 465 SPARK trios using TADA identified CLCN4 as an ASD candidate gene with a q-value 0.1. Mutations in the CLCN4 gene are also responsible for Raynaud-Claes syndrome (OMIM 300114), an X-linked intellectual developmental disorder characterized by borderline to severe intellectual disability and impaired language development; behavioral problems are frequently observed in individuals with this syndrome, and autistic features have been reported in a subset of affected individuals (Claes et al., 1997; Palmer et al., 2018). Palmer et al., 2022 assembled a collection of 90 rare CLCN4 missense variants in 90 families that included detailed clinical and segregation data for 43 families that included 22 males and 33 females; autism spectrum disorder (or autistic behavior) was observed in 54.5% of all males and 40% of females with de novo variants in this study, while functional assessment of the electrophysiological properties of these 59 variants in Xenopus oocytes identified variants with either loss-of-function or toxic gain-of-function effects.
Molecular Function
Proton-coupled chloride transporter. Functions as antiport system and exchanges chloride ions against protons.
References
Primary
Exome sequencing of 457 autism families recruited online provides evidence for autism risk genes
ASD
Support
A single center experience with publicly funded clinical exome sequencing for neurodevelopmental disorders or multiple congenital anomalies
DD, ID, epilepsy/seizures
Support
Novel CLCN4 variant associated with syndromic X-linked intellectual disability in a Chinese girl: a case report
DD, ID
Autistic features
Support
Regional localization of two genes for nonspecific X-linked mental retardation to Xp22.3-p22.2 (MRX49) and Xp11.3-p11.21 (MRX50).
Raynaud-Claes syndrome
Autistic features
Support
Refining the role of de novo protein-truncating variants in neurodevelopmental disorders by using population reference samples.
ASD
Support
X-linked mental retardation with neonatal hypotonia in a French family (MRX15): gene assignment to Xp11.22-Xp21.1.
Raynaud-Claes syndrome
Support
De novo and inherited mutations in the X-linked gene CLCN4 are associated with syndromic intellectual disability and behavior and seizure disorders...
Raynaud-Claes syndrome
Autistic features
Support
DD, ID, epilepsy/seizures
Autistic features, stereotypy
Support
Integrating de novo and inherited variants in 42
ASD
Support
Diagnostic yield of next-generation sequencing in 87 families with neurodevelopmental disorders
DD, ID
Recent Recommendation
Functional and clinical studies reveal pathophysiological complexity of CLCN4-related neurodevelopmental condition
DD, ID, epilepsy/seizures
ASD, ADHD
GEN1118R001
missense_variant
c.1621G>C
p.Glu541Gln
De novo
Simplex
GEN1118R002
missense_variant
c.2152C>T
p.Arg718Trp
De novo
Simplex
GEN1118R003
missense_variant
c.1885C>T
p.Arg629Trp
De novo
GEN1118R004
frameshift_variant
p.Asp15SerfsTer18
Familial
Maternal
Multi-generational
GEN1118R005
frameshift_variant
c.1876dup
p.Ile626AsnfsTer135
Familial
Maternal
Multiplex
GEN1118R006
missense_variant
c.2191G>C
p.Gly731Arg
Familial
Maternal
Multi-generational
GEN1118R007
missense_variant
c.232G>A
p.Gly78Ser
Familial
Maternal
Simplex
GEN1118R008
missense_variant
c.661C>G
p.Leu221Val
Familial
Maternal
Multi-generational
GEN1118R009
missense_variant
c.1606G>A
p.Val536Met
Familial
Maternal
Multi-generational
GEN1118R010
missense_variant
c.635T>G
p.Val212Gly
Familial
Maternal
Multiplex
GEN1118R011
missense_variant
c.662T>C
p.Leu221Pro
De novo
GEN1118R012
missense_variant
c.1601C>T
p.Ser534Leu
De novo
GEN1118R013
copy_number_loss
Familial
Maternal
Multiplex
GEN1118R014
missense_variant
c.43G>A
p.Asp15Asn
De novo
GEN1118R015
missense_variant
c.1664C>T
p.Ala555Val
De novo
GEN1118R016
missense_variant
c.2152C>T
p.Arg718Trp
De novo
GEN1118R017
missense_variant
c.823G>A
p.Val275Met
De novo
GEN1118R018
missense_variant
c.1630G>C
p.Gly544Arg
De novo
GEN1118R019
splice_site_variant
c.1107+5G>A
Familial
Maternal
Simplex
GEN1118R020
missense_variant
c.1343C>T
p.Ala448Val
Familial
Maternal
Simplex
GEN1118R021
stop_gained
c.875G>A
p.Trp292Ter
Familial
Maternal
GEN1118R022
missense_variant
c.758G>A
p.Arg253Gln
Familial
Maternal
Multiplex
GEN1118R023
missense_variant
c.274G>A
p.Val92Met
De novo
GEN1118R024
stop_gained
c.964G>T
p.Glu322Ter
De novo
GEN1118R025
missense_variant
c.1348G>A
p.Gly450Arg
De novo
GEN1118R026
missense_variant
c.1348G>A
p.Gly450Arg
De novo
Multiplex
GEN1118R027
frameshift_variant
c.2066_2067del
p.His689ProfsTer71
De novo
GEN1118R028
missense_variant
c.185A>G
p.Lys62Arg
Familial
Maternal
Multiplex
GEN1118R029
missense_variant
c.274G>A
p.Val92Met
Familial
Paternal
Extended multiplex
GEN1118R030
missense_variant
c.608C>T
p.Thr203Ile
Familial
Maternal
Simplex
GEN1118R031
missense_variant
c.677C>T
p.Pro226Leu
De novo
Simplex
GEN1118R032
missense_variant
c.806G>A
p.Gly269Asp
De novo
Simplex
GEN1118R033
missense_variant
c.823G>C
p.Val275Leu
Familial
Maternal
Simplex
GEN1118R034
missense_variant
c.826C>T
p.Leu276Phe
Familial
Maternal
Simplex
GEN1118R035
missense_variant
c.835C>G
p.Leu279Val
De novo
Simplex
GEN1118R036
missense_variant
c.840A>T
p.Glu280Asp
De novo
Simplex
GEN1118R037
missense_variant
c.848G>A
p.Ser283Asn
De novo
Simplex
GEN1118R038
missense_variant
c.926A>G
p.Asn309Ser
Familial
Maternal
Multiplex
GEN1118R039
missense_variant
c.956T>C
p.Phe319Ser
Familial
Maternal
Multiplex
GEN1118R040
missense_variant
c.1025G>A
p.Gly342Glu
Familial
Maternal
Simplex
GEN1118R041
missense_variant
c.1078C>A
p.Arg360Ser
Familial
Maternal
Simplex
GEN1118R042
missense_variant
c.1465C>A
p.Gln489Lys
De novo
GEN1118R043
missense_variant
c.1576G>A
p.Gly526Ser
Familial
Maternal
Extended multiplex
GEN1118R044
missense_variant
c.1597G>A
p.Val533Met
Familial
Maternal
Simplex
GEN1118R045
missense_variant
c.1904C>G
p.Pro635Arg
Familial
Maternal
Extended multiplex
GEN1118R046
missense_variant
c.1906G>A
p.Val636Met
Familial
Maternal
Simplex
GEN1118R047
missense_variant
c.2152C>T
p.Arg718Trp
De novo
Simplex
GEN1118R048
missense_variant
c.2192G>T
p.Gly731Val
Familial
Maternal
Simplex
GEN1118R049
missense_variant
c.265G>A
p.Asp89Asn
De novo
Simplex
GEN1118R050
missense_variant
c.804T>G
p.Phe268Leu
De novo
Simplex
GEN1118R051
missense_variant
c.928C>T
p.Pro310Ser
De novo
Simplex
GEN1118R052
missense_variant
c.949G>A
p.Val317Ile
De novo
Simplex
GEN1118R053
missense_variant
c.949G>A
p.Val317Ile
Familial
Maternal
Simplex
GEN1118R054
missense_variant
c.949G>A
p.Val317Ile
De novo
Simplex
GEN1118R055
missense_variant
c.1185C>G
p.Ser395Arg
De novo
Simplex
GEN1118R056
missense_variant
c.1646T>A
p.Ile549Asn
De novo
Simplex
GEN1118R057
missense_variant
c.1648G>C
p.Val550Leu
De novo
GEN1118R058
missense_variant
c.1664C>T
p.Ala555Val
De novo
Simplex
GEN1118R059
missense_variant
c.1664C>T
p.Ala555Val
De novo
Simplex
GEN1118R060
missense_variant
c.1664C>T
p.Ala555Val
De novo
Simplex
GEN1118R061
missense_variant
c.100G>A
p.Asp34Asn
Familial
Maternal
Multiplex
GEN1118R062
missense_variant
c.206C>T
p.Ser69Leu
Familial
Maternal
Simplex
GEN1118R063
missense_variant
c.1106C>T
p.Pro369Leu
De novo
GEN1118R064
missense_variant
c.87C>G
p.Asp29Glu
Familial
Maternal
Multiplex
GEN1118R065
missense_variant
c.944G>A
p.Arg315His
De novo
Simplex
GEN1118R066
missense_variant
c.1090A>G
p.Arg364Gly
Unknown
Extended multiplex
GEN1118R067
missense_variant
c.1886C>T
p.Thr629Ile
Familial
Maternal
Simplex
GEN1118R068
frameshift_variant
c.925_928del
p.Asn309ProfsTer67
Familial
Maternal
Extended multiplex
GEN1118R069
frameshift_variant
c.1987_1990del
p.Gln663GlyfsTer6
Familial
Maternal
Extended multiplex
GEN1118R070
stop_gained
c.2025C>G
p.Tyr675Ter
De novo
Simplex
GEN1118R071
missense_variant
c.1630G>A
p.Gly544Arg
De novo
No Common Variants Available
X
Deletion-Duplication
21
X
Deletion-Duplication
21
No Animal Model Data Available
No Interactions Available