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No HPO annotations are available for this condition.
Age of onset: adulthood, before birth, infancy.
The clinical phenotype of alpha-mannosidosis varies considerably, with a wide spectrum of clinical findings and broad variability in individual presentation. Designating clinical types can be useful in prognosis and management. At least three clinical types (mild, moderate, and severe) have been suggested based on individuals who have not been treated with enzyme replacement therapy (ERT; see ). Most individuals described fit into the moderate type.
A proposed diagnostic algorithm for alpha-mannosidosis has been published, but clinical findings alone are not enough to establish the diagnosis because they overlap with clinical findings in other storage disorders .
Alpha-mannosidosis should be suspected in individuals with the following clinical, radiographic, supportive laboratory, pathology, and family history findings.
Clinical features
No approved treatments are currently available for oligosaccharidosis. The disease remains an area of unmet medical need.
No clinical practice guidelines for alpha-mannosidosis have been published.
To establish the extent of disease and needs in an individual diagnosed with alpha-mannosidosis, the evaluations summarized (if not performed as part of the evaluation that led to the diagnosis) are recommended.
To monitor existing manifestations, the individual's response to supportive care, and the emergence of new manifestations, the evaluations summarized in are recommended.
Table 6.
Alpha-Mannosidosis: Recommended Surveillance1
System/Concern | Evaluation | Frequency
Constitutional/
No clinical trials have been registered for oligosaccharidosis.
1 publication has been identified in PubMed for oligosaccharidosis. Research spans Case Report / Case Series (100%).
Gaston J (2026). [PMID: 41399194](https://pubmed.ncbi.nlm.nih.gov/41399194/). *Australas J Dermatol*. [Case Report / Case Series]
Data assembled from 4 of 12 sources · Last updated Oct 3, 2026, 8:10 PM UTC
European rare disease database
Genetic and Rare Diseases Info Center
Source: GeneReviews — "Alpha-Mannosidosis"
Prominent forehead
Highly arched eyebrows
Depressed nasal bridge
Widely spaced teeth
Macroglossia
Prognathism
Hearing loss (sensorineural or mixed)
Frequent infections
Developmental delay/ intellectual disability
Ataxia
Source: GeneReviews — "Alpha-Mannosidosis"
Lysosomal storage disorders. The main clinical features in alpha-mannosidosis – intellectual disability, ataxia, coarse face, and dysostosis multiplex – may overlap with other lysosomal storage disorders (e.g., mucopolysaccharidosis type I and II). However, the distinctive clinical features associated with other lysosomal storage disorders, the availability of biochemical testing in clinical laboratories, and an understanding of their natural history should help in distinguishing between them.
Table 2.
Genes of Interest in the Differential Diagnosis of Alpha-Mannosidosis
Gene(s) | Disorder | MOI | Key Clinical Features of Disorder
Overlapping w/alpha-mannosidosis | Distinguishing from alpha-mannosidosis
ABCC9
| Cant syndrome | AD | • Coarse facial features
Thickened ribs
| • Heart defects
Source: GeneReviews — "Alpha-Mannosidosis"
Alpha-Mannosidosis: Recommended Evaluations Following Initial Diagnosis
System/Concern | Evaluation | Comment
| Measurement of weight, length/height, head circumference | To assess for poor growth /or macrocephaly
| Audiologic eval assessment for middle ear effusions | Assess for both sensorineural conductive hearing loss.
Immunologic/
| Assess for signs/symptoms of frequent infections. | Consider referral to immunologist.
Clinical laboratory assessment for features of SLE | • To incl immunologic testing such as anti-nuclear antibodies anti-double-stranded-DNA antibodies
Consider referral to rheumatologist.
| Developmental assessment | • To incl motor, adaptive, cognitive, speech-language eval
Eval for early intervention/ special education
Neurobehavioral/
| Neuropsychiatric eval | For persons age 12 mos: screening for concerns incl depression, sleep disturbances, anxiety, /or findings suggestive of psychosis (delusions, hallucinations)
| Neurologic eval | • Assess for asthenia1 signs/symptoms of communicating hydrocephalus.2
Source: GeneReviews — "Alpha-Mannosidosis"
View trials for oligosaccharidosis
Consider endocrinology evals, incl hormonal lipid profiles | Regular intervals based on clinical features
| Monitor developmental progress educational needs.3 | At each visit
Neurobehavioral/
| Assessment for depression, sleep disturbances, anxiety, /or findings suggestive of psychosis (delusions, hallucinations)
| • Assess for new manifestations such ataxia gait abnormalities.
Evaluate for asthenia4 signs/symptoms of communicating hydrocephalus.5
| Assessment for muscle pain, joint aches, reduced range of motion, bone pain6
PT assessment of fine motor function, gross motor function, endurance (e.g., via the 6MWT, the 3MSCT, or the 9-hole peg test), ataxia (e.g., via the SARA), muscle strength tone | • Every 6-12 mos in childhood
Annually in adults
Consider DXA bone densitometry scan7 to assess for osteopenia/osteoporosis.
Radiographs of hips/spine may be indicated.
| Every 2-5 yrs in children, adolescents, adults
| • Monitoring for diarrhea
Assessment of liver spleen size through physical exam
| At each visit
Source: GeneReviews — "Alpha-Mannosidosis"