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Features include very common findings: Ptosis; and common findings: Epicanthus, Anteverted nares, Exaggerated cupid's bow, and Short nose and others. 48 total HPO annotations.
Organ System | Phenotype Count | Example Features |
|---|---|---|
Brain and nerves | 5 | Mild intellectual disability, Mild global developmental delay, Enlarged brain ventricles (ventriculomegaly) |
ZNF462 function has not been fully characterized.
Weiss-Kruszka syndrome is caused by mutations in the ZNF462 gene on chromosome 9.
Formal diagnostic criteria for Weiss-Kruszka syndrome have not been established.
Weiss-Kruszka syndrome should be suspected in individuals presenting with the following clinical and brain MRI findings.
Clinical findings
Metopic ridging or synostosis
Ptosis
No approved treatments are currently available for Weiss-Kruszka 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 Weiss-Kruszka syndrome, the evaluations summarized (if not performed as part of the evaluation that led to diagnosis) are recommended. Table 3. Recommended Evaluations Following Initial Diagnosis in Individuals with Weiss-Kruszka Syndrome
Table 5. Recommended Surveillance for Individuals with Weiss-Kruszka Syndrome
System/Concern |
|---|
No clinical trials have been registered for Weiss-Kruszka syndrome.
36 publications have been identified in PubMed for Weiss-Kruszka syndrome. Research spans Case Report / Case Series (44%), Basic Science / Preclinical (22%), and Epidemiology / Natural History (14%).
Research Type | Count | % of Total |
|---|---|---|
Patient case studies | 16 | 44% |
Data assembled from 8 of 12 sources · Last updated Sep 19, 2026, 6:56 PM UTC
Online Mendelian Inheritance in Man
European rare disease database
Common questions about Weiss-Kruszka syndrome
Heart and blood vessels |
4 |
Ventricular septal defect, Bicuspid aortic valve, Thickened left heart wall (left ventricular hypertrophy) |
Arms and legs | 3 | Hypoplastic fingernail, Clinodactyly of the 5th finger, Abnormality of limbs |
Muscles | 2 | Generalized hypotonia, Low muscle tone (hypotonia) |
Ears | 1 | Hearing loss (hearing impairment) |
Digestive system | 1 | Feeding difficulties |
Eyes | 1 | Ptosis |
Hormones | 1 | Decreased response to growth hormone stimulation test |
Growth and development | 1 | Decreased response to growth hormone stimulation test |
Lungs and breathing | 1 | Obstructive sleep apnea |
To date, 24 individuals from 21 families are have been identified with a pathogenic variant in ZNF462 [, , , , ]. The following description of the phenotypic features associated with this condition is based on these reported cases. Note: The reports by and describe the same individual; the authors speculated that this individual's features may have resulted from a fusion protein created by a balanced translocation that disrupted ZNF462. Craniofacial features. The most common facial features:
Ptosis (20/24; 83%)
Downslanted palpebral fissures (13/24; 54%)
Exaggerated Cupid's Bow (13/24; 54%)
Arched eyebrows (12/24; 50%)
Epicanthal folds (11/24; 46%)
Short upturned nose with bulbous tip (11/24; 46%)
Source: GeneReviews — "Weiss-Kruszka Syndrome"
Nonspecific dysmorphic features (see , Craniofacial features)
Developmental delay and/or autistic features
Brain MRI findings. Corpus callosum abnormalities
The diagnosis of Weiss-Kruszka syndrome is established in a proband with and by the identification of one of the following on molecular genetic testing :
A heterozygous pathogenic variant involving ZNF462
A heterozygous deletion of 9q31.2 involving ZNF462
Source: GeneReviews — "Weiss-Kruszka Syndrome"
Table 2. Disorders with Intellectual Disability to Consider in the Differential Diagnosis of Weiss-Kruszka Syndrome
DiffDx Disorder | Gene(s) | MOI | Clinical Features of DiffDx Disorder |
|---|---|---|---|
FOXL2 | AD | Ptosis; Ear anomalies; Arched eyebrows | Blepharophimosis; Epicanthus inversus; Microphthalmia; Strabismus |
Noonan syndrome | BRAFKRASLZTR11MAP2K1NRASPTPN11RIT1SOS1 | AD(AR)1 | Ptosis; Low set ears; Congenital heart disease |
Webbed neck Hereditary congenital ptosis 1 (OMIM 178300) | Unknown | AD | Ptosis |
Hereditary congenital ptosis 2 (OMIM 300245) | Unknown | XL | Ptosis |
FGFR1 | AD | Trigonocephaly | Mild synophrys Trigonocephaly 2 (OMIM 614485) |
FREM1 | AD | Trigonocephaly | Microcephaly in some individuals AD = autosomal dominant; AR = autosomal recessive; DD = developmental delay; DiffDx = differential diagnosis; MOI = mode of inheritance; XL = X-linked 1. Autosomal recessive inheritance of LZTR1-related Noonan syndrome has been reported . |
Source: GeneReviews — "Weiss-Kruszka Syndrome"
Genetic testing for ZNF462 is available. Testing is considered confirmatory for diagnosis.
System/Concern | Evaluation | Comment |
|---|
Craniofacial | Physical exam to identify face shape suture ridging | — |
Eyes | Ophthalmologic eval | To address ptosis |
Development | Developmental assessment | To incl:; Motor, adaptive, cognitive, speech-language eval; Eval for early intervention / special education Psychiatric/ |
Behavioral | Neuropsychiatric eval | Persons age 12 mos: screen for behavior concerns incl traits suggestive of ASD. |
Ears/hearing | Audiology eval | To assess for hearing loss Gastrointestinal/ |
Feeding | Gastroenterology / nutrition / feeding team eval | To incl eval of aspiration risk nutritional status; Consider eval for gastrostomy tube placement in those w/dysphagia /or aspiration risk. |
Cardiovascular | Cardiology consultation | Baseline echocardiogram recommended |
Neurologic | Neurologic eval | Miscellaneous/ |
Other | Consultation w/clinical geneticist /or genetic counselor | Family supports/resources |
Craniosynostosis | Referral to a craniofacial team /or neurosurgeon | For discussion of surgical correction |
Ptosis | Standard treatment per ophthalmologist | — |
DD/ID | See . | — |
Hearing loss | Hearing aids may be helpful; as per otolaryngologist. | Community hearing services through early intervention or school district |
Feeding difficulties / dysphagia / poor weight gain | Feeding therapy; gastrostomy tube placement may be required for persistent feeding issues. | Low threshold for clinical feeding eval /or radiographic swallowing study if clinical signs or symptoms of dysphagia |
Congenital heart defects | Standard treatment per cardiologist | Family/Community |
Source: GeneReviews — "Weiss-Kruszka Syndrome"
View trials for Weiss-Kruszka syndrome
Evaluation
Frequency |
|---|
Head | Assessment of head circumference head shape | At each eval in infancy early childhood |
Eyes | Ophthalmology eval | Frequency to be determined by the degree of ptosis |
Development | Monitor developmental progress educational needs | At each visit |
Ears | Audiology eval | Based on clinical suspicion |
Feeding | Measurement of growth parameters | At each visit Eval of nutritional status safety of oral intake Miscellaneous/ Other |
Source: GeneReviews — "Weiss-Kruszka Syndrome"
Phenotype severity distribution: 1 very common feature, 17 common features.
Estimated prevalence: <1 in 1,000,000 (VERY_RARE).
8 |
22% |
Disease patterns and progression | 5 | 14% |
Research summaries | 4 | 11% |
Clinical study results | 3 | 8% |
Ketenci-İşlek S (2026). [PMID: 40538467](https://pubmed.ncbi.nlm.nih.gov/40538467/). *Mol Syndromol*. [Case Report / Case Series]
Bashawieh OO (2026). [PMID: 41604010](https://pubmed.ncbi.nlm.nih.gov/41604010/). *Childs Nerv Syst*. [Epidemiology / Natural History]
Arenas Ruiz JA (2026). [PMID: 41724090](https://pubmed.ncbi.nlm.nih.gov/41724090/). *J Clin Neurosci*. [Case Report / Case Series]
Konar S (2026). [PMID: 41422703](https://pubmed.ncbi.nlm.nih.gov/41422703/). *J Craniomaxillofac Surg*. [Epidemiology / Natural History]
Ward H (2026). [PMID: 42104108](https://pubmed.ncbi.nlm.nih.gov/42104108/). *Childs Nerv Syst*. [Case Report / Case Series]
Liu Z (2025). [PMID: 40353334](https://pubmed.ncbi.nlm.nih.gov/40353334/). *Mol Genet Genomic Med*. [Basic Science / Preclinical]
Zhang X (2025). [PMID: 40623936](https://pubmed.ncbi.nlm.nih.gov/40623936/). *Zhonghua Yi Xue Yi Chuan Xue Za Zhi*. [Case Report / Case Series]
Tio PAE (2025). [PMID: 41151318](https://pubmed.ncbi.nlm.nih.gov/41151318/). *J Plast Reconstr Aesthet Surg*. [Epidemiology / Natural History]
Lif H (2025). [PMID: 41408946](https://pubmed.ncbi.nlm.nih.gov/41408946/). *J Plast Surg Hand Surg*. [Clinical Trial Publication]
Yindeedej V (2025). [PMID: 39546784](https://pubmed.ncbi.nlm.nih.gov/39546784/). *J Neurosurg Pediatr*. [Basic Science / Preclinical]
AI-curated news mentioning Weiss-Kruszka syndrome
Updated Jul 20, 2026
Researchers have identified a DNA methylation episignature associated with Weiss-Kruszka syndrome, potentially aiding in diagnosis and understanding of the disease. This discovery could enhance genetic testing and patient management strategies.