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X-linked Dandy-Walker malformation with intellectual disability, basal ganglia disease and seizures (XDIBS), or Pettigrew syndrome is a central nervous system malformation characterized by severe intellectual deficit, early hypotonia with progression to spasticity and contractures, choreoathetosis, seizures, dysmorphic face (long face with prominent forehead), and brain imaging abnormalities such as Dandy-Walker malformation, and iron deposition.
Features include always present findings: Low muscle tone (hypotonia); and very common findings: Profound intellectual disability, Aggressive behavior, Enlarged brain ventricles (ventriculomegaly), and Microcephaly and others. 62 total HPO annotations.
Organ System | Phenotype Count | Example Features |
|---|---|---|
Brain and nerves | 18 | Mild intellectual disability, Moderate intellectual disability, Seizure |
Muscles | 7 | Flexion contracture, Low muscle tone (hypotonia), Damage to the optic nerve (optic atrophy) |
Head and neck | 7 | Coarse facial features, Microcephaly, Long face |
Bones and joints | 3 | Calvarial osteosclerosis, Sideways curvature of the spine (scoliosis), Skeletal muscle atrophy |
Ears | 2 | High-frequency hearing impairment, Inner ear hearing loss (sensorineural hearing impairment) |
Eyes | 2 | Damage to the optic nerve (optic atrophy), Strabismus |
Pregnancy and birth | 1 | Fetal distress |
Arms and legs | 1 | Stereotypical hand wringing |
Growth and development | 1 | Short stature |
Digestive system | 1 | Feeding difficulties |
AP1S2 encodes adaptor related protein complex 1 subunit sigma 2 (157 aa). Subunit of clathrin-associated adaptor protein complex 1 that plays a role in protein sorting in the late-Golgi/trans-Golgi network (TGN) and/or endosomes. Highest expression in Nerve Tibial (42.5 TPM) and Uterus (38.3 TPM).
Syndromic X-linked intellectual disability 5 is associated with mutations in the AP1S2 gene on chromosome X.
The AP1S2 protein participates in MITF-M-dependent TRPM1 expression pathway.
AP1S2 is classified as a druggable target with score 0.0.
Genetic testing for AP1S2 is available. Testing is considered confirmatory for diagnosis.
Biomarker and diagnostic research for syndromic X-linked intellectual disability 5 has been reported in the published literature.
Phenotype severity distribution: 1 always present feature, 23 very common features, 7 common features.
Estimated prevalence: <1 in 1,000,000 (VERY_RARE).
No clinical trials have been registered for syndromic X-linked intellectual disability 5.
223 publications have been identified in PubMed for syndromic X-linked intellectual disability 5. Research spans Basic Science / Preclinical (33%), Epidemiology / Natural History (19%), and Case Report / Case Series (19%).
Research Type | Count | % of Total |
|---|---|---|
Laboratory research | 73 | 33% |
Disease patterns and progression | 43 | 19% |
Patient case studies | 42 | 19% |
Research summaries | 24 | 11% |
Clinical study results | 22 | 10% |
New treatment approaches | 10 | 4% |
Testing and diagnosis research | 9 | 4% |
Guillon M (2026). [PMID: 42030940](https://pubmed.ncbi.nlm.nih.gov/42030940/). *Stem Cell Reports*. [Basic Science / Preclinical]
De Stefano LA (2026). [PMID: 41922399](https://pubmed.ncbi.nlm.nih.gov/41922399/). *Sci Rep*. [Clinical Trial Publication]
Boussetta A (2026). [PMID: 41501258](https://pubmed.ncbi.nlm.nih.gov/41501258/). *Pediatr Nephrol*. [Case Report / Case Series]
Rishabh RK (2026). [PMID: 42220602](https://pubmed.ncbi.nlm.nih.gov/42220602/). *JCEM Case Rep*. [Case Report / Case Series]
Du Y (2026). [PMID: 41501339](https://pubmed.ncbi.nlm.nih.gov/41501339/). *Sci Rep*. [Basic Science / Preclinical]
Möhrle D (2026). [PMID: 41399120](https://pubmed.ncbi.nlm.nih.gov/41399120/). *Autism Res*. [Epidemiology / Natural History]
Efrat K (2026). [PMID: 41797617](https://pubmed.ncbi.nlm.nih.gov/41797617/). *Quintessence Int*. [Case Report / Case Series]
Hourani SM (2026). [PMID: 41923202](https://pubmed.ncbi.nlm.nih.gov/41923202/). *J Neurodev Disord*. [Basic Science / Preclinical]
Li X (2026). [PMID: 42087737](https://pubmed.ncbi.nlm.nih.gov/42087737/). *Zhonghua Yi Xue Yi Chuan Xue Za Zhi*. [Review / Meta-Analysis]
Bergdolt L (2026). [PMID: 41850340](https://pubmed.ncbi.nlm.nih.gov/41850340/). *Neurobiol Dis*. [Basic Science / Preclinical]
Data assembled from 6 of 12 sources · Last updated Sep 20, 2026, 8:40 AM UTC
Online Mendelian Inheritance in Man
European rare disease database
Genetic and Rare Diseases Info Center