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Pierpont syndrome is a rare subcutaneous tissue disorder characterized by axial hypotonia after birth, prolonged feeding difficulties, moderate to severe global developmental delay, seizures (in particular absence seizures), fetal digital pads, distinctive plantar fat pads anteromedial to the heels, deep palmar and plantar grooves. Additionally, distinct craniofacial dysmorphic features, notably a broad face with high forehead, high anterior hairline, narrow palpebral fissures that take on a crescent moon shape when smiling, broad nasal bridge and tip with anteverted nostrils, mild midfacial hypoplasia, long, smooth philtrum, thin upper lip vermillion, small, widely spaced teeth and flat occiput/microcephaly/brachycephaly, are also chararteristic. Over time, fat pads may become less prominent and disappear.
Features include always present findings: Large fleshy ears, Hearing loss (hearing impairment), Prominent fingertip pads, and Short stature and others; and very common findings: Wide intermamillary distance, Sideways curvature of the spine (scoliosis), and Narrow palpebral fissure. 59 total HPO annotations.
Organ System | Phenotype Count | Example Features |
|---|---|---|
Arms and legs | 5 | Short foot, Prominent fingertip pads, Short finger |
TBL1XR1 function has not been fully characterized.
Pierpont syndrome is associated with mutations in the TBL1XR1 gene on chromosome 3.
Genetic testing for TBL1XR1 is available. Testing is considered confirmatory for diagnosis.
Phenotype severity distribution: 18 always present features, 3 very common features, 3 common features.
Estimated prevalence: <1 in 1,000,000 (VERY_RARE).
No clinical trials have been registered for Pierpont syndrome.
4 publications have been identified in PubMed for Pierpont syndrome. Research spans Case Report / Case Series (50%), Review / Meta-Analysis (25%), and Basic Science / Preclinical (25%).
Ciriaci N (2026). [PMID: 38900412](https://pubmed.ncbi.nlm.nih.gov/38900412/). *Hepatology (Baltimore, Md.)*. [Review / Meta-Analysis]
Wei L (2025). [PMID: 40426223](https://pubmed.ncbi.nlm.nih.gov/40426223/). *BMC medical genomics*. [Case Report / Case Series]
Xie Y (2025). [PMID: 41444645](https://pubmed.ncbi.nlm.nih.gov/41444645/). *Human genomics*. [Case Report / Case Series]
Hu Y (2024). [PMID: 38885822](https://pubmed.ncbi.nlm.nih.gov/38885822/). *Gene*. [Basic Science / Preclinical]
Data assembled from 6 of 12 sources · Last updated Sep 19, 2026, 6:54 PM UTC
Online Mendelian Inheritance in Man
European rare disease database
Genetic and Rare Diseases Info Center
Common questions about Pierpont syndrome
Brain and nerves | 4 | Seizure, Intellectual disability, Global developmental delay |
Head and neck | 4 | Broad face, Long upper lip, Microcephaly |
Eyes | 2 | Strabismus, Pendular nystagmus |
Growth and development | 2 | Short stature, Failure to thrive |
Ears | 1 | Hearing loss (hearing impairment) |
Muscles | 1 | Low muscle tone (hypotonia) |
Digestive system | 1 | Feeding difficulties |
Bones and joints | 1 | Sideways curvature of the spine (scoliosis) |
Age of onset: at birth.