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Severe hypotonia-psychomotor developmental delay-strabismus-cardiac septal defect syndrome(IHPMR)

MedGen UID:
902080
Concept ID:
C4225196
Disease or Syndrome
Synonym: Hypotonia, infantile, with psychomotor retardation
Modes of inheritance:
Autosomal recessive inheritance
MedGen UID:
141025
Concept ID:
C0441748
Intellectual Product
Source: Orphanet
A mode of inheritance that is observed for traits related to a gene encoded on one of the autosomes (i.e., the human chromosomes 1-22) in which a trait manifests in individuals with two pathogenic alleles, either homozygotes (two copies of the same mutant allele) or compound heterozygotes (whereby each copy of a gene has a distinct mutant allele).
 
Gene (location): CCDC174 (3p25.1)
 
Monarch Initiative: MONDO:0014784
OMIM®: 616816
Orphanet: ORPHA467176

Definition

Severe hypotonia-psychomotor developmental delay-strabismus-cardiac septal defect syndrome is a rare, genetic, non-dystrophic congenital myopathy disorder characterized by a neonatal-onset of severe generalized hypotonia associated with mild psychomotor delay, congenital strabismus with abducens nerve palsy, and atrial and/or ventricular septal defects. Cryptorchidism is commonly reported in male patients and muscle biopsy typically reveals increased variability in muscle fiber size. [from ORDO]

Clinical features

From HPO
Cryptorchidism
MedGen UID:
8192
Concept ID:
C0010417
Congenital Abnormality
Cryptorchidism, or failure of testicular descent, is a common human congenital abnormality with a multifactorial etiology that likely reflects the involvement of endocrine, environmental, and hereditary factors. Cryptorchidism can result in infertility and increases risk for testicular tumors. Testicular descent from abdomen to scrotum occurs in 2 distinct phases: the transabdominal phase and the inguinoscrotal phase (summary by Gorlov et al., 2002).
Ventricular septal defect
MedGen UID:
42366
Concept ID:
C0018818
Congenital Abnormality
A hole between the two bottom chambers (ventricles) of the heart. The defect is centered around the most superior aspect of the ventricular septum.
Hypoplasia of the corpus callosum
MedGen UID:
138005
Concept ID:
C0344482
Congenital Abnormality
Underdevelopment of the corpus callosum.
Delayed speech and language development
MedGen UID:
105318
Concept ID:
C0454644
Finding
A degree of language development that is significantly below the norm for a child of a specified age.
Global developmental delay
MedGen UID:
107838
Concept ID:
C0557874
Finding
A delay in the achievement of motor or mental milestones in the domains of development of a child, including motor skills, speech and language, cognitive skills, and social and emotional skills. This term should only be used to describe children younger than five years of age.
Lateral ventricle dilatation
MedGen UID:
383904
Concept ID:
C1856409
Pathologic Function
Abducens nerve palsy
MedGen UID:
1645218
Concept ID:
C4551519
Disease or Syndrome
Malfunction of the abducens nerve as manifested by impairment of the ability of the affected eye to be moved outward. Patients who develop abducens nerve palsy often present with binocular horizontal diplopia, which is a double vision when looking at objects side by side. There will be a notable weakness of the ipsilateral lateral rectus muscle leading to a deficit in of eye abduction on the affected side. Some patients may present with a constant head turning movement to maintain binocular fusion and to lessen the degree of diplopia.
Myopathy
MedGen UID:
10135
Concept ID:
C0026848
Disease or Syndrome
A disorder of muscle unrelated to impairment of innervation or neuromuscular junction.
Severe muscular hypotonia
MedGen UID:
326544
Concept ID:
C1839630
Finding
A severe degree of muscular hypotonia characterized by markedly reduced muscle tone.
Increased variability in muscle fiber diameter
MedGen UID:
336019
Concept ID:
C1843700
Finding
An abnormally high degree of muscle fiber size variation. This phenotypic feature can be observed upon muscle biopsy.
Neonatal hypotonia
MedGen UID:
412209
Concept ID:
C2267233
Disease or Syndrome
Muscular hypotonia (abnormally low muscle tone) manifesting in the neonatal period.
Respiratory insufficiency due to muscle weakness
MedGen UID:
812797
Concept ID:
C3806467
Finding
Open mouth
MedGen UID:
116104
Concept ID:
C0240379
Finding
A facial appearance characterized by a permanently or nearly permanently opened mouth.
Myopathic facies
MedGen UID:
90695
Concept ID:
C0332615
Finding
A facial appearance characteristic of myopathic conditions. The face appears expressionless with sunken cheeks, bilateral ptosis, and inability to elevate the corners of the mouth, due to muscle weakness.
Long face
MedGen UID:
324419
Concept ID:
C1836047
Finding
Facial height (length) is more than 2 standard deviations above the mean (objective); or, an apparent increase in the height (length) of the face (subjective).
Decreased fetal movement
MedGen UID:
68618
Concept ID:
C0235659
Finding
An abnormal reduction in quantity or strength of fetal movements.
Strabismus
MedGen UID:
21337
Concept ID:
C0038379
Disease or Syndrome
A misalignment of the eyes so that the visual axes deviate from bifoveal fixation. The classification of strabismus may be based on a number of features including the relative position of the eyes, whether the deviation is latent or manifest, intermittent or constant, concomitant or otherwise and according to the age of onset and the relevance of any associated refractive error.

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • Severe hypotonia-psychomotor developmental delay-strabismus-cardiac septal defect syndrome
  • Congenital myopathy
    • Severe hypotonia-psychomotor developmental delay-strabismus-cardiac septal defect syndrome

Professional guidelines

PubMed

Jonas RA
Semin Thorac Cardiovasc Surg 2015 Summer;27(2):177-88. Epub 2015 Jun 14 doi: 10.1053/j.semtcvs.2015.04.003. PMID: 26686446
Lin AE, Pober BR, Adatia I
Am J Med Genet C Semin Med Genet 2007 May 15;145C(2):201-16. doi: 10.1002/ajmg.c.30131. PMID: 17436301Free PMC Article

Recent clinical studies

Etiology

Castaldo MP, Neary E, Bischoff AR, Resende MHF, Weisz DE, Jain A, Giesinger RE, McNamara PJ
Am J Perinatol 2023 Aug;40(11):1223-1231. Epub 2021 Sep 28 doi: 10.1055/s-0041-1735214. PMID: 34583409
Serra G, Felice S, Antona V, Di Pace MR, Giuffrè M, Piro E, Corsello G
Ital J Pediatr 2022 May 4;48(1):65. doi: 10.1186/s13052-022-01241-6. PMID: 35509048Free PMC Article
Serra G, Memo L, Antona V, Corsello G, Favero V, Lago P, Giuffrè M
Ital J Pediatr 2021 Jul 1;47(1):147. doi: 10.1186/s13052-021-01108-2. PMID: 34210338Free PMC Article
Moore SW
Pediatr Surg Int 2013 Jul;29(7):665-76. Epub 2013 Apr 9 doi: 10.1007/s00383-013-3306-8. PMID: 23568541
Kwiatkowska J, Tomaszewski M, Bielińska B, Potaz P, Ereciński J
Med Sci Monit 2000 Nov-Dec;6(6):1148-54. PMID: 11208471

Diagnosis

Barili V, Dall'Asta A, Uliana V, Schera GBL, Ormitti F, Romanini E, Micalizzi A, Magliozzi M, Perrino D, Novelli A, Ghi T, Percesepe A
Eur J Med Genet 2022 Dec;65(12):104638. Epub 2022 Oct 8 doi: 10.1016/j.ejmg.2022.104638. PMID: 36216272
Kumps C, D'haenens E, Vergult S, Leus J, van Coster R, Jansen A, Devriendt K, Oostra A, Vanakker OM
Clin Genet 2021 Mar;99(3):449-456. Epub 2021 Jan 5 doi: 10.1111/cge.13901. PMID: 33340101
Palencia-Campos A, Aoto PC, Machal EMF, Rivera-Barahona A, Soto-Bielicka P, Bertinetti D, Baker B, Vu L, Piceci-Sparascio F, Torrente I, Boudin E, Peeters S, Van Hul W, Huber C, Bonneau D, Hildebrand MS, Coleman M, Bahlo M, Bennett MF, Schneider AL, Scheffer IE, Kibæk M, Kristiansen BS, Issa MY, Mehrez MI, Ismail S, Tenorio J, Li G, Skålhegg BS, Otaify GA, Temtamy S, Aglan M, Jønch AE, De Luca A, Mortier G, Cormier-Daire V, Ziegler A, Wallis M, Lapunzina P, Herberg FW, Taylor SS, Ruiz-Perez VL
Am J Hum Genet 2020 Nov 5;107(5):977-988. Epub 2020 Oct 14 doi: 10.1016/j.ajhg.2020.09.005. PMID: 33058759Free PMC Article
Durand B, Stoetzel C, Schaefer E, Calmels N, Scheidecker S, Kempf N, De Melo C, Guilbert AS, Timbolschi D, Donato L, Astruc D, Sauer A, Antal MC, Dollfus H, El Chehadeh S
Eur J Med Genet 2020 Apr;63(4):103857. Epub 2020 Jan 21 doi: 10.1016/j.ejmg.2020.103857. PMID: 31978614
Jonas RA
Semin Thorac Cardiovasc Surg 2015 Summer;27(2):177-88. Epub 2015 Jun 14 doi: 10.1053/j.semtcvs.2015.04.003. PMID: 26686446

Therapy

Castaldo MP, Neary E, Bischoff AR, Resende MHF, Weisz DE, Jain A, Giesinger RE, McNamara PJ
Am J Perinatol 2023 Aug;40(11):1223-1231. Epub 2021 Sep 28 doi: 10.1055/s-0041-1735214. PMID: 34583409
Jonas RA
Semin Thorac Cardiovasc Surg 2015 Summer;27(2):177-88. Epub 2015 Jun 14 doi: 10.1053/j.semtcvs.2015.04.003. PMID: 26686446
Baquero-Montoya C, Gil-Rodríguez MC, Hernández-Marcos M, Teresa-Rodrigo ME, Vicente-Gabas A, Bernal ML, Casale CH, Bueno-Lozano G, Bueno-Martínez I, Queralt E, Villa O, Hernando-Davalillo C, Armengol L, Gómez-Puertas P, Puisac B, Selicorni A, Ramos FJ, Pié J
Eur J Med Genet 2014 Sep;57(9):503-9. Epub 2014 May 27 doi: 10.1016/j.ejmg.2014.05.006. PMID: 24874887

Prognosis

Kumps C, D'haenens E, Vergult S, Leus J, van Coster R, Jansen A, Devriendt K, Oostra A, Vanakker OM
Clin Genet 2021 Mar;99(3):449-456. Epub 2021 Jan 5 doi: 10.1111/cge.13901. PMID: 33340101
Durand B, Stoetzel C, Schaefer E, Calmels N, Scheidecker S, Kempf N, De Melo C, Guilbert AS, Timbolschi D, Donato L, Astruc D, Sauer A, Antal MC, Dollfus H, El Chehadeh S
Eur J Med Genet 2020 Apr;63(4):103857. Epub 2020 Jan 21 doi: 10.1016/j.ejmg.2020.103857. PMID: 31978614
Douglas G, Cho MT, Telegrafi A, Winter S, Carmichael J, Zackai EH, Deardorff MA, Harr M, Williams L, Psychogios A, Erwin AL, Grebe T, Retterer K, Juusola J
Am J Med Genet A 2018 Sep;176(9):1845-1851. Epub 2018 Jul 28 doi: 10.1002/ajmg.a.40368. PMID: 30055086
Louis-Jacques AF, Običan SG, Nguyen T, Odibo A
Cardiol Young 2017 Sep;27(7):1441-1443. Epub 2017 Mar 16 doi: 10.1017/S104795111700035X. PMID: 28300009
Lin AE, Pober BR, Adatia I
Am J Med Genet C Semin Med Genet 2007 May 15;145C(2):201-16. doi: 10.1002/ajmg.c.30131. PMID: 17436301Free PMC Article

Clinical prediction guides

Barili V, Dall'Asta A, Uliana V, Schera GBL, Ormitti F, Romanini E, Micalizzi A, Magliozzi M, Perrino D, Novelli A, Ghi T, Percesepe A
Eur J Med Genet 2022 Dec;65(12):104638. Epub 2022 Oct 8 doi: 10.1016/j.ejmg.2022.104638. PMID: 36216272
Serra G, Memo L, Antona V, Corsello G, Favero V, Lago P, Giuffrè M
Ital J Pediatr 2021 Jul 1;47(1):147. doi: 10.1186/s13052-021-01108-2. PMID: 34210338Free PMC Article
Palencia-Campos A, Aoto PC, Machal EMF, Rivera-Barahona A, Soto-Bielicka P, Bertinetti D, Baker B, Vu L, Piceci-Sparascio F, Torrente I, Boudin E, Peeters S, Van Hul W, Huber C, Bonneau D, Hildebrand MS, Coleman M, Bahlo M, Bennett MF, Schneider AL, Scheffer IE, Kibæk M, Kristiansen BS, Issa MY, Mehrez MI, Ismail S, Tenorio J, Li G, Skålhegg BS, Otaify GA, Temtamy S, Aglan M, Jønch AE, De Luca A, Mortier G, Cormier-Daire V, Ziegler A, Wallis M, Lapunzina P, Herberg FW, Taylor SS, Ruiz-Perez VL
Am J Hum Genet 2020 Nov 5;107(5):977-988. Epub 2020 Oct 14 doi: 10.1016/j.ajhg.2020.09.005. PMID: 33058759Free PMC Article
Nalbantoğlu B, Donma MM, Nişli K, Paketçi C, Karasu E, Ozdilek B, Mintaş NE
Turk J Pediatr 2013 Mar-Apr;55(2):203-6. PMID: 24192682
Lin AE, Pober BR, Adatia I
Am J Med Genet C Semin Med Genet 2007 May 15;145C(2):201-16. doi: 10.1002/ajmg.c.30131. PMID: 17436301Free PMC Article

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