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Any sclerosteosis in which the cause of the disease is a mutation in the SOST gene.
Features include always present findings: Nail dysplasia, Irregular menstruation, Large face, and Headache and others. 40 total HPO annotations.
Organ System | Phenotype Count | Example Features |
|---|---|---|
Head and neck | 4 | Facial palsy, Facial palsy secondary to cranial hyperostosis, Large face |
SOST function has not been fully characterized.
Sclerosteosis 1 is associated with mutations in the SOST gene on chromosome 17.
There is no apparent difference in phenotype associated with any of the known SOST pathogenic variants. The phenotype of van Buchem disease, which is caused by a 52-kb deletion downstream of SOST, is milder than that of SOST-related sclerosteosis.
SOST-related sclerosteosis and SOST-related endosteal hyperostosis, van Buchem type (van Buchem disease) are clinically and radiographically similar disorders of progressive bone overgrowth due to increased bone formation. The disorders differ in severity and in type of molecular genetic variants.
SOST-related sclerosing bone dysplasias should be suspected in individuals with the following findings.
Clinical findings
Source: GeneReviews —
No approved treatments are currently available for sclerosteosis 1. The disease remains an area of unmet medical need.
No clinical practice guidelines for SOST-related sclerosing bone dysplasias have been published. In the absence of published guidelines, the following recommendations are based on the authors' personal experience managing individuals with these disorders. Evaluations Following Initial Diagnosis To establish the extent of disease in an individual diagnosed with a SOST-related sclerosing bone dysplasia, the evaluations summarized (if not performed as part of the evaluation that led to the diagnosis) are recommended. Table 4. SOST-Related Sclerosing Bone Dysplasias: Recommended Evaluations Following Initial Diagnosis
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. SOST-Related Sclerosing Bone Dysplasias: Recommended Surveillance
No clinical trials have been registered for sclerosteosis 1.
6 publications have been identified in PubMed for sclerosteosis 1. Research spans Review / Meta-Analysis (60%), Case Report / Case Series (20%), and Gene Therapy / Novel Therapeutics (20%).
Uludağ Alkaya D (2025). [PMID: 40198394](https://pubmed.ncbi.nlm.nih.gov/40198394/). *Calcified tissue international*. [Review / Meta-Analysis]
Sangar M (2025). [PMID: 40914927](https://pubmed.ncbi.nlm.nih.gov/40914927/). *Calcified tissue international*. [Review / Meta-Analysis]
Guo Y (2025). [PMID: 40605263](https://pubmed.ncbi.nlm.nih.gov/40605263/). *Molecular genetics & genomic medicine*. [Case Report / Case Series]
Dreyer TJ (2025). [PMID: 40189599](https://pubmed.ncbi.nlm.nih.gov/40189599/). *Bone research*. [Gene Therapy / Novel Therapeutics]
Abhishek Shah A (2024). [PMID: 39447984](https://pubmed.ncbi.nlm.nih.gov/39447984/). *Biochemical pharmacology*. [Review / Meta-Analysis]
Data assembled from 6 of 12 sources · Last updated Sep 18, 2026, 5:42 AM UTC
Online Mendelian Inheritance in Man
Genetic and Rare Diseases Info Center
4 |
Cortically dense long tubular bones, Sclerotic vertebral endplates, Arthralgia |
Brain and nerves | 3 | Difficulty with thinking and memory (cognitive impairment), Headache, Depressed nasal bridge |
Eyes | 3 | Nystagmus, Damage to the optic nerve (optic atrophy), Blurred vision |
Arms and legs | 2 | 2-3 finger cutaneous syndactyly, Deviation of finger |
Ears | 1 | Hearing loss (hearing impairment) |
Skin | 1 | Nail dysplasia |
Kidneys and urinary system | 1 | Cortically dense long tubular bones |
Muscles | 1 | Damage to the optic nerve (optic atrophy) |
SOST-related sclerosteosis and SOST-related endosteal hyperostosis, van Buchem type (van Buchem disease) have very similar phenotypes. However, the manifestations of van Buchem disease are generally milder than those in sclerosteosis . To date, more than 100 individuals have been identified with biallelic pathogenic variants in SOST or a biallelic 52-kb deletion downstream of SOST. The following description of the phenotypic features associated with this condition is based on these reports. Table 2. SOST-Related Sclerosing Bone Dysplasias: Comparison of Phenotypes by Select Features
Feature | Sclerosteosis(n=96) | Van Buchem Disease(n=31) | Comment |
|---|---|---|---|
Linear overgrowth | 100% | 0% | Normal stature in van Buchem disease |
Hearing loss | 94% | 78% | — |
Facial palsies | 93% | 89% | — |
Cranial hyperostosis causing facial distortion | 90% | 68% | Typically only prominent mandible in van Buchem disease |
Increased intracranial pressure | 71% | 16% | — |
Syndactyly | 66% | 0% | No syndactyly in van Buchem disease Modified from and Tall stature. Accelerated linear growth becomes evident in early childhood. Longitudinal growth arrests at puberty, by which time individuals can reach heights exceeding two meters (6.5 feet). |
Source: GeneReviews — "SOST-Related Sclerosing Bone Dysplasias"
Source: GeneReviews — "SOST-Related Sclerosing Bone Dysplasias"
SOST-related sclerosing bone dysplasias must be distinguished from other sclerosing bone dysplasias, including: • The osteoscleroses, notably osteopetrosis, characterized by increased bone density with no bone overgrowth and little or no disturbance of the contours of the bones; • The craniotubular dysplasias, characterized by abnormal modeling of the skeleton and moderate sclerosis of the calvarium and base of the skull. The predominant feature of the craniotubular hyperostoses is overgrowth of bone, which leads to alterations of contours and increase in radiologic density of the skeleton. The bones are often very resistant to trauma. In addition to SOST-related sclerosing bone dysplasias, this group of disorders includes the conditions summarized in . Table 3. Other Craniotubular Hyperostoses to Consider in the Differential Diagnosis of SOST-Related Sclerosing Bone Dysplasias
Gene | Disorder | MOI | Features of Disorder |
|---|---|---|---|
LRP4 | LRP4-related sclerosteosis (OMIM 614305) | ADAR | Hyperostosis of long bones skull; Facial deformity; Cranial nerve impingement hearing loss; Tall stature |
LRP5 | Endosteal hyperostosis, Worth type (OMIM 144750) | AD | Hyperostosis of long bones skull; Cranial nerve impingement hearing loss; Enlargement of mandible |
No syndactyly SOST1 | SOST-related craniodiaphyseal dysplasia | AD | Hyperostosis of skull; Facial deformity w/hypertelorism; Cranial nerve impingement hearing loss |
No syndactyly SP72 | SP7-related craniodiaphyseal dysplasia | AR | Facial dysmorphism; Severe hyperostosis of calvarium, skull base, mandible |
1 of 2 persons reported had recurrent fractures. TGFB13 | TGFB1-related Camurati-Engelmann diaphyseal dysplasia (See Camurati-Engelmann Disease.) | AD | Hyperostosis of long bones; Frontal bossing, enlargement of mandible, proptosis, cranial nerve impingement later in life in those w/severe disease |
Source: GeneReviews — "SOST-Related Sclerosing Bone Dysplasias"
Genetic testing for SOST is available. Testing is considered confirmatory for diagnosis.
System/Concern | Evaluation | Comment |
|---|---|---|
Hearing | Formal audiologic eval | Neurologic |
Ophthalmologic | Ophthalmologic eval for evidence of intracranial pressure /or proptosis | — |
Dental | Dental /or orthodontic eval for malalignment malocclusion in children | — |
Genetic counseling | By genetics professionals1 | To obtain a pedigree inform affected persons their families re nature, MOI, implications of SOST-related sclerosing bone dysplasias to facilitate medical personal decision making DXA = dual-energy x-ray absorptiometry; MOI = mode of inheritance 1. |
SOST-Related Sclerosing Bone Dysplasias: Treatment of Manifestations Manifestation/Concern | Treatment | Considerations/Other Hearing loss |
Cranial nerve entrapment | Surgical decompression as needed for recurrent facial paralysis or facial pain | May be needed from age 2 yrs onward |
Mandibular overgrowth | Surgical reduction | May be performed for cosmetic reasons or if mouth closure is impaired due to mandible overgrowth; Tooth extraction may be difficult.; Mgmt by an orthodontic or craniofacial team is recommended. |
Proptosis | Orbital decompression | In adulthood |
Dental manifestations | Treatment per orthodontist /or as part of craniofacial team | Increased intracranial pressure |
Syndactyly | Surgical correction | May be necessary in early childhood to improve function cosmetic appearance 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. |
Source: GeneReviews — "SOST-Related Sclerosing Bone Dysplasias"
Avoid agents known to suppress bone resorption:
Bisphosphonates
Denosumab
Selective estrogen receptor modulators
Avoid agents known to stimulate bone formation:
Teriparatide
Abaloparatide
Romozosumab
Source: GeneReviews — "SOST-Related Sclerosing Bone Dysplasias"
Search ClinicalTrials.gov in the US and EU Clinical Trials Register in Europe for information on clinical studies for a wide range of diseases and conditions. Note: There may not be clinical trials for this disorder.
Source: GeneReviews — "SOST-Related Sclerosing Bone Dysplasias"
View trials for sclerosteosis 1
Evaluation |
|---|
Frequency1 |
|---|
Bone mass | DXA scan to assess bone mineral density2 | Intermittently until age 18 yrs; Every 5 yrs in adults Biochemical markers of bone turnover:3; Serum P1NP, alkaline phosphatase, osteocalcin; Urine NTX serum CTX |
Hearing | Audiologic assessment | Annually in childhood; As needed in adults |
Neurologic | Exam for evidence of cranial nerve entrapment intracranial pressure | Every 6 mos until age 18 yrs; Annually in adults |
Ophthalmologic | Ophthalmologic exam to assess for proptosis, intraocular pressure, eval of optic nerve papilla | Annually |
Teeth | Dental orthodontic eval of tooth malalignment malocclusion | Annually until age 18 yrs CTX = type I collagen cross-linked C-terminal telopeptide; NTX = type I collagen cross-linked N-terminal telopeptide; P1NP = procollagen type 1 amino terminal propeptide 1. |
Source: GeneReviews — "SOST-Related Sclerosing Bone Dysplasias"
Phenotype severity distribution: 17 always present features.