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A disorder resulting from an abnormality in the immune system.
No HPO annotations are available for this condition.
Age of onset: adulthood, childhood, infancy.
With the current widespread use of multigene panels and comprehensive genomic testing, it has become apparent that the phenotypic spectrum of biallelic EPG5 pathogenic variants causing EPG5-related disorder represents a continuum of variable severity. Vici syndrome (defined as a neurodevelopmental disorder with multisystem involvement characterized by the combination of agenesis of the corpus callosum, cataracts, hypopigmentation, cardiomyopathy, combined immunodeficiency, microcephaly, and failure to thrive; see Suggestive Findings, ) is at the most severe end of the spectrum; however, milder, attenuated neurodevelopmental phenotypes with a variable degree of multisystem involvement are increasingly recognized. To date, around 90 individuals have been identified with biallelic EPG5 pathogenic variants. These reports have mostly shown individuals toward the more severe end of the phenotypic spectrum, while reports of individuals with only neurologic disease but no more extensive multisystem involvement are scarce . Several sub-phenotypes (e.g., those presenting with predominantly immunologic features) remain very likely underdiagnosed and should be carefully evaluated in future genotype-phenotype correlation studies. The description of the phenotypic spectrum associated with EPG5-related disorders is based on clinical reports published to date . Table 2. EPG5-Related Disorder: Frequency of Select Features Feature | % of Personsw/Feature Most common findings
At the more severe end of the spectrum of EPG5-related disorder, clinically defined classic Vici syndrome commonly involves the common combined presence of agenesis of corpus callosum, cataract, cardiomyopathy, hypopigmentation, primary immunodeficiency, failure to gain weight, and microcephaly. The milder end of the spectrum involves primarily neurodevelopmental and/or neurologic features with variable but (in general) less pronounced multisystem involvement . EPG5-related disorder should be suspected in individuals with the following suggestive findings across the phenotypic spectrum and family history.
No approved treatments are currently available for immune system disorder. The disease remains an area of unmet medical need.
No comprehensive clinical practice guidelines for EPG5-related disorder have been published; however, a number of investigations for the diagnosis and surveillance of individuals with clinically defined classic Vici syndrome have been recommended [, Table 2] (full text). These evaluations are presented in more detail below. Evaluations Following Initial Diagnosis To establish the extent of disease and needs in an individual diagnosed with EPG5-related disorder, the evaluations summarized (if not performed as part of initial diagnostic process) are recommended. Table 4. Recommended Evaluations Following Initial Diagnosis in Individuals with EPG5-Related Disorder
To identify the multidisciplinary evaluations (and their frequency) for assessing disease progression, optimizing functional abilities and communication skills, and addressing other disease manifestations, see . Table 6. Recommended Surveillance for Individuals with EPG5-Related Disorder
119 clinical trials registered, 40 recruiting. Interventions under study include biologic therapy, other interventions, drug therapy, and medical devices. Pipeline includes 3 PHASE4, 10 PHASE2, 24 PHASE1. Research is sponsored by a mix of industry and academic institutions.
NCT ID | Title | Phase | Sponsor | Status |
|---|---|---|---|---|
[NCT05982925](https://clinicaltrials.gov/study/NCT05982925) |
Data assembled from 4 of 12 sources · Last updated Sep 19, 2026, 4:50 AM UTC
Brain malformations | Corpus callosum agenesis or thinning | 100% |
|---|---|---|
Neuronal migration abnormalities or polymicrogyria | 20% Neurologic | Developmental delay/ Intellectual disability |
Microcephaly | 90% Cardiacinvolvement | Cardiomyopathy |
Congenital heart defects | 8%-15% Ophthalmologicinvolvement2 | Cataract |
Source: GeneReviews — "EPG5-Related Disorder"
Neurodevelopmental manifestations
Source: GeneReviews — "EPG5-Related Disorder"
The differential diagnosis of EPG5-related disorder depends on the presenting features and severity on the phenotypic spectrum. Differential diagnoses with features overlapping those of individuals with phenotypes on the more severe end of the disorder spectrum are summarized in . Note: For more information on the immunologic abnormalities in EPG5-related disorder and related differential diagnoses, see and . Table 3. Multisystem Disorders in the Differential Diagnosis of EPG5-Related Disorder
Gene(s) | Differential Disorder | MOI | Phenotype |
|---|---|---|---|
AP3D1 | Hermansky-Pudlak syndrome types 2 (AP3B1) 10 (AP3D1) | AR | Primary immunodeficiency w/(oculo-)cutaneous hypopigmentation, DD, seizures, failure to gain weight; Not assoc w/ACC or cardiomyopathy CTDP1 |
Congenital cataracts, facial dysmorphism, neuropathy | AR | Cataracts, myopathy, neuropathy, DD, brain malformation; Not assoc w/cardiomyopathy, immunodeficiency, or hypopigmentation | — |
LAMTOR2 | LAMTOR2-associated primary immunodeficiency (OMIM 610798) | AR | Primary immunodeficiency w/ of memory B cells, cutaneous hypopigmentation, coarse facies, short stature; Not assoc w/neurologic features (DD, mvmt disorders) or brain malformations LYST |
Chediak-Higashi syndrome | AR | Primary immunodeficiency w/hemophagocytic lymphohistiocytosis, oculocutaneous albinism, failure to gain weight, delayed myelination, cortical atrophy, mvmt disorder, myopathy | — |
Not assoc w/ACC or cardiomyopathy PI4K2A1PI4KA2 | PI4 kinase deficiency (See PI4KA-Related Disorder.) | AR | Neurodevelopmental disabilities, dysplastic corpus callosum, immunodeficiency |
RAB27A | Griscelli syndrome type 2 (OMIM 607624) | AR | Primary immunodeficiency w/hemophagocytic lymphohistiocytosis, cutaneous albinism, mvmt disorder; Not assoc w/ACC or cardiomyopathy RAB3GAP1 RAB3GAP2 RAB18 |
TBC1D20 | Warburg micro syndrome (See RAB18 Deficiency.) | AR | Dysgenesis of corpus callosum, DD, mvmt disorder, microcephaly; Not assoc w/immunodeficiency or hypopigmentation SIL1 |
Marinesco-Sjgren syndrome | AR | DD, cataracts, myopathy, neuropathy, mvmt disorder, skeletal deformities; Not assoc w/cardiomyopathy, immunodeficiency, or hypopigmentation | — |
SNAP29 | SNAP29-associated cerebral dysgenesis (OMIM 609528) | AR | Dysgenesis of corpus callosum, neuronal migration abnormalities, progressive microcephaly, DD, ichthyosis, palmoplantar keratoderma; Not assoc w/immunodeficiency or cardiomyopathy |
VPS45 | VPS45-associated immunodeficiency (OMIM 615285) | AR | Primary immunodeficiency w/failure to gain weight DD; Not assoc w/hypopigmentation or brain malformations Adapted from , Table 3 ACC = agenesis of the corpus callosum; AR = autosomal recessive; DD = developmental delay; MOI = mode of inheritance 1. 2. |
Source: GeneReviews — "EPG5-Related Disorder"
Biomarker and diagnostic research for immune system disorder has been reported in the published literature.
System/Concern | Evaluation | Comment |
|---|---|---|
involvement | By pediatric neurologist/ developmental pediatrician | To evaluate development of motor, speech, language abilities; Brain MRI for agenesis/dysgenesis of corpus callosum other brain malformations; Consider specific treatment for mvmt disorders (e.g., PT, botulinum toxin or baclofen for spasticity, /or trihexyphenidyl for dystonia). |
Musculoskeletal | By orthopedics | To assess for contractures, scoliosis, foot deformities By PT |
weight | By pediatric gastroenterologist/ speech-language pathologist/ dietician | To incl eval of aspiration risk nutritional status; Consider eval for gastric tube placement in those w/dysphagia /or risk of aspiration, or poor weight gain. Ophthalmologic |
involvement | By pediatric ophthalmologist | To assess visual acuity, refractive error, strabismus, more complex findings (e.g., cataracts, fundus changes consistent w/ocular albinism) that may require referral for subspecialty care /or low vision services Sensorineural |
hearing loss | By audiologist | To evaluate degree of hearing loss as indicated Cardiac |
involvement | By pediatric cardiologist | To assess for cardiac malformations /or degree/type of cardiomyopathy Immuno- |
deficiency | By pediatric immunologist | To evaluate for symptoms of primary immunodeficiency; To arrange specific testing (i.e., immunoglobulins, T, B, NK cell numbers function); To assess for thymus aplasia/hypoplasia on chest x-ray Pulmonary |
function | By pediatric pulmonologist | To evaluate for aspiration risk secretion mgmt; Consider antibiotic prophylaxis. Hepatic |
function | By pediatrician; referral to hepatologist as needed | To assess liver function; liver ultrasound as indicated Renal |
function | By pediatrician; referral to nephrologist as needed | To assess kidney function as indicated Thyroid |
function | By pediatrician; referral to endocrinologist as needed | To check for thyroid aplasia/hypoplasia; To assess thyroid function as clinically indicated Ethics |
consultation | Clinical ethics services | To assess health care decisions in context of best interest of child values preferences of family Genetic |
counseling | By genetics professionals1 | To inform affected persons their families re nature, MOI, implications of EPG5-related disorder to facilitate medical personal decision making Family support resources |
Source: GeneReviews — "EPG5-Related Disorder"
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. Note: There may not be clinical trials for this disorder.
Source: GeneReviews — "EPG5-Related Disorder"
119 trials found
System/Concern
Evaluation |
|---|
Frequency |
|---|
hearing loss | Brain stem evoked responses in case of suspected hearing impairment | As clinically indicated Cardiac |
involvement | Echocardiography per treating cardiologist | Every 6 mos Pulmonary function |
Thyroid function | Monitor for hypothyroidism. | As clinically indicated Renal function |
Liver function | Monitor liver function. | As clinically indicated Family support |
resources | Monitor educational/family needs. | Every 12 mos Adapted from , Table 2 |
Source: GeneReviews — "EPG5-Related Disorder"
Longitudinal Cortical Demyelination in Multiple Sclerosis and Related Disorders |
— |
Icahn School of Medicine at Mount Sinai |
RECRUITING |
[NCT04452305](https://clinicaltrials.gov/study/NCT04452305) | Spermatogonial Stem Cell (SSC) Transplant and Testicular Tissue Grafting | NA | University of Pittsburgh | RECRUITING |
[NCT05875155](https://clinicaltrials.gov/study/NCT05875155) | Ovarian Tissue Cryopreservation for Fertility Preservation | — | University of Pittsburgh | RECRUITING |
[NCT06503224](https://clinicaltrials.gov/study/NCT06503224) | An Exploratory Clinical Study of SCAR02 Targeting BCMA and CD19 for the Treatment of Refractory Autoimmune Diseases | NA | The First Affiliated Hospital of University of Science and Technology of China | RECRUITING |
[NCT05883371](https://clinicaltrials.gov/study/NCT05883371) | IMPACT - AndHealth Autoimmune Research Registry | — | AndHealth | RECRUITING |
178 publications have been identified in PubMed for immune system disorder. Research spans Review / Meta-Analysis (66%), Basic Science / Preclinical (13%), and Epidemiology / Natural History (7%).
Research Type | Count | % of Total |
|---|---|---|
Research summaries | 118 | 66% |
Laboratory research | 23 | 13% |
Disease patterns and progression | 12 | 7% |
Patient case studies | 9 | 5% |
Testing and diagnosis research | 7 | 4% |
Other research | 6 | 3% |
New treatment approaches | 2 | 1% |
Clinical study results | 1 | 1% |
Ghosh R (2026). [PMID: 41724404](https://pubmed.ncbi.nlm.nih.gov/41724404/). *J Allergy Clin Immunol*. [Diagnostic / Biomarker]
Kayama H (2026). [PMID: 41714083](https://pubmed.ncbi.nlm.nih.gov/41714083/). *Prog Mol Biol Transl Sci*. [Review / Meta-Analysis]
Fiumara M (2026). [PMID: 41175032](https://pubmed.ncbi.nlm.nih.gov/41175032/). *Curr Opin Rheumatol*. [Review / Meta-Analysis]
Li YR (2026). [PMID: 41383015](https://pubmed.ncbi.nlm.nih.gov/41383015/). *Mol Ther*. [Review / Meta-Analysis]
Eindor-Abarbanel A (2026). [PMID: 41536225](https://pubmed.ncbi.nlm.nih.gov/41536225/). *J Pediatr Gastroenterol Nutr*. [Basic Science / Preclinical]
Walsh MJ (2026). [PMID: 41602911](https://pubmed.ncbi.nlm.nih.gov/41602911/). *iScience*. [Diagnostic / Biomarker]
Amado C (2026). [PMID: 40975490](https://pubmed.ncbi.nlm.nih.gov/40975490/). *Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology*. [Review / Meta-Analysis]
Deng W (2026). [PMID: 41809776](https://pubmed.ncbi.nlm.nih.gov/41809776/). *Translational andrology and urology*. [Epidemiology / Natural History]
Li H (2026). [PMID: 41766899](https://pubmed.ncbi.nlm.nih.gov/41766899/). *Front Immunol*. [Review / Meta-Analysis]
Peng XP (2026). [PMID: 42187544](https://pubmed.ncbi.nlm.nih.gov/42187544/). *NEJM Evid*. [Review / Meta-Analysis]
AI-curated news mentioning immune system disorder
Updated Aug 5, 2026
Attovia Therapeutics Inc. jumped 29% in its trading debut, after the early-stage drug developer focused on immune system diseases raised $289 million in a US initia… The company’s shares ended at $21.90 each on Wednesday, above its IPO price of $17 apiece. The trading gives the company a market value of $942.3 million, based on the outstanding shares in its filings. ... We apologize, but this video has failed to load. Try refreshing your browser, or tap here to see other videos from our team. ... Attovia is developing drugs using a technology platform and patents licensed from Alamar Biosciences Inc., a maker of medical devices focused on studying proteins and disease detection. IPOs of biotechnology and pharmaceutical companies have been among the strongest performing new listings this year, led by pattern hair loss-focused Veradermics Inc.’s more than 550% increase since its debut in February and a 178% gain in the shares of blood disorder specialist Hemab Therapeutics Inc. (Bloomberg) — Attovia Therapeutics Inc. jumped 29% in its trading debut, after the early-stage drug developer focused on immune system diseases raised $289 million in a US initial public offering. Attovia’s IPO was led by Morgan Stanley, Leerink Partners, Citigroup Inc. and Royal Bank of Canada.
/PRNewswire/ -- Eli Lilly and Company (NYSE: LLY) today announced that the U.S. Food and Drug Administration (FDA) has granted Breakthrough Therapy designation... Olomorasib is currently being studied in the LOXO-RAS-20001 Phase 1/2 trial (NCT04956640) in patients with KRAS G12C-mutant NSCLC and other advanced solid tumors and in the pivotal, registrational SUNRAY-01 global study (NCT06119581) investigating olomorasib in combination with pembrolizumab with or without chemotherapy for first-line treatment of KRAS G12C-mutant advanced NSCLC, and the SUNRAY-02 (NCT06890598) global study investigating olomorasib in combination with standard of care immunotherapy in patients with resected or unresectable KRAS G12C-mutant NSCLC. For additional information about olomorasib clinical trials, please refer to clinicaltrials.gov. ... What is Breakthrough Therapy designation and why does it matter? Harnessing the power of biotechnology, chemistry and genetic medicine, our scientists are urgently advancing new discoveries to solve some of the world's most significant health challenges: redefining diabetes care; treating obesity and curtailing its most devastating long-term effects; advancing the fight against Alzheimer's disease; providing solutions to some of the most debilitating immune system disorders; and transforming the most difficult-to-treat cancers into manageable diseases. With each step toward a healthier world, we're motivated by one thing: making life better for millions more people. That includes delivering innovative clinical trials that reflect the diversity of our world and working to ensure our medicines are accessible and affordable. "Pancreatic cancer has historically been one of the most difficult-to-treat cancers and people whose tumors harbor a KRAS G12C mutation face limited options once their disease progresses," said Jacob Van Naarden, executive vice president, and president of Lilly Oncology. "This Breakthrough Therapy designation reflects the early potential we're seeing with olomorasib in this setting and the critical need for new treatment options. With now two Breakthrough Therapy designations across pancreatic and lung cancers, olomorasib continues to demonstrate broad potential clinical evidence across KRAS G12C-driven tumors and reflects our commitment to bringing meaningful new treatment options to patients living with these cancers." KRAS mutations account for approximately 85% of RAS-associated cancers in humans, including about 90% of pancreatic cancers, and KRAS G12C mutations occur in approximately 1% to 2% of patients with pancreatic cancer.8,9 The study includes a Phase 1a dose escalation phase of olomorasib monotherapy in KRAS G12C-mutant solid tumors and Phase 1b dose expansion and optimization phases which are evaluating olomorasib as a monotherapy and in combination with other treatments. More information can be found at clinicaltrials.gov. Where can patients find more information about the LOXO-RAS-20001 trial?
Attovia Therapeutics, a Phase 1 biotech developing biotherapeutics for immune-mediated diseases, announced terms for its IPO on Wednesday.The San Carlos, CA-based company plans to raise $200 million by offering 12.5 million shares at a price range of $15 to $17. Attovia Therapeutics, a Phase 1 biotech developing biotherapeutics for immune-mediated diseases, announced terms for its IPO on Wednesday.The San Carlos, CA-based company plans to raise $200 million by offering 12.5 million shares at a price range of $15 to $17. - Renaissance Capital Attovia Therapeutics, a Phase 1 biotech developing biotherapeutics for immune-mediated diseases, announced terms for its IPO on Wednesday. The San Carlos, CA-based company plans to raise $200 million by offering 12.5 million shares at a price range of $15 to $17.