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Holoprosencephaly 12 with or without pancreatic agenesis(HPE12)

MedGen UID:
1684550
Concept ID:
C5193131
Disease or Syndrome
Synonyms: HOLOPROSENCEPHALY 12 WITH OR WITHOUT PANCREATIC AGENESIS; HPE12
 
Gene (location): CNOT1 (16q21)
 
Monarch Initiative: MONDO:0032787
OMIM®: 618500

Definition

Holoprosencephaly-12 with or without pancreatic agenesis (HPE12) is a developmental disorder characterized by abnormal separation of the embryonic forebrain (HPE) resulting in dysmorphic facial features and often, but not always, impaired neurologic development. Most patients with this form of HPE also have congenital absence of the pancreas, resulting in early-onset type 1 diabetes mellitus and requiring pancreatic enzyme replacement. Other features may include hearing loss and absence of the gallbladder (summary by De Franco et al., 2019 and Kruszka et al., 2019). For a phenotypic description and a discussion of genetic heterogeneity of holoprosencephaly, see HPE1 (236100). [from OMIM]

Clinical features

From HPO
Fetal growth restriction
MedGen UID:
4693
Concept ID:
C0015934
Pathologic Function
An abnormal restriction of fetal growth with fetal weight below the tenth percentile for gestational age.
Conductive hearing impairment
MedGen UID:
9163
Concept ID:
C0018777
Disease or Syndrome
An abnormality of vibrational conductance of sound to the inner ear leading to impairment of sensory perception of sound.
Sensorineural hearing impairment
MedGen UID:
9164
Concept ID:
C0018784
Disease or Syndrome
A type of hearing impairment in one or both ears related to an abnormal functionality of the cochlear nerve.
Microtia
MedGen UID:
57535
Concept ID:
C0152423
Congenital Abnormality
Underdevelopment of the external ear.
Low-set ears
MedGen UID:
65980
Concept ID:
C0239234
Congenital Abnormality
Upper insertion of the ear to the scalp below an imaginary horizontal line drawn between the inner canthi of the eye and extending posteriorly to the ear.
Abnormal pinna morphology
MedGen UID:
167800
Concept ID:
C0857379
Congenital Abnormality
An abnormality of the pinna, which is also referred to as the auricle or external ear.
Spasticity
MedGen UID:
7753
Concept ID:
C0026838
Sign or Symptom
A motor disorder characterized by a velocity-dependent increase in tonic stretch reflexes with increased muscle tone, exaggerated (hyperexcitable) tendon reflexes.
Seizure
MedGen UID:
20693
Concept ID:
C0036572
Sign or Symptom
A seizure is an intermittent abnormality of nervous system physiology characterised by a transient occurrence of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain.
Global developmental delay
MedGen UID:
107838
Concept ID:
C0557874
Finding
A delay in the achievement of motor or mental milestones in the domains of development of a child, including motor skills, speech and language, cognitive skills, and social and emotional skills. This term should only be used to describe children younger than five years of age.
Generalized hypotonia
MedGen UID:
346841
Concept ID:
C1858120
Finding
Generalized muscular hypotonia (abnormally low muscle tone).
Microcephaly
MedGen UID:
1644158
Concept ID:
C4551563
Finding
Head circumference below 2 standard deviations below the mean for age and gender.
Diabetes mellitus type 1
MedGen UID:
41522
Concept ID:
C0011854
Disease or Syndrome
Type 1 diabetes mellitus (T1D), also designated insulin-dependent diabetes mellitus (IDDM), is a disorder of glucose homeostasis characterized by susceptibility to ketoacidosis in the absence of insulin therapy. It is a genetically heterogeneous autoimmune disease affecting about 0.3% of Caucasian populations (Todd, 1990). Genetic studies of T1D have focused on the identification of loci associated with increased susceptibility to this multifactorial phenotype. The classic phenotype of diabetes mellitus is polydipsia, polyphagia, and polyuria which result from hyperglycemia-induced osmotic diuresis and secondary thirst. These derangements result in long-term complications that affect the eyes, kidneys, nerves, and blood vessels.
High palate
MedGen UID:
66814
Concept ID:
C0240635
Congenital Abnormality
Height of the palate more than 2 SD above the mean (objective) or palatal height at the level of the first permanent molar more than twice the height of the teeth (subjective).
Epicanthus
MedGen UID:
151862
Concept ID:
C0678230
Congenital Abnormality
Epicanthus is a condition in which a fold of skin stretches from the upper to the lower eyelid, partially covering the inner canthus. Usher (1935) noted that epicanthus is a normal finding in the fetus of all races. Epicanthus also occurs in association with hereditary ptosis (110100).
Depressed nasal bridge
MedGen UID:
373112
Concept ID:
C1836542
Finding
Posterior positioning of the nasal root in relation to the overall facial profile for age.
Sloping forehead
MedGen UID:
346640
Concept ID:
C1857679
Finding
Inclination of the anterior surface of the forehead from the vertical more than two standard deviations above the mean (objective); or apparently excessive posterior sloping of the forehead in a lateral view.
Long philtrum
MedGen UID:
351278
Concept ID:
C1865014
Finding
Distance between nasal base and midline upper lip vermilion border more than 2 SD above the mean. Alternatively, an apparently increased distance between nasal base and midline upper lip vermilion border.
Diabetes insipidus
MedGen UID:
8349
Concept ID:
C0011848
Disease or Syndrome
A state of excessive water intake and hypotonic (dilute) polyuria. Diabetes insipidus may be due to failure of vasopressin (AVP) release (central or neurogenic diabetes insipidus) or to a failure of the kidney to respond to AVP (nephrogenic diabetes insipidus).
Hypotelorism
MedGen UID:
96107
Concept ID:
C0424711
Finding
Interpupillary distance less than 2 SD below the mean (alternatively, the appearance of an decreased interpupillary distance or closely spaced eyes).

Professional guidelines

PubMed

Hernandez P, Passi N, Modarressi T, Kulkarni V, Soni M, Burke F, Bajaj A, Soffer D
Curr Atheroscler Rep 2021 Sep 13;23(11):72. doi: 10.1007/s11883-021-00962-z. PMID: 34515873Free PMC Article
Simha V
BMJ 2020 Oct 12;371:m3109. doi: 10.1136/bmj.m3109. PMID: 33046451
Gutta A, Fogel E, Sherman S
Expert Rev Gastroenterol Hepatol 2019 Nov;13(11):1089-1105. Epub 2019 Nov 8 doi: 10.1080/17474124.2019.1685871. PMID: 31663403Free PMC Article

Recent clinical studies

Etiology

Hernandez P, Passi N, Modarressi T, Kulkarni V, Soni M, Burke F, Bajaj A, Soffer D
Curr Atheroscler Rep 2021 Sep 13;23(11):72. doi: 10.1007/s11883-021-00962-z. PMID: 34515873Free PMC Article
Suzuki M, Minowa K, Isayama H, Shimizu T
Pediatr Int 2021 Feb;63(2):137-149. Epub 2021 Feb 18 doi: 10.1111/ped.14415. PMID: 32745358
Schima W, Böhm G, Rösch CS, Klaus A, Függer R, Kopf H
Cancer Imaging 2020 Jul 23;20(1):52. doi: 10.1186/s40644-020-00324-z. PMID: 32703312Free PMC Article
Gutta A, Fogel E, Sherman S
Expert Rev Gastroenterol Hepatol 2019 Nov;13(11):1089-1105. Epub 2019 Nov 8 doi: 10.1080/17474124.2019.1685871. PMID: 31663403Free PMC Article
Kleeff J, Whitcomb DC, Shimosegawa T, Esposito I, Lerch MM, Gress T, Mayerle J, Drewes AM, Rebours V, Akisik F, Muñoz JED, Neoptolemos JP
Nat Rev Dis Primers 2017 Sep 7;3:17060. doi: 10.1038/nrdp.2017.60. PMID: 28880010

Diagnosis

Suzuki M, Minowa K, Isayama H, Shimizu T
Pediatr Int 2021 Feb;63(2):137-149. Epub 2021 Feb 18 doi: 10.1111/ped.14415. PMID: 32745358
Gutta A, Fogel E, Sherman S
Expert Rev Gastroenterol Hepatol 2019 Nov;13(11):1089-1105. Epub 2019 Nov 8 doi: 10.1080/17474124.2019.1685871. PMID: 31663403Free PMC Article
Gandhi NS, Feldman MK, Le O, Morris-Stiff G
Abdom Radiol (NY) 2018 Feb;43(2):273-284. doi: 10.1007/s00261-017-1330-1. PMID: 29038855
Kleeff J, Whitcomb DC, Shimosegawa T, Esposito I, Lerch MM, Gress T, Mayerle J, Drewes AM, Rebours V, Akisik F, Muñoz JED, Neoptolemos JP
Nat Rev Dis Primers 2017 Sep 7;3:17060. doi: 10.1038/nrdp.2017.60. PMID: 28880010
Geokas MC, Baltaxe HA, Banks PA, Silva J Jr, Frey CF
Ann Intern Med 1985 Jul;103(1):86-100. doi: 10.7326/0003-4819-103-1-86. PMID: 3890660

Therapy

Hernandez P, Passi N, Modarressi T, Kulkarni V, Soni M, Burke F, Bajaj A, Soffer D
Curr Atheroscler Rep 2021 Sep 13;23(11):72. doi: 10.1007/s11883-021-00962-z. PMID: 34515873Free PMC Article
Simha V
BMJ 2020 Oct 12;371:m3109. doi: 10.1136/bmj.m3109. PMID: 33046451
DeFronzo RA, Ferrannini E, Groop L, Henry RR, Herman WH, Holst JJ, Hu FB, Kahn CR, Raz I, Shulman GI, Simonson DC, Testa MA, Weiss R
Nat Rev Dis Primers 2015 Jul 23;1:15019. doi: 10.1038/nrdp.2015.19. PMID: 27189025
Heck AM, Yanovski JA, Calis KA
Pharmacotherapy 2000 Mar;20(3):270-9. doi: 10.1592/phco.20.4.270.34882. PMID: 10730683Free PMC Article
Geokas MC, Baltaxe HA, Banks PA, Silva J Jr, Frey CF
Ann Intern Med 1985 Jul;103(1):86-100. doi: 10.7326/0003-4819-103-1-86. PMID: 3890660

Prognosis

Schima W, Böhm G, Rösch CS, Klaus A, Függer R, Kopf H
Cancer Imaging 2020 Jul 23;20(1):52. doi: 10.1186/s40644-020-00324-z. PMID: 32703312Free PMC Article
Gutta A, Fogel E, Sherman S
Expert Rev Gastroenterol Hepatol 2019 Nov;13(11):1089-1105. Epub 2019 Nov 8 doi: 10.1080/17474124.2019.1685871. PMID: 31663403Free PMC Article
Al-Hader A, Al-Rohil RN, Han H, Von Hoff D
World J Gastroenterol 2017 Dec 7;23(45):7945-7951. doi: 10.3748/wjg.v23.i45.7945. PMID: 29259370Free PMC Article
DiMagno MJ, Wamsteker EJ
Curr Gastroenterol Rep 2011 Apr;13(2):150-6. doi: 10.1007/s11894-010-0170-8. PMID: 21222060Free PMC Article
Geokas MC, Baltaxe HA, Banks PA, Silva J Jr, Frey CF
Ann Intern Med 1985 Jul;103(1):86-100. doi: 10.7326/0003-4819-103-1-86. PMID: 3890660

Clinical prediction guides

Gutta A, Fogel E, Sherman S
Expert Rev Gastroenterol Hepatol 2019 Nov;13(11):1089-1105. Epub 2019 Nov 8 doi: 10.1080/17474124.2019.1685871. PMID: 31663403Free PMC Article
DiMagno MJ, Wamsteker EJ
Curr Gastroenterol Rep 2011 Apr;13(2):150-6. doi: 10.1007/s11894-010-0170-8. PMID: 21222060Free PMC Article
Varshney S, Johnson CD
Int J Pancreatol 1999 Apr;25(2):135-41. doi: 10.1385/IJGC:25:2:135. PMID: 10360226
Ryan CM, Sheridan RL, Schoenfeld DA, Warshaw AL, Tompkins RG
Ann Surg 1995 Aug;222(2):163-70. doi: 10.1097/00000658-199508000-00008. PMID: 7543741Free PMC Article
Geokas MC, Baltaxe HA, Banks PA, Silva J Jr, Frey CF
Ann Intern Med 1985 Jul;103(1):86-100. doi: 10.7326/0003-4819-103-1-86. PMID: 3890660

Recent systematic reviews

Pappachan JM, Lahart IM, Viswanath AK, Borumandi F, Sodi R, Metzendorf MI, Bongaerts B
Cochrane Database Syst Rev 2023 Mar 8;3(3):CD013035. doi: 10.1002/14651858.CD013035.pub2. PMID: 36883976Free PMC Article
Bagias G, Kanavidis P, Vailas M, Despotidis M, Sotiropoulou M, Katsaros I, Maroulis I, Filippou D, Schizas D
ANZ J Surg 2022 Nov;92(11):2816-2821. Epub 2022 Jun 27 doi: 10.1111/ans.17834. PMID: 35758214
Dehghanian F, Azhir Z, Khalilian S, Grüning B
J Diabetes Investig 2022 Mar;13(3):405-428. Epub 2021 Dec 14 doi: 10.1111/jdi.13727. PMID: 34859606Free PMC Article
Srisajjakul S, Prapaisilp P, Bangchokdee S
Clin Imaging 2016 Nov-Dec;40(6):1173-1181. Epub 2016 Aug 6 doi: 10.1016/j.clinimag.2016.08.007. PMID: 27572283
Majumder K, Gupta A, Arora N, Singh PP, Singh S
Clin Gastroenterol Hepatol 2016 Mar;14(3):355-368.e; quiz e32. Epub 2015 Oct 14 doi: 10.1016/j.cgh.2015.09.036. PMID: 26460214Free PMC Article

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