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Features include always present findings: Upslanted palpebral fissure, Short palpebral fissure, Low hanging columella, and Intellectual disability and others; and common findings: Ventricular septal defect, Recurrent urinary tract infections, Dental malocclusion, and Myopia. 22 total HPO annotations.
Organ System | Phenotype Count | Example Features |
|---|---|---|
Kidneys and urinary system | 3 | Unilateral renal agenesis, Horseshoe kidney, Recurrent urinary tract infections |
Brain and nerves | 2 | Intellectual disability, Global developmental delay |
Heart and blood vessels | 1 | Ventricular septal defect |
Head and neck | 1 | Microcephaly |
Blood and immune system | 1 | Recurrent urinary tract infections |
THOC6 intellectual disability syndrome is associated with intellectual disability, distinctive facial features, microcephaly, teeth anomalies, and cardiac and renal malformations. To date, 19 individuals from 15 families with pathogenic variants in THOC6 have been identified [, , , , , , , , , , , ]. The following description of the phenotypic features associated with this condition is based on these reports. Table 2. Features of THOC6 Intellectual Disability Syndrome
Feature | Proportion of Persons w/Feature | Comment |
|---|---|---|
Intellectual disability | 19/19 | Moderate to severe |
Facial dysmorphisms | 17/19 | — |
THOC6 function has not been fully characterized.
THOC6-related developmental delay-microcephaly-facial dysmorphism syndrome is caused by mutations in the THOC6 gene on chromosome 16.
No genotype-phenotype correlations have been identified.
Source: GeneReviews — "THOC6 Intellectual Disability Syndrome"
Formal diagnostic criteria for THOC6 intellectual disability syndrome have not been established.
THOC6 intellectual disability syndrome should be considered in individuals with the following clinical and imaging findings:
Moderate-to-severe developmental delay (DD) or intellectual disability (ID)
AND
One or more of the following features presenting in infancy or childhood:
Microcephaly
Multiple dental caries and/or dental malocclusion
Nonspecific dysmorphic features, including tall forehead, deep set eyes, short and upslanted palpebral fissures, epicanthal folds and long nose with low hanging columella
Cryptorchidism in males
Structural cardiac anomalies
Structural renal anomalies
Ventriculomegaly on brain imaging
The diagnosis of THOC6 intellectual ...
Source: GeneReviews — "THOC6 Intellectual Disability Syndrome"
Several intellectual disability disorders are associated with additional features that overlap those observed in THOC6 intellectual disability syndrome . However, because the phenotypic features associated with THOC6 intellectual disability syndrome can be nonspecific, all disorders with intellectual disability without other distinctive findings should be considered in the differential diagnosis. See OMIM Autosomal Dominant, Autosomal Recessive, Nonsyndromic X-Linked, and Syndromic X-Linked Intellectual Developmental Disorder Phenotypic Series. Table 3. Genes of Interest in the Differential Diagnosis of THOC6 Intellectual Disability Syndrome
Gene(s) | Disorder | MOI | Clinical Features of Differential Diagnosis Disorder |
|---|---|---|---|
Overlapping w/THOC6 ID syndrome | Distinguishing from THOC6 ID syndrome ATRCPAP (CENPJ)CEP152CEP63DNA2NINNSMCE2RBBP8TRAIP |
Genetic testing for THOC6 is available. Testing is considered confirmatory for diagnosis.
No approved treatments are currently available for THOC6-related developmental delay-microcephaly-facial dysmorphism syndrome. The disease remains an area of unmet medical need.
Evaluations Following Initial Diagnosis To establish the extent of disease and needs in an individual diagnosed with THOC6 intellectual disability syndrome, the evaluations summarized in this section (if not performed as part of the evaluation that led to the diagnosis) are recommended. Table 4. Recommended Evaluations Following Initial Diagnosis in Individuals with THOC6 Intellectual Disability Syndrome
System/Concern | Evaluation | Comment |
|---|---|---|
Development | Developmental assessment | Incl motor, adaptive, cognitive, speech-language eval; Eval for early intervention/ special education Psychiatric/ |
Behavioral | Neuropsychiatric eval | For persons age 12 mos: screening for concerns incl sleep disturbances, ADHD, anxiety, /or findings suggestive of ASD |
Neurologic | Neurologic eval | Incl brain MRI to assess for hydrocephalus or other cerebral anomalies; Consider EEG if seizures are a concern. Gastrointestinal/ |
Feeding | Gastroenterology/ nutrition/ feeding team eval | Incl eval of aspiration risk nutritional status; Consider eval for gastrostomy tube placement in those w/dysphagia /or aspiration risk. Assess for anal anomalies. |
Hearing | Audiologic eval |
Source: GeneReviews — "THOC6 Intellectual Disability Syndrome"
Search ClinicalTrials.gov in the US and EU Clinical Trials Register in Europe for access to information on clinical studies for a wide range of diseases and conditions. Note: There may not be clinical trials for this disorder.
Source: GeneReviews — "THOC6 Intellectual Disability Syndrome"
View trials for THOC6-related developmental delay-microcephaly-facial dysmorphism syndrome
Table 6. Recommended Surveillance for Individuals with THOC6 Intellectual Disability Syndrome
System/Concern | Evaluation | Frequency |
|---|---|---|
Development | Monitor developmental progress educational needs. | At each visit Psychiatric/ Behavioral |
Renal | Eval of renal function1 in individuals w/anomaly of kidney urinary tract | At each visit or annually |
Hearing | Audiologic eval | Annually or as clinically indicated |
Endocrine | Eval of secondary sexual characteristics menstruation cycles in females | At each visit for females age 12 yrs Miscellaneous/ |
Other | Assess family need for social work support (e.g., palliative/respite care, home nursing, other local resources) care coordination. | At each visit OT = occupational therapy; PT = physical therapy 1. Such as blood urea nitrogen (BUN), creatinine, and urinalysis |
Source: GeneReviews — "THOC6 Intellectual Disability Syndrome"
Phenotype severity distribution: 11 always present features, 4 common features.
Estimated prevalence: <1 in 1,000,000 (VERY_RARE).
No clinical trials have been registered for THOC6-related developmental delay-microcephaly-facial dysmorphism syndrome.
5 publications have been identified in PubMed for THOC6-related developmental delay-microcephaly-facial dysmorphism syndrome. Research spans Basic Science / Preclinical (60%), Review / Meta-Analysis (20%), and Case Report / Case Series (20%).
Yuan W (2026). [PMID: 41967792](https://pubmed.ncbi.nlm.nih.gov/41967792/). *Exp Cell Res*. [Basic Science / Preclinical]
Altay MF (2026). [PMID: 41145827](https://pubmed.ncbi.nlm.nih.gov/41145827/). *Eur J Hum Genet*. [Basic Science / Preclinical]
Manav Yiğit Z (2026). [PMID: 41320952](https://pubmed.ncbi.nlm.nih.gov/41320952/). *Balkan Med J*. [Review / Meta-Analysis]
Humeedat M (2025). [PMID: 40760536](https://pubmed.ncbi.nlm.nih.gov/40760536/). *Medicine (Baltimore)*. [Case Report / Case Series]
Knight HM (2024). [PMID: 37905873](https://pubmed.ncbi.nlm.nih.gov/37905873/). *Neural Regen Res*. [Basic Science / Preclinical]
Data assembled from 8 of 12 sources · Last updated Sep 20, 2026, 4:50 AM UTC
Online Mendelian Inheritance in Man
European rare disease database
Genetic and Rare Diseases Info Center
Common questions about THOC6-related developmental delay-microcephaly-facial dysmorphism syndrome
Microcephaly |
13/19 |
— |
Teeth anomalies | 10/19 | Dental caries dental malocclusion |
Congenital heart defects | 9/19 | Atrial /or ventricular septal defects |
Short stature | 8/19 | — |
Cryptorchidism in males | 7/19 | — |
Renal malformations | 6/19 | Mainly unilateral renal agenesis |
Ventriculomegaly1 | Observed in at least 6 persons | Ventriculomegaly may not have been assessed in all 19 reported cases in the literature so this may underestimate the actual incidence. Moderate-to-severe intellectual disability has been noted in all reported individuals. |
Source: GeneReviews — "THOC6 Intellectual Disability Syndrome"
AR |
Rubinstein-Taybi syndrome | AD1 | ID; microcephaly; genitourinary anomalies; low-hanging columella | Broad angulated thumbs halluces; downslanting palpebral fissures grimacing smile |
EMG1 | Bowen-Conradi syndrome (OMIM 211180) | AR | Severe ID, microcephaly, micrognathia; founder effect in Hutterite population |
KIF7 | Acrocallosal syndrome (OMIM 200990) | AR | Severe ID; corpus callosum dysgenesis; genital anomalies |
Mowat-Wilson syndrome | AD1 | Severe ID; microcephaly; corpus callosum dysgenesis; genitourinary anomalies; congenital heart defects | Hirschsprung disease or chronic constipation; distinctive facial features (uplifted earlobes, widely spaced eyes, prominent pointed chin) AD = autosomal dominant; AR = autosomal recessive; ID = intellectual disability; MOI = mode of inheritance 1. |
Source: GeneReviews — "THOC6 Intellectual Disability Syndrome"
Assess for hearing loss.
Eyes | Ophthalmologic eval | Assess for reduced vision, abnormal ocular movement, strabismus. |
ENT/Mouth | Teeth palate eval | Assess for dental caries, dental malocclusion, cleft palate/ velopharyngeal insufficiency. |
Cardiovascular | Echocardiogram | Assess for congenital heart defects. |
Genital | External genitalia exam, esp in males | Assess for cryptorchidism, hypospadias, or other genital anomalies. |
Endocrine | Eval of secondary sexual characteristics menstruation cycles in adolescent adult females | Assess for primary amenorrhea or signs of premature ovarian failure. |
Renal | Renal ultrasound | Assess for unilateral renal agenesis, ectopic kidney, or horseshoe kidney.; Assess renal function1 consider referral to nephrologist if an anomaly of kidney urinary tract is present. |
Musculoskeletal | Orthopedics/ physical medicine rehab/ PT OT eval | Incl assessment of:; Gross motor fine motor skills; Contractures, vertebral defects, kyphoscoliosis; Mobility, ADLs, need for adaptive devices; Need for PT (to improve gross motor skills) /or OT (to improve fine motor skills) Miscellaneous/ |
Other | Consultation w/clinical geneticist /or genetic counselor | Incl genetic counseling Family support resources |
Treatment of Manifestations in Individuals with THOC6 Intellectual Disability Syndrome Manifestation/Concern | Treatment | Considerations/Other Developmental delay/ |
Intellectual disability | See . | Hydrocephalus/ |
Cerebral malformations | Standard treatment(s) as recommended by neurologist/neurosurgeon | — |
Epilepsy | Standardized treatment w/ASMs by experienced neurologist | Many ASMs may be effective; none has been demonstrated effective specifically for this disorder.; Education of parents/caregivers1 Poor weight gain/ Failure to thrive |
Atresia | Standard treatment per gastroenterologist /or surgeon | Hearing |