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An autosomal recessively inherited syndromic developmental defect of the eye characterized by a variable phenotype including Peters anomaly and other anterior chamber eye anomalies, short limbs, limb abnormalities (i.e. rhizomelia and brachydactyly), characteristic facial features (upper lip with cupid bow, short palpebral fissures), cleft lip/palate, and mild to severe developmental delay/intellectual disability. Other associated abnormalities reported in some patients include congenital heart defects (i.e. hypoplastic left heart, absence of right pulmonary vein, bicuspid pulmonary valve), genitourinary anomalies (hydronephrosis, renal hypoplasia, renal and ureteral duplication, multicystic dysplastic kidneys, glomerulocystic kidneys) and congenital hypothyroidism.
Features include always present findings: Broad palm, Disproportionate short-limb short stature, and Short palm; and very common findings: Exaggerated cupid's bow, Clinodactyly of the 5th finger, Long philtrum, and Global developmental delay and others. 97 total HPO annotations.
Organ System | Phenotype Count | Example Features |
|---|---|---|
Head and neck | 12 | Microcephaly, Thin upper lip vermilion, Facial hypertrichosis |
B3GLCT encodes beta 3-glucosyltransferase (498 aa). Beta-1,3-glucosyltransferase involved in one of the two pathways responsible for protein O-linked fucosylation, a unique post-translational modification of cysteine-knotted proteins that regulates various biological processes. Highest expression in Uterus (25.1 TPM) and Artery Tibial (13.7 TPM).
Peters plus syndrome is caused by mutations in the B3GLCT gene on chromosome 13.
The B3GLCT protein participates in Defective B3GALTL causes PpS, B3GALTL transfers glucose to O-fucosyl-proteins, and Defective B3GALTL does not transfer glucose to O-fucosyl-proteins pathways.
B3GLCT is classified as a druggable target with score 0.0.
Peters plus syndrome should be suspected in individuals with anterior chamber anomalies of the eye (usually bilateral but in some cases unilateral), with or without any of the following:
Short limbs with broad distal extremities
Characteristic facial features including an exaggerated Cupid's bow of the upper lip, short palpebral fissures, and ear anomalies
No approved treatments are currently available for Peters plus syndrome. The disease remains an area of unmet medical need.
To establish the extent of disease and needs in an individual diagnosed with Peters plus syndrome, the following evaluations are recommended if they have not already been completed:
Complete ophthalmologic assessment including ocular ultrasonography for characterization of the eye anomaly and an assessment for associated ocular defects
The following are appropriate:
Assessment by a pediatric ophthalmologist every three months or as indicated to monitor for glaucoma and amblyopia
Regular developmental assessments
Source: GeneReviews — "Peters Plus Syndrome"
No clinical trials have been registered for Peters plus syndrome.
6 publications have been identified in PubMed for Peters plus syndrome. Research spans Case Report / Case Series (40%), Other (20%), and Diagnostic / Biomarker (20%).
Jat NS (2026). [PMID: 35593847](https://pubmed.ncbi.nlm.nih.gov/35593847/). *Unknown Journal*. [Other]
Fortún Agud M (2026). [PMID: 41598247](https://pubmed.ncbi.nlm.nih.gov/41598247/). *Life (Basel)*. [Case Report / Case Series]
Akalın A (2025). [PMID: 40211555](https://pubmed.ncbi.nlm.nih.gov/40211555/). *J Clin Res Pediatr Endocrinol*. [Diagnostic / Biomarker]
Delas F (2025). [PMID: 40650233](https://pubmed.ncbi.nlm.nih.gov/40650233/). *Int J Mol Sci*. [Case Report / Case Series]
Cronemberger S (2025). [PMID: 40641960](https://pubmed.ncbi.nlm.nih.gov/40641960/). *Front Med (Lausanne)*. [Clinical Trial Publication]
Data assembled from 8 of 12 sources · Last updated Sep 19, 2026, 7:11 AM UTC
Online Mendelian Inheritance in Man
European rare disease database
Genetic and Rare Diseases Info Center
Common questions about Peters plus syndrome
Brain and nerves |
6 |
Hydrocephalus, Enlarged brain ventricles (ventriculomegaly), Seizure |
Eyes | 5 | Retinal coloboma, Cataract, Nystagmus |
Arms and legs | 5 | Clinodactyly of the 5th finger, Disproportionate short-limb short stature, Short toe |
Bones and joints | 4 | Sideways curvature of the spine (scoliosis), Abnormal pelvic girdle bone morphology, Square pelvis bone |
Growth and development | 3 | Postnatal growth retardation, Disproportionate short-limb short stature, Intrauterine growth retardation |
Digestive system | 2 | Feeding difficulties in infancy, Biliary tract abnormality |
Heart and blood vessels | 2 | Ventricular septal defect, Atrial septal defect |
Ears | 1 | Hearing loss (hearing impairment) |
Kidneys and urinary system | 1 | Renal hypoplasia |
Muscles | 1 | Brain shrinkage (cerebral atrophy) |
Peters plus syndrome is characterized by anterior chamber eye anomalies, short limbs with broad distal extremities, variable developmental delay / intellectual disability, typical facial features, and cleft lip/palate. Unless otherwise stated, the following description of clinical findings is based on the reports of and . Eyes. The most common anterior chamber defect is Peters' anomaly, consisting of central corneal clouding, thinning of the posterior cornea, and iridocorneal adhesions. Peters' anomaly may be classified as type I, a mild form, or type II, a more severe form associated with lens abnormalities including cataracts, congenital glaucoma, and a poorer visual prognosis . The eye involvement is usually, but not always, bilateral.
Source: GeneReviews — "Peters Plus Syndrome"
Cleft lip/palate
Variable developmental delay / intellectual disability
The diagnosis of Peters plus syndrome can be established clinically in a proband with the above . The diagnosis can be confirmed by identification of biallelic pathogenic variants in B3GLCT on molecular genetic testing :
Source: GeneReviews — "Peters Plus Syndrome"
The differential diagnosis of Peters plus syndrome comprises other conditions with short stature and limb shortening, including the following:
Isolated Peters' anomaly (OMIM 604229), which can be inherited in an autosomal dominant or autosomal recessive manner or can occur in simplex cases (i.e., a single occurrence in a family) in which the mode of inheritance is unknown. It has been reported in association with mutation of the following genes: CYP1B1, FOXC1, PAX6, FOXE3, NDP, SLC4A11, HCCS, PITX2, and PITX3.
• Cornelia de Lange syndrome
• Smith-Lemli-Opitz syndrome
• Autosomal dominant Robinow syndrome
• ROR2-related Robinow syndrome
Source: GeneReviews — "Peters Plus Syndrome"
Genetic testing for B3GLCT is available. Testing is considered confirmatory for diagnosis.
Biomarker and diagnostic research for Peters plus syndrome has been reported in the published literature.
Growth hormone stimulation testing to address the possibility of a treatable cause of growth delay in those affected individuals in whom increased height would improve quality of life
For neonates or infants, referral to an infant development program for appropriate developmental assessment
Echocardiography for congenital heart malformations
Abdominal ultrasound examination for renal anomalies
Cranial imaging with head ultrasound examination or CT scan/MRI for hydrocephalus and/or structural brain abnormalities if neurologic symptoms are present
Thyroid function testing in all infants who have not undergone newborn screening for congenital hypothyroidism
Hearing assessment in a child with cleft palate or speech delay
Consultation with a clinical geneticist and/or genetic counselor
Eye. Potential preservation of vision in the affected eye(s) often requires surgery. For severe bilateral corneal opacification consideration of corneal transplantation (penetrating keratoplasty) is suggested before age three to six months to prevent amblyopia; in mild cases simple separation of iridocorn...
Source: GeneReviews — "Peters Plus Syndrome"
Agents that increase risk of glaucoma (e.g., corticosteroids) are to be avoided.
Source: GeneReviews — "Peters Plus Syndrome"
View trials for Peters plus syndrome
Phenotype severity distribution: 3 always present features, 5 very common features, 10 common features.
Estimated prevalence: <1 in 1,000,000 (VERY_RARE).