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An X-linked multiple congenital anomaly disorder with variable severity. The classic triad, which defines IFAP, is ichthyosis follicularis, atrichia, and photophobia. Some patients have additional features, including mental retardation, brain anomalies, Hirschsprung disease, corneal opacifications, kidney dysplasia, cryptorchidism, cleft palate, and skeletal malformations, particularly of the vertebrae, which constitutes BRESHECK syndrome.
Features include very common findings: Atrichia; and common findings: Ectrodactyly, Ichthyosis follicularis, and Photophobia. 63 total HPO annotations.
Organ System | Phenotype Count | Example Features |
|---|---|---|
Skin | 14 | Dry skin, Recurrent skin infections, Scaling skin |
Eyes | 5 | Opacification of the corneal stroma, Recurrent corneal erosions, Keratitis |
Brain and nerves | 5 | Seizure, Intellectual disability, Global developmental delay |
Kidneys and urinary system | 4 | Unilateral renal agenesis, Multicystic kidney dysplasia, Renal dysplasia |
Muscles | 2 | Olivopontocerebellar atrophy, Brain atrophy |
Growth and development | 2 | Short stature, Growth delay |
Head and neck | 2 | Cleft palate, Microcephaly |
Blood and immune system | 2 | Recurrent skin infections, Recurrent upper respiratory tract infections |
Bones and joints | 2 | Butterfly vertebrae, Sideways curvature of the spine (scoliosis) |
Arms and legs | 2 | Dystrophic fingernails, Postaxial hand polydactyly |
Heart and blood vessels | 2 | Hypertension, Atrial septal defect |
Ears | 1 | Hearing loss (hearing impairment) |
Lungs and breathing | 1 | Recurrent upper respiratory tract infections |
MBTPS2 encodes membrane bound transcription factor peptidase, site 2 (519 aa). Zinc metalloprotease that mediates intramembrane proteolysis of proteins such as ATF6, ATF6B, SREBF1/SREBP1 and SREBF2/SREBP2. Highest expression in Cells Cultured fibroblasts (16.6 TPM) and Brain Cerebellar Hemisphere (10.1 TPM).
IFAP syndrome 1, with or without BRESHECK syndrome is caused by mutations in the MBTPS2 gene on chromosome X.
The MBTPS2 protein participates in CREB3L2 translocates from the cytosol to the nucleus pathway.
MBTPS2 is classified as a druggable target (Enzyme, Protease, and Transcription Factor categories) with score 0.0.
Genetic testing for MBTPS2 is available. Testing is considered confirmatory for diagnosis.
Phenotype severity distribution: 1 very common feature, 3 common features.
No clinical trials have been registered for IFAP syndrome 1, with or without BRESHECK syndrome.
7 publications have been identified in PubMed for IFAP syndrome 1, with or without BRESHECK syndrome. Research spans Basic Science / Preclinical (57%), Review / Meta-Analysis (29%), and Case Report / Case Series (14%).
Butovich IA (2026). [PMID: 41130335](https://pubmed.ncbi.nlm.nih.gov/41130335/). *Exp Eye Res*. [Basic Science / Preclinical]
Kumar S (2026). [PMID: 41974659](https://pubmed.ncbi.nlm.nih.gov/41974659/). *Hum Genome Var*. [Basic Science / Preclinical]
Slater BA (2026). [PMID: 41492963](https://pubmed.ncbi.nlm.nih.gov/41492963/). *Clin Genet*. [Review / Meta-Analysis]
Iwaki T (2026). [PMID: 41980932](https://pubmed.ncbi.nlm.nih.gov/41980932/). *Hum Genome Var*. [Basic Science / Preclinical]
Ghaznavi A (2025). [PMID: 41458897](https://pubmed.ncbi.nlm.nih.gov/41458897/). *Clin Cosmet Investig Dermatol*. [Case Report / Case Series]
Butovich IA (2025). [PMID: 40778116](https://pubmed.ncbi.nlm.nih.gov/40778116/). *medRxiv*. [Basic Science / Preclinical]
Zhang J (2024). [PMID: 39912473](https://pubmed.ncbi.nlm.nih.gov/39912473/). *Eur J Dermatol*. [Review / Meta-Analysis]
Data assembled from 6 of 12 sources · Last updated Sep 20, 2026, 5:39 PM UTC
Online Mendelian Inheritance in Man
Genetic and Rare Diseases Info Center
Common questions about IFAP syndrome 1, with or without BRESHECK syndrome