Kisho is an information platform, not a medical provider. Nothing on this site constitutes medical advice, diagnosis, or treatment recommendations. All content is aggregated from publicly available sources (including ClinicalTrials.gov, PubMed, FDA.gov, and Orphanet) and is provided for informational purposes only. Clinical trial eligibility, treatment decisions, and any health-related actions should always be discussed with a qualified healthcare professional. Kisho does not endorse any specific therapy, organization, or clinical trial. Terms of use · Privacy policy
Baller-Gerold syndrome is characterized by the association of coronal craniosynostosis with radial ray anomalies (oligodactyly, aplasia or hypoplasia of the thumb, aplasia or hypoplasia of the radius).
Features include common findings: Absent thumb, Brachycephaly, Hypoplasia of the radius, and Wide anterior fontanel and others; and sometimes findings: Severe short stature, Astigmatism, Brachyturricephaly, and Lambdoidal craniosynostosis and others. 82 total HPO annotations.
Organ System | Phenotype Count | Example Features |
|---|---|---|
Head and neck | 7 | Lambdoidal craniosynostosis, Sagittal craniosynostosis, Coronal craniosynostosis |
RECQL4 function has not been fully characterized.
Baller-Gerold syndrome is associated with mutations in the RECQL4 gene on chromosome 8.
No formal genotype-phenotype correlations have been made owing to the small number of affected individuals reported to date.
Baller-Gerold syndrome should be suspected in individuals with a combination of the following findings:
Coronal craniosynostosis, manifest clinically as abnormal shape of the skull (brachycephaly) with ocular proptosis and prominent forehead and confirmed by skull x-ray or (preferably) 3D-CT reconstruction
When the coronal sutures are fused, the orbit is pulled forward. The coronal sutures cannot be discerned on the frontal view, and the same holds true for the lambdoidal sutures.
No approved treatments are currently available for Baller-Gerold syndrome. The disease remains an area of unmet medical need.
To establish the extent of disease in an individual diagnosed with Baller-Gerold syndrome (BGS), the following are recommended if they have not already been completed:
Consultation with a clinical geneticist and/or genetic counselor
Although lymphoma has only been described in one individual with BGS to date , it is known that individuals with RECQL4 pathogenic variants associated with both Rothmund-Thomson syndrome and RAPADILINO syndrome are at increased risk for developing osteosarcoma and lymphoma. Given the potential risk, it would be reasonable for affected individuals with BGS and RECQL4 pathogenic variants (or their guardians) to be aware of the signs and symptoms associated with these malignancies. These signs and symptoms may include bone pain, swelling, and/or limp for osteosarcoma, and lymph node enlargement or generalized symptoms such as fever or unexplained weight loss for lymphoma.
No clinical trials have been registered for Baller-Gerold syndrome.
6 publications have been identified in PubMed for Baller-Gerold syndrome. Research spans Basic Science / Preclinical (50%), Case Report / Case Series (33%), and Review / Meta-Analysis (17%).
Nunes SC (2025). [PMID: 40600615](https://pubmed.ncbi.nlm.nih.gov/40600615/). *Am J Hematol*. [Case Report / Case Series]
Buco PAV (2025). [PMID: 40777487](https://pubmed.ncbi.nlm.nih.gov/40777487/). *bioRxiv*. [Basic Science / Preclinical]
Beck CW (2025). [PMID: 40819286](https://pubmed.ncbi.nlm.nih.gov/40819286/). *G3 (Bethesda)*. [Basic Science / Preclinical]
Kanai Y (2025). [PMID: 39324487](https://pubmed.ncbi.nlm.nih.gov/39324487/). *Am J Med Genet A*. [Case Report / Case Series]
Sun M (2025). [PMID: 40692799](https://pubmed.ncbi.nlm.nih.gov/40692799/). *Front Pediatr*. [Review / Meta-Analysis]
Thakur BL (2025). [PMID: 40319014](https://pubmed.ncbi.nlm.nih.gov/40319014/). *Nat Commun*. [Basic Science / Preclinical]
Data assembled from 7 of 12 sources · Last updated Sep 19, 2026, 5:32 AM UTC
Online Mendelian Inheritance in Man
European rare disease database
Genetic and Rare Diseases Info Center
Common questions about Baller-Gerold syndrome
Bones and joints | 4 | Aplasia of metacarpal bones, Abnormal vertebral morphology, Sideways curvature of the spine (scoliosis) |
Growth and development | 3 | Severe short stature, Short stature, Severe intrauterine growth retardation |
Eyes | 3 | Strabismus, Optic nerve hypoplasia, Damage to the optic nerve (optic atrophy) |
Brain and nerves | 3 | Seizure, Hydrocephalus, Intellectual disability |
Muscles | 2 | Dermal atrophy, Damage to the optic nerve (optic atrophy) |
Digestive system | 2 | Feeding difficulties, Anomalous splenoportal venous system |
Ears | 2 | Conductive hearing impairment, Mixed hearing impairment |
Arms and legs | 2 | Radial deviation of the hand, Aphalangy of the hands |
Lungs and breathing | 1 | Obstructive sleep apnea |
Skin | 1 | Erythema |
Heart and blood vessels | 1 | Abnormal heart morphology |
Kidneys and urinary system | 1 | Abnormality of the kidney |
Since the original description of Baller-Gerold syndrome (BGS) by and , fewer than 40 individuals with BGS have been reported [, , , , , ]. BGS can be suspected at birth in an infant with craniosynostosis and upper limb abnormality. The coronal suture is most commonly affected; the metopic, lambdoid, and sagittal sutures may also be involved alone or in combination .
Craniofacial findings associated with craniosynostosis
Brachycephaly
Proptosis
Prominent forehead
Large fontanelles
Additional craniofacial features
Concave nasal ridge
Short nose
Narrow mouth with thin vermilion of the lips
High arched palate
Skeletal anomalies
Source: GeneReviews — "Baller-Gerold Syndrome"
Source: GeneReviews — "Baller-Gerold Syndrome"
Radial ray defect, manifest as aplasia or hypoplasia of the thumb, and/or aplasia or hypoplasia of the radius
Note: Radiographs may be necessary for confirmation of minor radial ray malformations.
• Growth restriction
Source: GeneReviews — "Baller-Gerold Syndrome"
The major differential diagnosis for Baller-Gerold syndrome (BGS) comprises the allelic disorders Rothmund-Thomson syndrome and RAPADILINO syndrome (OMIM 266280). (See .) See . Additional conditions to consider are included in . Table 2. Disorders to Consider in the Differential Diagnosis of BGS
Differential Disorder | Gene(s) | MOI | Clinical Features of the Differential Disorder |
|---|---|---|---|
Overlapping w/BGS | Distinguishing from BGS Fanconi anemia (FA) | Various1 | ARADXL |
Chromosome breakage after incubation w/clastogens Fetal valproate syndrome (OMIM 609442) | NA | NA | Radial hypo-or aplasia; Craniosynostosis (metopic) |
Neural tube defect VACTERL (OMIM 192350) | Unknown | Sporadic | Thumb hypo- or aplasia |
SALL4 | AD | Radial ray malformations | Shape of pinnae; Anorectal anomalies Holt-Oram syndrome |
TBX5 | AD | Upper-extremity malformations may involve radial bones. | Cardiac malformation /or conduction defect present; No craniosynostosis |
Thrombocytopenia-absent radius (TAR) syndrome | See footnote 2. | See footnote 2. | Shortening of upper limbs, sometimes severe |
TWIST | AD | Craniosynostosis; Occasional radial defects (radioulnar synostosis or hypoplastic radius) | Facial asymmetry; Small ears w/prominent crus; Brachydactyly; Partial 2-3 syndactyly of hand Roberts syndrome |
ESCO2 | AR | Radial aplasia/hypoplasia; Occasional craniosynostosis | Shortening of 4 limbs |
Intellectual disability CDAGS syndrome (OMIM 603116) | Unknown | AR | Craniosynostosis; Porokeratosis resembling poikiloderma |
Source: GeneReviews — "Baller-Gerold Syndrome"
Genetic testing for RECQL4 is available. Testing is considered confirmatory for diagnosis.
Neurosurgery or craniofacial specialist consultation for evaluation of craniosynostosis
Orthopedic surgery and occupational therapy assessment to evaluate hand and arm function and need for surgery
Dermatology evaluation if poikiloderma develops
Craniosynostosis should be managed by neurosurgical/craniofacial specialists. When craniosynostosis is bilateral, surgery is usually performed before age six months. Pollicization of the index finger to restore a functional grasp has had satisfactory results in a number of persons with absence of the thumb . However, many children with aplasia of the thumb are able to function without orthopedic surgical intervention. If poikiloderma is present, sensible use of sunscreens may protect against potential risk for skin cancer due to UV exposure. If cancer arises, medical care should be sought from an oncologist familiar with the type of cancer.
Although lymphoma has only been described in one individual with BGS to date , it is known that individuals with RECQL4 pathogenic variants associated with both Rothmund-Thomson syndrome and RAPADILINO syndrome are at increased risk for developing osteosarcoma and lymphoma.
Source: GeneReviews — "Baller-Gerold Syndrome"
Excessive sun exposure should be avoided because of the theoretic increased risk for skin cancer.
Source: GeneReviews — "Baller-Gerold Syndrome"
Search ClinicalTrials.gov in the US and EU Clinical Trials Register in Europe for information on clinical studies for a wide range of diseases and conditions. Note: There may not be clinical trials for this disorder.
Source: GeneReviews — "Baller-Gerold Syndrome"
View trials for Baller-Gerold syndrome
Source: GeneReviews — "Baller-Gerold Syndrome"
Phenotype severity distribution: 8 common features.
Estimated prevalence: <1 in 1,000,000 (VERY_RARE).
AI-curated news mentioning Baller-Gerold syndrome
Updated Jul 21, 2026
FDA approved Casgevy CRISPR gene therapy for children as young as 2 with sickle cell disease on July 1, 2026. Here's what families need to know about this milestone. Approximately 5,500 additional American children are now eligible for this established one-time therapy, according to Vertex Pharmaceuticals, Casgevy's developer. Casgevy also covers transfusion-dependent beta-thalassemia in this new age indication. Sickle cell disease is a lifelong inherited blood disorder that warps red blood cells into stiff, crescent shapes that can block blood flow, starving organs and tissues of oxygen. The world's first CRISPR-based gene therapy has been approved for children as young as two years old, opening the possibility of a single, potentially curative treatment to thousands of American children with sickle cell disease before years of organ damage can narrow what medicine can do for them. Families with children aged 2 and older who have sickle cell disease should speak with their pediatric hematologist about whether Casgevy is appropriate to consider at this stage of their child's disease. Ask specifically which authorized treatment centers perform Casgevy in your region. Treatment is available only at specialized sites, and geographic access remains limited. Contact your child's insurance plan or Medicaid office to ask about coverage. Medicaid coverage for gene therapies varies by state, and some states have developed outcomes-based payment models for high-cost therapies. "With today's decision, pediatric patients as young as 2 years of age can now access a critical additional treatment option to treat these debilitating, life-threatening diseases," said Karim Mikhail, acting director of the Office of Therapeutic Products at the FDA's Center for Biologics Evaluation and Research, according to the FDA press announcement. Casgevy is a non-viral, ex vivo CRISPR/Cas9 gene-edited cell therapy.