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Keutel syndrome(KTLS)

MedGen UID:
383722
Concept ID:
C1855607
Disease or Syndrome
Synonyms: KTLS; Pulmonic stenosis brachytelephalangism and calcification of cartilages
SNOMED CT: Keutel syndrome (724208006); Pulmonic stenosis, brachytelephalangism, calcification of cartilage syndrome (724208006)
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): MGP (12p12.3)
 
Monarch Initiative: MONDO:0009495
OMIM®: 245150
Orphanet: ORPHA85202

Definition

Keutel syndrome (KTLS) is an autosomal recessive disorder characterized by multiple peripheral pulmonary stenoses, brachytelephalangy, inner ear deafness, and abnormal cartilage ossification or calcification (summary by Khosroshahi et al., 2014). [from OMIM]

Clinical features

From HPO
Short thumb
MedGen UID:
98469
Concept ID:
C0431890
Congenital Abnormality
Hypoplasia (congenital reduction in size) of the thumb.
Short distal phalanx of finger
MedGen UID:
326590
Concept ID:
C1839829
Finding
Short distance from the end of the finger to the most distal interphalangeal crease or the distal interphalangeal joint flexion point. That is, hypoplasia of one or more of the distal phalanx of finger.
Short hallux
MedGen UID:
400890
Concept ID:
C1865992
Finding
Underdevelopment (hypoplasia) of the big toe.
Shortening of all distal phalanges of the fingers
MedGen UID:
867248
Concept ID:
C4021608
Finding
Hypoplasia of all of the distal phalanx of finger.
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.
Hypertensive disorder
MedGen UID:
6969
Concept ID:
C0020538
Disease or Syndrome
The presence of chronic increased pressure in the systemic arterial system.
Pulmonary artery hypoplasia
MedGen UID:
75585
Concept ID:
C0265910
Congenital Abnormality
Underdevelopment of the pulmonary artery.
Peripheral pulmonary artery stenosis
MedGen UID:
138014
Concept ID:
C0345030
Finding
Stenosis of a peripheral branch of the pulmonary artery.
Pulmonic stenosis
MedGen UID:
408291
Concept ID:
C1956257
Disease or Syndrome
A narrowing of the right ventricular outflow tract that can occur at the pulmonary valve (valvular stenosis), below the pulmonary valve (infundibular stenosis), or above the pulmonary valve (supravalvar stenosis).
Growth abnormality
MedGen UID:
808205
Concept ID:
C0262361
Finding
Macrotia
MedGen UID:
488785
Concept ID:
C0152421
Congenital Abnormality
Median longitudinal ear length greater than two standard deviations above the mean and median ear width greater than two standard deviations above the mean (objective); or, apparent increase in length and width of the pinna (subjective).
Hearing impairment
MedGen UID:
235586
Concept ID:
C1384666
Disease or Syndrome
A decreased magnitude of the sensory perception of sound.
Intellectual disability, mild
MedGen UID:
10044
Concept ID:
C0026106
Mental or Behavioral Dysfunction
Mild intellectual disability is defined as an intelligence quotient (IQ) in the range of 50-69.
Seizure
MedGen UID:
20693
Concept ID:
C0036572
Sign or Symptom
A seizure is an intermittent abnormality of nervous system physiology characterized by a transient occurrence of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain.
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.
Tracheal calcification
MedGen UID:
75539
Concept ID:
C0264324
Disease or Syndrome
Calcification (abnormal deposits of calcium) in the tracheal tissues.
Cerebral calcification
MedGen UID:
124360
Concept ID:
C0270685
Finding
The presence of calcium deposition within the cerebrum.
Calcification of the auricular cartilage
MedGen UID:
278057
Concept ID:
C1408806
Pathologic Function
Ossification affecting the external ear cartilage.
Costal cartilage calcification
MedGen UID:
344533
Concept ID:
C1855608
Finding
Calcification of the costal cartilages, which are bars of hyaline cartilage found at the anterior ends of the ribs which serve to prolong the ribs forward and contribute to the elasticity of the walls of the thorax.
Premature fusion of phalangeal epiphyses
MedGen UID:
344537
Concept ID:
C1855620
Finding
Fusion of the epiphysis and metaphysis of one or more phalanges prior to the normal age or stage of growth.
Malar flattening
MedGen UID:
347616
Concept ID:
C1858085
Finding
Underdevelopment of the malar prominence of the jugal bone (zygomatic bone in mammals), appreciated in profile, frontal view, and/or by palpation.
Epiphyseal stippling
MedGen UID:
349104
Concept ID:
C1859126
Finding
The presence of abnormal punctate (speckled, dot-like) calcifications in one or more epiphyses.
Airway obstruction
MedGen UID:
1387
Concept ID:
C0001883
Disease or Syndrome
Obstruction of conducting airways of the lung.
Emphysema
MedGen UID:
18764
Concept ID:
C0034067
Disease or Syndrome
A subcategory of chronic obstructive pulmonary disease (COPD). It occurs in people who smoke and suffer from chronic bronchitis. It is characterized by inflation of the alveoli, alveolar wall damage, and reduction in the number of alveoli, resulting in difficulty breathing.
Recurrent bronchitis
MedGen UID:
148159
Concept ID:
C0741796
Disease or Syndrome
An increased susceptibility to bronchitis as manifested by a history of recurrent bronchitis.
Cartilaginous ossification of larynx
MedGen UID:
344538
Concept ID:
C1855622
Finding
Ossification affecting the set of cartilages of larynx.
Sinusitis
MedGen UID:
20772
Concept ID:
C0037199
Disease or Syndrome
Inflammation of the paranasal sinuses owing to a viral, bacterial, or fungal infection, allergy, or an autoimmune reaction.
Chronic sinusitis
MedGen UID:
101751
Concept ID:
C0149516
Disease or Syndrome
A chronic form of sinusitis.
Recurrent otitis media
MedGen UID:
155436
Concept ID:
C0747085
Disease or Syndrome
Increased susceptibility to otitis media, as manifested by recurrent episodes of otitis media.
Hypernasal speech
MedGen UID:
107884
Concept ID:
C0566620
Finding
A type of speech characterized by the presence of an abnormally increased nasal airflow during speech associated with structural abnormality of the nasal passages.
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).
Depressed nasal bridge
MedGen UID:
373112
Concept ID:
C1836542
Finding
Posterior positioning of the nasal root in relation to the overall facial profile for age.
Deep philtrum
MedGen UID:
374311
Concept ID:
C1839797
Finding
Accentuated, prominent philtral ridges giving rise to an exaggerated groove in the midline between the nasal base and upper vermillion border.
Wide nasal bridge
MedGen UID:
341441
Concept ID:
C1849367
Finding
Increased breadth of the nasal bridge (and with it, the nasal root).
Midface retrusion
MedGen UID:
339938
Concept ID:
C1853242
Anatomical Abnormality
Posterior positions and/or vertical shortening of the infraorbital and perialar regions, or increased concavity of the face and/or reduced nasolabial angle.
Cartilaginous ossification of nose
MedGen UID:
340915
Concept ID:
C1855616
Finding

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVKeutel syndrome
Follow this link to review classifications for Keutel syndrome in Orphanet.

Professional guidelines

PubMed

Nitschke Y, Rutsch F
Curr Osteoporos Rep 2017 Aug;15(4):255-270. doi: 10.1007/s11914-017-0370-3. PMID: 28585220

Recent clinical studies

Etiology

Nitschke Y, Rutsch F
Curr Osteoporos Rep 2017 Aug;15(4):255-270. doi: 10.1007/s11914-017-0370-3. PMID: 28585220
Khosroshahi HE, Sahin SC, Akyuz Y, Ede H
Am J Med Genet A 2014 Nov;164A(11):2849-56. Epub 2014 Aug 13 doi: 10.1002/ajmg.a.36699. PMID: 25123378
Levaillant JM, Moeglin D, Zouiten K, Bucourt M, Burglen L, Soupre V, Baumann C, Jaquemont ML, Touraine R, Picard A, Vuillard E, Belarbi N, Oury JF, Verloes A, Vazquez MP, Labrune P, Delezoide AL, Gérard-Blanluet M
Prenat Diagn 2009 Feb;29(2):140-50. doi: 10.1002/pd.2167. PMID: 19156647
Meier M, Weng LP, Alexandrakis E, Rüschoff J, Goeckenjan G
Eur Respir J 2001 Mar;17(3):566-9. doi: 10.1183/09031936.01.17305660. PMID: 11405537

Diagnosis

Caiado H, Cancela ML, Conceição N
Biochimie 2023 Nov;214(Pt B):49-60. Epub 2023 Jun 10 doi: 10.1016/j.biochi.2023.06.004. PMID: 37307958
Weaver KN, El Hallek M, Hopkin RJ, Sund KL, Henrickson M, Del Gaudio D, Yuksel A, Acar GO, Bober MB, Kim J, Boyadjiev SA
Am J Med Genet A 2014 Apr;164A(4):1062-8. Epub 2014 Jan 23 doi: 10.1002/ajmg.a.36390. PMID: 24458983
Bosemani T, Felling RJ, Wyse E, Pearl MS, Tekes A, Ahn E, Poretti A, Huisman TA
Pediatr Radiol 2014 Jan;44(1):73-8. Epub 2013 Aug 7 doi: 10.1007/s00247-013-2768-0. PMID: 23917590
Miller SF
Pediatr Radiol 2003 Mar;33(3):186-9. Epub 2002 Dec 19 doi: 10.1007/s00247-002-0846-9. PMID: 12612818
Ziereisen F, De Munter C, Perlmutter N
Pediatr Radiol 1993;23(4):314-5. doi: 10.1007/BF02010925. PMID: 8414764

Therapy

Bosemani T, Felling RJ, Wyse E, Pearl MS, Tekes A, Ahn E, Poretti A, Huisman TA
Pediatr Radiol 2014 Jan;44(1):73-8. Epub 2013 Aug 7 doi: 10.1007/s00247-013-2768-0. PMID: 23917590
Cranenburg EC, VAN Spaendonck-Zwarts KY, Bonafe L, Mittaz Crettol L, Rödiger LA, Dikkers FG, VAN Essen AJ, Superti-Furga A, Alexandrakis E, Vermeer C, Schurgers LJ, Laverman GD
J Thromb Haemost 2011 Jun;9(6):1225-35. doi: 10.1111/j.1538-7836.2011.04263.x. PMID: 21435166

Prognosis

Caiado H, Cancela ML, Conceição N
Biochimie 2023 Nov;214(Pt B):49-60. Epub 2023 Jun 10 doi: 10.1016/j.biochi.2023.06.004. PMID: 37307958
Caiado H, Conceição N, Tiago D, Marreiros A, Vicente S, Enriquez JL, Vaz AM, Antunes A, Guerreiro H, Caldeira P, Cancela ML
Gene 2020 Jan 10;723:144120. Epub 2019 Oct 4 doi: 10.1016/j.gene.2019.144120. PMID: 31589964
Weaver KN, El Hallek M, Hopkin RJ, Sund KL, Henrickson M, Del Gaudio D, Yuksel A, Acar GO, Bober MB, Kim J, Boyadjiev SA
Am J Med Genet A 2014 Apr;164A(4):1062-8. Epub 2014 Jan 23 doi: 10.1002/ajmg.a.36390. PMID: 24458983
Sun LF, Chen X
Indian Pediatr 2012 Sep;49(9):759. doi: 10.1007/s13312-012-0141-2. PMID: 23024086
Meier M, Weng LP, Alexandrakis E, Rüschoff J, Goeckenjan G
Eur Respir J 2001 Mar;17(3):566-9. doi: 10.1183/09031936.01.17305660. PMID: 11405537

Clinical prediction guides

Gourgas O, Lemire G, Eaton AL, Alshahrani S, Duker AL, Li J, Carroll RS, Mackenzie S, Nikkel SM; Care4Rare Canada Consortium, Bober MB, Boycott KM, Murshed M
Nat Commun 2023 Nov 3;14(1):7054. doi: 10.1038/s41467-023-41651-6. PMID: 37923733Free PMC Article
Caiado H, Cancela ML, Conceição N
Biochimie 2023 Nov;214(Pt B):49-60. Epub 2023 Jun 10 doi: 10.1016/j.biochi.2023.06.004. PMID: 37307958
Caiado H, Conceição N, Tiago D, Marreiros A, Vicente S, Enriquez JL, Vaz AM, Antunes A, Guerreiro H, Caldeira P, Cancela ML
Gene 2020 Jan 10;723:144120. Epub 2019 Oct 4 doi: 10.1016/j.gene.2019.144120. PMID: 31589964
Weaver KN, El Hallek M, Hopkin RJ, Sund KL, Henrickson M, Del Gaudio D, Yuksel A, Acar GO, Bober MB, Kim J, Boyadjiev SA
Am J Med Genet A 2014 Apr;164A(4):1062-8. Epub 2014 Jan 23 doi: 10.1002/ajmg.a.36390. PMID: 24458983
Hur DJ, Raymond GV, Kahler SG, Riegert-Johnson DL, Cohen BA, Boyadjiev SA
Am J Med Genet A 2005 May 15;135(1):36-40. doi: 10.1002/ajmg.a.30680. PMID: 15810001

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