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KLHL9-related early-onset distal myopathy is a rare, genetic distal myopathy characterized by slowly progressive distal limb muscle weakness and atrophy (beginning with anterior tibial muscle involvement followed by the intrinsic hand muscles) in association with reduced sensation in a stocking-glove distribution. Patients present with high stepping gait, ankle areflexia and contractures in the first to second decade of life, associated with marked ankle extensor muscle atrophy; later proximal muscle involvement is moderate and ambulation is preserved throughout the life.
Features include very common findings: Distal sensory impairment, EMG: myopathic abnormalities, Ankle flexion contracture, and Weakness of the intrinsic hand muscles and others; and common findings: Abnormal calf musculature morphology, Impaired vibration sensation in the lower limbs, Difficulty walking (gait disturbance), and Steppage gait and others. 17 total HPO annotations.
Organ System | Phenotype Count | Example Features |
|---|---|---|
Muscles | 6 |
Phenotype severity distribution: 5 very common features, 9 common features.
Estimated prevalence: <1 in 1,000,000 (VERY_RARE).
No clinical trials have been registered for KLHL9-related early-onset distal myopathy.
13 publications have been identified in PubMed for KLHL9-related early-onset distal myopathy. Research spans Case Report / Case Series (55%), Review / Meta-Analysis (18%), and Basic Science / Preclinical (18%).
Research Type | Count | % of Total |
|---|---|---|
Patient case studies | 6 | 55% |
Data assembled from 4 of 12 sources · Last updated Sep 20, 2026, 5:02 PM UTC
European rare disease database
Genetic and Rare Diseases Info Center
Common questions about KLHL9-related early-onset distal myopathy
Arms and legs | 3 | Weakness of the intrinsic hand muscles, Impaired vibration sensation in the lower limbs, Intrinsic hand muscle atrophy |
Brain and nerves | 3 | Difficulty walking (gait disturbance), Steppage gait, Peripheral axonal neuropathy |
Lab test results | 1 | Abnormal circulating creatine kinase concentration |
Research summaries
2 |
18% |
Laboratory research | 2 | 18% |
Disease patterns and progression | 1 | 9% |
Velardo D (2026). [PMID: 42211024](https://pubmed.ncbi.nlm.nih.gov/42211024/). *Front Genet*. [Case Report / Case Series]
Costa AF (2025). [PMID: 41331965](https://pubmed.ncbi.nlm.nih.gov/41331965/). *J Clin Neuromuscul Dis*. [Case Report / Case Series]
Inoue M (2025). [PMID: 40696134](https://pubmed.ncbi.nlm.nih.gov/40696134/). *J Hum Genet*. [Review / Meta-Analysis]
Gadaleta G (2025). [PMID: 40626683](https://pubmed.ncbi.nlm.nih.gov/40626683/). *Acta Myol*. [Case Report / Case Series]
Sian V (2025). [PMID: 41246854](https://pubmed.ncbi.nlm.nih.gov/41246854/). *Eur J Neurol*. [Case Report / Case Series]
Oommen AT (2025). [PMID: 40512964](https://pubmed.ncbi.nlm.nih.gov/40512964/). *J Clin Neuromuscul Dis*. [Epidemiology / Natural History]
Yao Y (2025). [PMID: 39708321](https://pubmed.ncbi.nlm.nih.gov/39708321/). *Cell Rep*. [Basic Science / Preclinical]
Izumi R (2025). [PMID: 40818927](https://pubmed.ncbi.nlm.nih.gov/40818927/). *Neuromuscul Disord*. [Case Report / Case Series]
Clayton JS (2024). [PMID: 39047410](https://pubmed.ncbi.nlm.nih.gov/39047410/). *Stem Cell Res*. [Basic Science / Preclinical]
Õunap K (2024). [PMID: 39807212](https://pubmed.ncbi.nlm.nih.gov/39807212/). *Neurol Genet*. [Case Report / Case Series]