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Eiken syndrome is a rare familial skeletal dysplasia characterized by multiple epiphyseal dysplasia, with extremely retarded ossification. It has been described in 6 members of a unique consanguineous family.
Features include always present findings: Decreased body weight, Broad femoral neck, Thickened calvaria, and Short stature and others. 37 total HPO annotations.
Organ System | Phenotype Count | Example Features |
|---|---|---|
Bones and joints | 4 | Broad femoral neck, Narrow pelvis bone, Skeletal dysplasia |
PTH1R function has not been fully characterized.
Eiken syndrome is associated with mutations in the PTH1R gene on chromosome 3.
Given the ultra-rare nature of PTH1R-JMC, studies detailing genotype-phenotype correlation have not been performed.
No consensus clinical diagnostic criteria for PTH1R-related Jansen metaphyseal chondrodysplasia (PTH1R-JMC) have been published. Short-limb short stature with flaring of the metaphyses in the extremities and hypercalcemia with low serum parathyroid hormone (PTH) levels are highly suggestive of PTH1R-JMC.
PTH1R-JMC should be suspected in probands with the following clinical, laboratory, and imaging findings and family history.
Clinical findings
Source:
No approved treatments are currently available for Eiken syndrome. The disease remains an area of unmet medical need.
No clinical practice guidelines for PTH1R-related Jansen metaphyseal chondrodysplasia (PTH1R-JMC) have been published. In the absence of published guidelines, the following recommendations are based on the authors' personal experience managing individuals with this disorder.
To establish the extent of disease and needs in an individual diagnosed with PTH1R-JMC, the evaluations summarized (if not performed as part of the evaluation that led to the diagnosis) are recommended.
To monitor existing manifestations, the individual's response to supportive care, and the emergence of new manifestations, the evaluations summarized in are recommended. There is no evidence informing the frequency of surveillance in individuals with PTH1R-JMC. The recommendations are based on the authors' experience. Table 6. PTH1R-Related Jansen Metaphyseal Chondrodysplasia: Recommended Surveillance
No clinical trials have been registered for Eiken syndrome.
3 publications have been identified in PubMed for Eiken syndrome. Research spans Review / Meta-Analysis (33%), Case Report / Case Series (33%), and Basic Science / Preclinical (33%).
Portales-Castillo I (2025). [PMID: 40904804](https://pubmed.ncbi.nlm.nih.gov/40904804/). *Front Endocrinol (Lausanne)*. [Review / Meta-Analysis]
Monahan G (2025). [PMID: 41031626](https://pubmed.ncbi.nlm.nih.gov/41031626/). *J Bone Miner Res*. [Basic Science / Preclinical]
Calder AD (2024). [PMID: 39276366](https://pubmed.ncbi.nlm.nih.gov/39276366/). *J Bone Miner Res*. [Case Report / Case Series]
Data assembled from 7 of 12 sources · Last updated Sep 18, 2026, 7:14 PM UTC
Online Mendelian Inheritance in Man
European rare disease database
Genetic and Rare Diseases Info Center
Common questions about Eiken syndrome
2 |
Intellectual disability, Febrile seizure (within the age range of 3 months to 6 years) |
Growth and development | 1 | Short stature |
Lab test results | 1 | Elevated circulating alkaline phosphatase concentration |
Head and neck | 1 | Thick lower lip vermilion |
Arms and legs | 1 | Short middle phalanx of finger |
PTH1R-related Jansen metaphyseal chondrodysplasia (PTH1R-JMC) is an ultra-rare disorder characterized by short-limb short stature with swelling of the joints in the extremities and hypercalcemia with low-normal or suppressed parathyroid hormone (PTH) . To date, at least 30 individuals have been identified with a pathogenic variant in PTH1R . There is a wide spectrum of clinical variability. However, the natural history of PTH1R-JMC and the full spectrum of its manifestations has not been adequately described. Skeletal features may not be clinically evident at birth. Postnatal growth failure and accompanying skeletal deformities typically become apparent within early childhood . Skeletal deformities may contribute to delayed motor milestones such as pulling to stand or walking .
Source: GeneReviews — "PTH1R-Related Jansen Metaphyseal Chondrodysplasia"
Source: GeneReviews — "PTH1R-Related Jansen Metaphyseal Chondrodysplasia"
PTH1R-JMC has a high penetrance, and individuals with a PTH1R-JMC-related pathogenic variant are likely to develop some clinical and/or radiographic manifestations. There is wide heterogeneity in the phenotype in terms of clinical manifestations, onset, and severity. Short-limbed dwarfism appears to be a highly penetrant manifestation, seen in almost all affected individuals .
Source: GeneReviews — "PTH1R-Related Jansen Metaphyseal Chondrodysplasia"
Genetic disorders of interest in the differential diagnosis of PTH1R-related Jansen metaphyseal chondrodysplasia (PTH1R-JMC) are listed in .
Table 3.
Genes of Interest in the Differential Diagnosis of PTH1R-Related Jansen Metaphyseal Chondrodysplasia
Gene(s) | Disorder | MOI | Features of Disorder
Overlapping w/PTH1R-JMC | Distinguishing from PTH1R-JMC
| Schmid metaphyseal chondrodysplasia | AD | • Short stature
Metaphyseal dysplasia
| No disturbances of mineral-ion homeostasis
COL2A1FN11 | Spondylometaphyseal dysplasia, corner fracture type | AD | • Short stature
Irregular metaphysis
Bowed legs
| Hypochondroplasia | AD | • Short stature
Bowed legs
PHEX | X-linked hypophosphatemia (XLH) | XL | • Short stature
Bowed legs
Hypophosphatemia
Source: GeneReviews — "PTH1R-Related Jansen Metaphyseal Chondrodysplasia"
Genetic testing for PTH1R is available. Testing is considered confirmatory for diagnosis.
Table 4.
PTH1R-Related Jansen Metaphyseal Chondrodysplasia: Recommended Evaluations Following Initial Diagnosis
System/Concern | Evaluation | Comment
| • Referral to orthopedist physiatrist for mgmt
Skeletal radiographs to determine timing extent of surgical procedures to improve alignment range of motion
|
| Assess growth incl head circumference. |
| • CT skull to help determine need for intervention in those w/craniosynostosis
Referral to oromaxillofacial surgeon or neurosurgeon for mgmt in those w/craniosynostosis
|
| • Dental exam radiographs
Referral to oromaxillofacial specialist as needed
|
| Referral to otolaryngologist audiologist for audiogram tympanogram |
| Referral to ophthalmologist for visual field exam, optical coherence tomography, orbital MRI (if indicated) to assess for optic canal narrowing |
| • Referral to endocrinologist for laboratory assessment i...
Source: GeneReviews — "PTH1R-Related Jansen Metaphyseal Chondrodysplasia"
Contact sports and other high-risk activities should likely be avoided in those with significant skeletal involvement. Individuals with PTH1R-JMC should be encouraged to participate in low-impact exercise as tolerated, such as swimming.
Source: GeneReviews — "PTH1R-Related Jansen Metaphyseal Chondrodysplasia"
PTH-IA is a 30-amino-acid peptide expected to act as an inverse agonist, decreasing the proportion of parathyroid hormone/parathyroid hormone-related peptide receptors (PTH1R) in the constitutively active state, leading to a reduction in basal cAMP signaling. To date, information on PTH-IA is limited to cell and animal models . An Investigational New Drug approval was granted to a Phase I/II study evaluating the safety and efficacy of PTH-IA, which is expected to start enrolling soon. Search ClinicalTrials.gov in the US and EU Clinical Trials Register in Europe for access to information on clinical studies for a wide range of diseases and conditions.
Source: GeneReviews — "PTH1R-Related Jansen Metaphyseal Chondrodysplasia"
View trials for Eiken syndrome
System/Concern |
|---|
Evaluation |
|---|
Frequency |
|---|
Skeletal abnormalities | Physical exam | Every 6-12 mos in children adolescents, then annually in adults Limb length measurement, growth assessment incl height weight |
Hearing | Audiogram tympanogram | Every 1-2 yrs Eyes/ Visual deficits |
Airway | Assess for signs symptoms of dyspnea. | At each visit Consider pulmonary function testing. |
Blood pressure/ Cardiovascular issues | Blood pressure measurement | At each visit Consider echocardiogram in those w/dyspnea or severe scoliosis. |
Source: GeneReviews — "PTH1R-Related Jansen Metaphyseal Chondrodysplasia"
Phenotype severity distribution: 32 always present features.
Estimated prevalence: <1 in 1,000,000 (VERY_RARE).