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Agnathia-holoprosencephaly-situs inversus syndrome is an extremely rare and fatal association syndrome, characterized by absence of the mandible, cerebral malformations with facial anomalies related to a defect in cleavage in the embryonic brain (e.g. synophthalmia, malformed and low-set ears fused in midline (otocephaly), agenesis of the olfactory bulbs, microstomia, hypoglossia/aglossia) and situs inversus partialis or totalis.
Features include always present findings: Laryngeal hypoplasia, Pulmonary hypoplasia, Tracheomalacia, and Hypoplasia of the epiglottis and others; and very common findings: Situs inversus totalis, Mandibular aplasia, Narrow mouth, and Agenesis of corpus callosum and others. 31 total HPO annotations.
Organ System | Phenotype Count | Example Features |
|---|---|---|
Head and neck | 2 | Mandibular aplasia, Cleft palate |
PRRX1 function has not been fully characterized.
Agnathia-otocephaly complex is associated with mutations in the PRRX1 gene on chromosome 1.
Genetic testing for PRRX1 is available. Testing is considered confirmatory for diagnosis.
Phenotype severity distribution: 9 always present features, 19 very common features.
Estimated prevalence: <1 in 1,000,000 (VERY_RARE).
No clinical trials have been registered for agnathia-otocephaly complex.
4 publications have been identified in PubMed for agnathia-otocephaly complex. Research spans Case Report / Case Series (75%) and Basic Science / Preclinical (25%).
Corona-Rivera JR (2025). [PMID: 40079387](https://pubmed.ncbi.nlm.nih.gov/40079387/). *American journal of medical genetics. Part A*. [Case Report / Case Series]
Velisavljev-Filipovic GM (2025). [PMID: 40709982](https://pubmed.ncbi.nlm.nih.gov/40709982/). *Diseases (Basel, Switzerland)*. [Case Report / Case Series]
Konukcu B (2024). [PMID: 39697072](https://pubmed.ncbi.nlm.nih.gov/39697072/). *Birth defects research*. [Case Report / Case Series]
Kock KH (2024). [PMID: 38600112](https://pubmed.ncbi.nlm.nih.gov/38600112/). *Nature communications*. [Basic Science / Preclinical]
Data assembled from 6 of 12 sources · Last updated Sep 19, 2026, 6:43 AM UTC
Online Mendelian Inheritance in Man
European rare disease database
Genetic and Rare Diseases Info Center
Common questions about agnathia-otocephaly complex
Lungs and breathing |
2 |
Pulmonary hypoplasia, Respiratory distress |
Eyes | 1 | Abnormality of the eye |
Heart and blood vessels | 1 | Secundum atrial septal defect |
Ears | 1 | Conductive hearing impairment |
Brain and nerves | 1 | Abnormal cranial nerve morphology |