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No HPO annotations are available for this condition.
FGS1 is an X-linked disorder associated with intellectual disability, hypotonia, relative macrocephaly, broad and flat thumbs, and imperforate anus. The clinical phenotype attributed to FGS1 has widened since the initial description. Many of the clinical features in individuals reported to have FGS1 are nonspecific and may lead to overdiagnosis . Craniofacial. The most characteristic craniofacial feature is small, simple ears. Other common craniofacial features in individuals with FGS1 include dolichocephaly, frontal hair upsweep, tall forehead, downslanted palpebral fissures, and widely spaced eyes . High arched palate, micrognathia, open mouth, narrow auditory canals, fullness of the upper eyelids, and craniosynostosis have also been described . Growth.
An MED12-related disorder should be suspected in an individual with a phenotype associated with FG syndrome type 1, Lujan syndrome, X-linked Ohdo syndrome, or Hardikar syndrome, or with nonspecific intellectual disability with overlapping features of an MED12-related disorder. FG syndrome type 1 (FGS1). Formal clinical diagnostic criteria for FGS1 have not been established; however, the following clinical features would be suggestive:
Source: GeneReviews — "MED12-Related Disorders"
No approved treatments are currently available for Ohdo syndrome and variants. The disease remains an area of unmet medical need.
Evaluations Following Initial Diagnosis To establish the extent of disease and needs in an individual diagnosed with an MED12-related disorder, the evaluations summarized (if not performed as part of the evaluation that led to the diagnosis) are recommended. Table 3. Recommended Evaluations Following Initial Diagnosis in Individuals with MED12-Related Disorders
Table 5. Recommended Surveillance for Individuals with MED12-Related Disorders
System/Concern |
|---|
1 clinical trial registered, 1 recruiting. Interventions under study include other interventions. Research is primarily sponsored by academic and government institutions.
7 publications have been identified in PubMed for Ohdo syndrome and variants. Research spans Basic Science / Preclinical (57%), Case Report / Case Series (29%), and Review / Meta-Analysis (14%).
Warmoeskerken T (2026). [PMID: 41821414](https://pubmed.ncbi.nlm.nih.gov/41821414/). *Am J Med Genet A*. [Review / Meta-Analysis]
Ura H (2025). [PMID: 39986018](https://pubmed.ncbi.nlm.nih.gov/39986018/). *Stem Cell Res*. [Basic Science / Preclinical]
Ura H (2025). [PMID: 39986017](https://pubmed.ncbi.nlm.nih.gov/39986017/). *Stem Cell Res*. [Basic Science / Preclinical]
Bergamasco MI (2025). [PMID: 39832706](https://pubmed.ncbi.nlm.nih.gov/39832706/). *Dev Biol*. [Basic Science / Preclinical]
Kao EC (2025). [PMID: 39215511](https://pubmed.ncbi.nlm.nih.gov/39215511/). *Am J Med Genet A*. [Case Report / Case Series]
Data assembled from 4 of 12 sources · Last updated Sep 19, 2026, 8:51 AM UTC
Common questions about Ohdo syndrome and variants
Source: GeneReviews — "MED12-Related Disorders"
Disorders with features overlapping those of FG syndrome type 1 (FGS1), Lujan syndrome (LS), X-linked Ohdo syndrome (XLOS) and/or Hardikar syndrome (HS) are summarized in .
Table 2.
Disorders to Consider in the Differential Diagnosis of FG Syndrome Type 1, Lujan Syndrome, X-Linked Ohdo Syndrome, and Hardikar Syndrome
Gene /Genetic Mechanism | Disorder | MOI | Clinical Overlap with:
FGS1 | LS | XLOS | HS
CBS | Homocystinuria | AR | + |
CHD7 | CHARGE syndrome (See CHD7 Disorder.) | AD |
+
CREBBP
| Rubinstein-Taybi syndrome | AD | + |
FBN1 | Marfan syndrome | AD | + |
FLNA | FG syndrome 2 (OMIM 300321) | XL | + |
FMR1 | Fragile X syndrome | XL | + | + |
FOLX23q23 rearrangements | Blepharophimosis, ptosis, epicanthus inversus syndrome | AD(AR) |
+ |
Source: GeneReviews — "MED12-Related Disorders"
System/Concern | Evaluation | Comment |
|---|
Growth | Measure height, weight, head circumference. | — |
Development | Developmental assessment | To incl motor, adaptive, cognitive, speech/language eval; Eval for early intervention / special education Psychiatric/ |
Behavioral | Neuropsychiatric eval | For persons age 12 mos: screen for behavior concerns Neurologic |
Eyes | Ophthalmologic eval | To assess for strabismus, visual deficits, other ophthalmologic features Eval for retinal issues |
Musculoskeletal | Eval for evidence of joint contractures or hypermobility | — |
Genitourinary | Exam for genitourinary anomalies | — |
Cardiovascular | Cardiology eval w/echocardiogram | MRA of head neck for vascular malformations |
Hearing | Audiologic eval | — |
Dental | Dental eval for dental anomalies | Genetic |
counseling | By genetics professionals1 | To inform affected persons their families re nature, MOI, implications of MED12-related disorders in order to facilitate medical personal decision making Family support resources |
Treatment of Manifestations in Individuals with MED12-Related Disorders Manifestation/Concern | Treatment | Considerations/Other DD/ID/Behavioral |
concerns | See . | — |
Seizures | Standardized treatment w/ASM by experienced neurologist. | Many ASMs may be effective; none has been demonstrated effective specifically for this disorder.; Education of parents/caregivers1 |
Aneurysms | Treatment as recommended by surgeon | In persons w/HS Strabismus other |
ocular anomalies | Standard treatment(s) as recommended by ophthalmologist | — |
Imperforate anus | Surgical intervention | — |
Bowel dysfunction | Standard management of chronic constipation | Intestinal |
malrotation | Mgmt as recommended by surgeon | — |
Liver disease | Treatment as recommended by gastroenterologist | In persons w/HS |
Joint contractures | PT can help prevent manage contractures. | Genitourinary |
anomalies | Treatment as recommended by urologist | — |
Congenital heart defects | Treatment as recommended by cardiologist cardiothoracic surgeon | — |
Hearing loss | Hearing aids may be helpful; per otolaryngologist. | Community hearing services through early intervention or school district |
Palatal issues | Treatment as recommended by otolaryngologist | — |
Dental anomalies | Treatment per dentist /or orthodontist | Family/Community |
Source: GeneReviews — "MED12-Related Disorders"
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 — "MED12-Related Disorders"
1 trial found
Evaluation
Frequency |
|---|
Growth | Measure height, weight, head circumference. | At each visit throughout childhood |
Development | Monitor developmental progress educational needs. | At each visit Psychiatric/ Behavioral |
Eyes | Ophthalmologic eval for evidence of strabismus other visual issues; eval for retinal issues in those w/HS | Annually |
Gastrointestinal | Assess for feeding problems, constipation gastroesophageal reflux | At each visit |
Liver disease | Gastroenterology eval w/liver function testing consideration of clotting studies, serum bile acids, liver ultrasound per recommendations of gastroenterologist in persons w/HS | Annually |
Musculoskeletal | Assess for joint contractures, joint hypermobility, scoliosis. | At each visit |
Cardiovascular | Echocardiogram carotid ultrasound in persons w/HS | Annually MRA of head neck for development of aneurysms in those w/HS |
Hearing | Audiology eval | Annually |
Dental | Dental eval | Every 6 mos HS = Hardikar syndrome |
Source: GeneReviews — "MED12-Related Disorders"
Ura H (2024). [PMID: 38492468](https://pubmed.ncbi.nlm.nih.gov/38492468/). *Stem Cell Res*. [Basic Science / Preclinical]
Togi S (2024). [PMID: 38655688](https://pubmed.ncbi.nlm.nih.gov/38655688/). *Am J Med Genet A*. [Case Report / Case Series]