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A form of microcephalic primordial dwarfism (MPD) characterized by severe pre- and postnatal growth retardation, with marked microcephaly in proportion to body size, skeletal dysplasia, abnormal dentition, insulin resistance, and increased risk for cerebrovascular disease.
Features include sometimes findings: Hypoplastic scapulae, Limited elbow extension, Long clavicles, and Microdontia and others. 51 total HPO annotations.
Organ System | Phenotype Count | Example Features |
|---|---|---|
Bones and joints | 4 | Narrow pelvis bone, Delayed skeletal maturation, Proximal femoral epiphysiolysis |
Growth and development | 3 | Postnatal growth retardation, Disproportionate short stature, Intrauterine growth retardation |
Brain and nerves | 3 | Intellectual disability, Global developmental delay, Dilatation of the cerebral artery |
Arms and legs | 3 | Short middle phalanx of finger, Clinodactyly of the 5th finger, Short distal phalanx of finger |
Hormones | 2 | Type II diabetes mellitus, Precocious puberty |
Skin | 1 | Areas of hypopigmentation and hyperpigmentation that do not follow Blaschko lines |
Head and neck | 1 | Microcephaly |
Microcephalic osteodysplastic primordial dwarfism type II (MOPDII), the most common of the microcephalic primordial dwarfism syndromes, is characterized by extreme short stature and microcephaly along with distinctive facial features. Associated features that differentiate it from other forms of primordial dwarfism and which may necessitate treatment include: abnormal dentition, a slender bone skeletal dysplasia with hip deformity and/or scoliosis, insulin resistance / diabetes mellitus, chronic kidney disease, cardiac malformations, and global vascular disease. The latter includes neurovascular disease such as moyamoya vasculopathy and intracranial aneurysms (which can lead to strokes), coronary artery disease (which can lead to premature myocardial infarctions), and renal vascular disease. Hypertension, which is also common, can have multiple underlying causes given the complex comorbidities . Anticipated life expectancy is shortened due to the associated comorbidities, which when untreated can lead to early death, predominately in early adulthood (age range 7-41 years) . More than 150 individuals with a molecularly confirmed diagnosis have been identified . The following description of the phenotypic features associated with this condition is based on the most recent review of 47 individuals with molecularly confirmed MOPDII . Table 2. Features of Microcephalic Osteodysplastic Primordial Dwarfism Type II
Feature | % of Personsw/Feature |
|---|
PCNT function has not been fully characterized.
Microcephalic osteodysplastic primordial dwarfism type II is caused by mutations in the PCNT gene on chromosome 21.
No clinically relevant genotype-phenotype correlations have been identified.
Source: GeneReviews — "Microcephalic Osteodysplastic Primordial Dwarfism Type II"
No consensus clinical diagnostic criteria for microcephalic osteodysplastic primordial dwarfism type II (MOPDII) have been published.
MOPDII should be suspected in individuals with the following clinical and radiographic findings and family history.
Clinical findings
Source: GeneReviews — "Microcephalic Osteodysplastic Primordial Dwarfism Type II"
Table 3. Microcephalic Osteodysplastic Primordial Dwarfism Type II: Differential Diagnosis
Gene(s)/GeneticMechanism | DiffDx Disorder | MOI | Key Features of DiffDx Disorder |
|---|---|---|---|
ORC6 | Meier-Gorlin syndrome (OMIM PS224690) | ARAD1 | IUGR, extreme short stature w/microcephaly |
IMAGe syndrome | AD (imprinted) | IUGR, extreme short stature; may have microcephaly |
Genetic testing for PCNT is available. Testing is considered confirmatory for diagnosis.
No approved treatments are currently available for microcephalic osteodysplastic primordial dwarfism type II. The disease remains an area of unmet medical need.
Clinical practice guidelines for microcephalic osteodysplastic primordial dwarfism type II (MOPDII) have been proposed . Evaluations Following Initial Diagnosis To establish the extent of disease and needs in an individual diagnosed with MOPDII, the evaluations summarized (if not performed as part of the evaluation that led to the diagnosis) are recommended. Table 4. Recommended Evaluations Following Initial Diagnosis in Individuals with Microcephalic Osteodysplastic Primordial Dwarfism Type II
System/Concern | Evaluation | Comment |
|---|---|---|
Growth restriction | Measure height, weight, head circumference. | Use MOPDII-specific growth curves.1 |
Skeletal dysplasia | AP/lateral radiograph of thoracolumbar spine AP radiograph of hips | Radiographs in early childhood to evaluate for slipped capital femoral epiphysis, coxa vara, scoliosis |
Cerebrovascular | Brain MRI MRA | Incl at birth, as both in utero strokes moyamoya vasculopathy have been identified in neonatal period. |
Cardiac | Echocardiogram, EKG | Renal |
Diabetes mellitus | If age ≥5 yrs, perform lab studies to assess glucose homeostasis, lipids, hepatic function. |
Source: GeneReviews — "Microcephalic Osteodysplastic Primordial Dwarfism Type II"
Growth hormone supplementation in the absence of growth hormone deficiency has not been helpful, and in fact can contribute to morbidity .
Source: GeneReviews — "Microcephalic Osteodysplastic Primordial Dwarfism Type II"
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 — "Microcephalic Osteodysplastic Primordial Dwarfism Type II"
View trials for microcephalic osteodysplastic primordial dwarfism type II
Table 6. Recommended Surveillance for Individuals with Microcephalic Osteodysplastic Primordial Dwarfism Type II
System/Concern | Evaluation | Frequency |
|---|---|---|
restriction | Measurement of growth parameters1 for appropriate mgmt expectations | At each visit Skeletal dysplasia |
abnormalities | Complete blood count3 | Annually Cerebrovascular |
disease | Brain MRA/MRI3,4 | Childhood: Every 12-18 mos Adulthood: Every 12-24 mos Coronary artery disease |
Cognitive ability | Monitor developmental progress educational needs. | At each visit |
Source: GeneReviews — "Microcephalic Osteodysplastic Primordial Dwarfism Type II"
Estimated prevalence: Unknown (Unknown prevalence).
No clinical trials have been registered for microcephalic osteodysplastic primordial dwarfism type II.
11 publications have been identified in PubMed for microcephalic osteodysplastic primordial dwarfism type II. Research spans Case Report / Case Series (50%), Basic Science / Preclinical (30%), and Review / Meta-Analysis (20%).
Research Type | Count | % of Total |
|---|---|---|
Patient case studies | 5 | 50% |
Laboratory research | 3 | 30% |
Research summaries | 2 | 20% |
Thomas MS (2026). [PMID: 42146478](https://pubmed.ncbi.nlm.nih.gov/42146478/). *bioRxiv*. [Basic Science / Preclinical]
Little SM (2026). [PMID: 40878899](https://pubmed.ncbi.nlm.nih.gov/40878899/). *American journal of medical genetics. Part A*. [Basic Science / Preclinical]
Hong L (2026). [PMID: 41621849](https://pubmed.ncbi.nlm.nih.gov/41621849/). *Zhonghua yi xue yi chuan xue za zhi = Zhonghua yixue yichuanxue zazhi = Chinese journal of medical genetics*. [Review / Meta-Analysis]
Carroll RS (2025). [PMID: 40581356](https://pubmed.ncbi.nlm.nih.gov/40581356/). *Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research*. [Case Report / Case Series]
Makretskaya NA (2025). [PMID: 40734297](https://pubmed.ncbi.nlm.nih.gov/40734297/). *Problemy endokrinologii*. [Case Report / Case Series]
Al Farsi A (2025). [PMID: 41583253](https://pubmed.ncbi.nlm.nih.gov/41583253/). *Cureus*. [Case Report / Case Series]
Jurca AD (2024). [PMID: 39597091](https://pubmed.ncbi.nlm.nih.gov/39597091/). *Medicina (Kaunas, Lithuania)*. [Case Report / Case Series]
Akalın A (2024). [PMID: 38860472](https://pubmed.ncbi.nlm.nih.gov/38860472/). *American journal of medical genetics. Part A*. [Case Report / Case Series]
Gharehdaghi EE (2024). [PMID: 39560799](https://pubmed.ncbi.nlm.nih.gov/39560799/). *Metabolic brain disease*. [Basic Science / Preclinical]
Clarac C (2024). [PMID: 39364542](https://pubmed.ncbi.nlm.nih.gov/39364542/). *Cardiology in the young*. [Review / Meta-Analysis]
Data assembled from 8 of 12 sources · Last updated Sep 19, 2026, 1:06 PM UTC
Online Mendelian Inheritance in Man
European rare disease database
Genetic and Rare Diseases Info Center
Comment
Extreme pre- postnatal growth restriction | ~100% | IUGR, severe short stature |
Microcephaly | ~100% | — |
Skeletal dysplasia | ~100% | Can develop hip deformity /or scoliosis in addition to osteochondrodysplasia. Dysplasia may be difficult to recognize in newborn period. |
Small, loosely rooted teeth | ~100% | Frequency not definitively evaluated in large studies, but typically secondary teeth are more affected than primary teeth. |
Hematologic | Anemia | 75% |
Thrombocytosis | 75% | Asymptomatic |
Cerebrovascular | Aneurysms | ~50% |
Moyamoya vasculopathy | ~50% | Risk mainly in younger ages, starting in utero |
Aneurysms moyamoya disease | 36% | — |
Cardiovascular | Hypertension | 43% |
Hypercholesterolemia | 32% | Median age 18 yrs |
Cardiac malformations | 28% | ASD, VSD, PFO |
Coronary artery disease w/premature MIs | 17% | Median age of MI 24 yrs |
Renal | Chronic kidney disease | 32% |
Accessory renal arteries | 15% | All known affected persons have been male. |
Renal vascular disease | 4% | Renal artery stenosis, aneurysm |
Genital | Cryptorchidism/ retractile testes | 44% of males |
Hypospadias | 8% of males | — |
Endocrine | Insulin resistance /or diabetes mellitus | 38% |
Cognitive ability | Borderline/low-normal intellectual function | Most |
ADHD | Most | Not yet definitively evaluated in large studies ADHD = attention-deficit/hyperactivity disorder; ASD = atrial septal defect; IUGR = intrauterine growth restriction; MI = myocardial infarction; PFO = patent foramen ovale; VSD = ventricular septal defect Growth restriction and microcephaly. |
Source: GeneReviews — "Microcephalic Osteodysplastic Primordial Dwarfism Type II"
Congenital adrenal insufficiency, cryptorchidism, small penis |
LIG4 | Ligase IV deficiency (LIG4 syndrome; OMIM 606593) | AR | IUGR, extreme short stature w/microcephaly |
POLE | IMAGe-I syndrome (OMIM 618336) | AR | IUGR, extreme short stature; may have microcephaly |
RNU4ATAC | RNU4atac-opathy (incl MOPDI/III, Roifman syndrome, Lowry-Wood syndrome) | AR | IUGR, microcephaly, skeletal dysplasia |
XRCC4 | XRCC4 deficiency (OMIM 616541) | AR | IUGR, extreme short stature w/microcephaly |
4p2ASPMATRBLMCDK5RAP2CPAP (CENPJ)CEP152DNA2DNMT3ADONSONERCC6IGF1RNBNNCAPD3PHGDHPLK4PRIM1RTTNSMARCAL1SRCAPTOP3ATRAIPVPS13B | See footnote 3. | ARAD | Extreme short stature w/microcephaly |
Source: GeneReviews — "Microcephalic Osteodysplastic Primordial Dwarfism Type II"
Cognitive abilities | Developmental assessment | Incl motor, adaptive, cognitive, speech-language eval; Eval for early intervention/ special education |
Genetic counseling | By genetics professionals2 | To obtain a pedigree inform affected persons their families re nature, MOI, implications of MOPDII to facilitate medical personal decision making Family support resources |
Treatment of Manifestations in Individuals with Microcephalic Osteodysplastic Primordial Dwarfism Type II Manifestation/Concern | Treatment | Considerations/Other |
Growth | Expect ~2 g/day weight gain throughout infancy childhood. Avoid gastrostomy tube placement unless less-than-expected gain apparent for this disorder, after typical feeding regimens employed. | Use MOPDII-specific growth curves1 for appropriate mgmt expectations.; G-tube overfeeding can result in iatrogenic oral aversion. Skeletal dysplasia |
Dental abnormalities | Ultimately treated w/dentures or implants | Typically in late teens or early adulthood |
Hematologic abnormalities | Anemia thrombocytosis are common but have generally not required treatment. | — |
Cerebrovascular disease | Moyamoya vasculopathy in MOPDII has been treated w/encephaloduroarteriosynangiosis or pial synangiosis. | Moyamoya vasculopathy treatment predominately required in childhood Aneurysm treatment has been by clipping, coiling, or stenting.3 |
Kidney disease | Chronic kidney disease has been treated w/medication, dialysis, /or kidney transplant.4 | Insulin resistance / |
Diabetes mellitus | Diabetes has been treated w/medication.4 | Majority treated w/metformin /or insulin |
Cognitive ability | See . | Unless there have been complications from neurovascular disease, intellectual development is generally in typical-to-borderline range, social skills are excellent. |
Transition to adult care | Develop plan for transition from pediatric to adult care. | See . Based on clinical practice guidelines proposed by 1. , 2. 3. 4. Individuals with MOPDII are likely to need emergency care at the age they are transitioning into adulthood. |
AI-curated news mentioning microcephalic osteodysplastic primordial dwarfism type II
Updated Aug 14, 2026
A study published in PubMed details the prenatal phenotypic features of five fetal cases associated with RNU4ATAC mutations leading to microcephalic osteodysplastic primordial dwarfism type I. This research enhances understanding of the condition's prenatal presentation.