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A rare congenital disorder of glycosylation characterized by neonatal hypotonia, global development delay, developmental regress and severe to profound intellectual disability, infantile onset seizures that are initially associated with febrile episodes with subsequent transition to unprovoked seizures, impaired vision with esotropia and nystagmus, progressive cerebral and cerebellar atrophy, skeletal abnormalities (including brachycephaly, scoliosis, slender long bones, delayed bone age, pectus excavatum and osteopenia), inverted nipples and dysmorphic features including high and narrow forehead, frontal bossing, short nose, depressed nasal bridge, anteverted nares, high palate and wide open mouth consistent with facial hypotonia. Other features may include cardiac abnormalities (such as patent ductus arteriosus, atrial septal defects), urogenital abnormalities (such as nephrocalcinosis, urolithiasis), and low plasma concentration of alkaline phosphatase.
Features include always present findings: Strabismus, Low muscle tone (hypotonia), Nystagmus, and Intellectual disability and others; and common findings: Lambdoidal craniosynostosis, Myoclonic seizure, Multifocal epileptiform discharges, and Metopic synostosis and others. 54 total HPO annotations.
Organ System | Phenotype Count | Example Features |
|---|---|---|
Brain and nerves | 14 | Bilateral tonic-clonic seizure, Seizure, Ataxia |
Eyes | 5 | Strabismus, Nystagmus, Abnormal eye movements (abnormality of eye movement) |
Muscles | 4 | Low muscle tone (hypotonia), Generalized hypotonia, Shrinkage of the cerebellum (cerebellar atrophy) |
Bones and joints | 4 | Delayed skeletal maturation, Weak and brittle bones (osteoporosis), Mild bone density loss (osteopenia) |
Head and neck | 3 | Lambdoidal craniosynostosis, High palate, Macrocephaly |
Kidneys and urinary system | 2 | Nephrocalcinosis, Renal cyst |
Heart and blood vessels | 1 | Restrictive cardiomyopathy |
PIGT function has not been fully characterized.
Multiple congenital anomalies-hypotonia-seizures syndrome 3 is caused by mutations in the PIGT gene on chromosome 20.
Genetic testing for PIGT is available. Testing is considered confirmatory for diagnosis.
Phenotype severity distribution: 7 always present features, 9 common features.
Estimated prevalence: <1 in 1,000,000 (VERY_RARE).
No clinical trials have been registered for multiple congenital anomalies-hypotonia-seizures syndrome 3.
2 publications have been identified in PubMed for multiple congenital anomalies-hypotonia-seizures syndrome 3. Research spans Review / Meta-Analysis (50%) and Case Report / Case Series (50%).
Klangjorhor J (2025). [PMID: 40141433](https://pubmed.ncbi.nlm.nih.gov/40141433/). *Int J Mol Sci*. [Case Report / Case Series]
Ranjan A (2024). [PMID: 38903302](https://pubmed.ncbi.nlm.nih.gov/38903302/). *Cureus*. [Review / Meta-Analysis]
Data assembled from 7 of 12 sources · Last updated Sep 20, 2026, 5:41 PM UTC
Online Mendelian Inheritance in Man
European rare disease database
Genetic and Rare Diseases Info Center