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Pitt–Hopkins syndrome

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and more progressive therapies, many individuals can achieve much more than initially thought. It has become clearer that there is a wider range of cognitive abilities in Pitt–Hopkins than reported in much of the scientific literature. No cure is known for Pitt-Hopkins syndrome, but it is possible to
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Gastrointestinal difficulties are common in individuals with Pitt-Hopkins and can include constipation, reflux, and burping. Severe constipation often occurs over the entire lifespan. Breathing issues may cause air swallowing and associated pain. Low muscle tone can cause feeding issues at an early
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Minor hand and foot anomalies such as slender or small hands and feet, broad fingertips, clinodactyly, tapered fingers, transverse palmar crease, flat feet with hindfoot valgus deformity, overriding toes, and short metatarsals have been reported. Absent flexion creases of the thumbs may occur with
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Magnetic resonance imaging (MRI) reveals that deviations in the brain may occur in individuals with Pitt-Hopkins. These can include a small corpus callosum, wide ventricles, and deviations in the posterior fossa. Many individuals with Pitt Hopkins can also have typical brain structures.
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Epilepsy is not uncommon in Pitt-Hopkins and is reported in 37%-50% of cases. The onset of seizures can occur in infants or throughout adulthood. A variety of seizures can occur. Electroencephalographic (EEG) patterns can be typical or atypical, depending on the individual.
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Other features of Pitt-Hopkins syndrome may include constipation and other gastrointestinal problems, an unusually small head (microcephaly), nearsightedness (myopia), eyes that do not look in the same direction (strabismus), short stature, and minor brain abnormalities
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Zollino and colleagues defined diagnostic criteria based on characteristic features found in 75% of cases genetically confirmed for PTHS, termed cardinal features. If a person shows 9 cardinal features, they are classified as having PTHS.
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Whalen S, Héron D, Gaillon T, Moldovan O, Rossi M, Devillard F, et al. (January 2012). "Novel comprehensive diagnostic strategy in Pitt-Hopkins syndrome: clinical score and further delineation of the TCF4 mutational spectrum".
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There is no specific treatment for this condition. It is based on symptomatology. Since there is a lack of treatment, people with PTHS use behavioral and training approaches. Comorbidities may also be treated.
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Children with Pitt-Hopkins syndrome typically have a happy, excitable demeanor with frequent smiling, laughter, and hand-flapping movements. However, they can also experience anxiety and behavioral problems.
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There is not a certain diagnostic criteria, but there are a few symptoms that support a diagnosis of PTHS. Some examples are: facial dysmorphism, early onset global developmental delay, moderate to severe
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Angelman syndrome most closely resembles PTHS. Both have absent speech and a "happy" disposition. Of the differentials, Rett syndrome is the least close to PTHS. This syndrome is seen as a progressive
1052:"Mutations in TCF4, encoding a class I basic helix-loop-helix transcription factor, are responsible for Pitt-Hopkins syndrome, a severe epileptic encephalopathy associated with autonomic dysfunction" 396:. Both Angelman syndrome and Rett syndrome lack the distinctive facial features of PTHS. Mowat–Wilson syndrome is seen in early infancy and is characterized by distinctive facial abnormalities. 331:
It is possible that a phenotype resembling PTHS can occur without the mutation in the TCF4 gene. Mutations in the TCF4 gene do not always result in stereotypical Pitt-Hopkins syndrome.
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When a patient is suspected of having PTHS, genetic tests looking at the TCF4 gene are typically done. Some argue for a genetic test to occur first, followed by a clinical assessment.
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Developmental preschool through public school systems from ages 3 to 5. The child will need an evaluation before getting into the program, to see what kind of therapy is needed.
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gene. Those with PTHS have reported high rates of self-injury and aggressive behaviors usually related to autism and their sensory disorders.
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Early intervention program from newborn to age 3 will allow access to different therapies (occupational, physical, speech, and feeding).
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As more is learned about Pitt–Hopkins, the developmental spectrum of the disorder is widening, and can also include difficulties with
1368: 702:"Behavioural and psychological characteristics in Pitt-Hopkins syndrome: a comparison with Angelman and Cornelia de Lange syndromes" 1799: 1629: 1558: 1500: 1990: 1490: 661: 1522: 17: 1017:
Sweetser DA, Elsharkawi I, Yonker L, Steeves M, Parkin K, Thibert R (1993), Adam MP, Feldman J, Mirzaa GM, Pagon RA (eds.),
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Sweetser DA, Elsharkawi I, Yonker L, Steeves M, Parkin K, Thibert R (1993), Adam MP, Feldman J, Mirzaa GM, Pagon RA (eds.),
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Care from a medical team including neurologists, ophthalmologists, pulmonologists, and gastroenterologists may be utilized.
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The condition was first described in 1978, by D. Pitt and I. Hopkins (The Children's Cottages Training Centre, Kew and
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Pitt D, Hopkins I (September 1978). "A syndrome of mental retardation, wide mouth and intermittent overbreathing".
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Recommendations for developmental delay and intellectual disability in the U.S. (may differ depending on country):
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treat associated symptoms. Researchers have developed cell and rodent models to test therapies for Pitt–Hopkins.
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Half of the individuals with PTHS are reported to have seizures, starting from childhood to the late teens.
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Flat feet, overriding toes, and fetal pads are also common. Short stature and scoliosis occur frequently.
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Zollino M, Zweier C, Van Balkom ID, Sweetser DA, Alaimo J, Bijlsma EK, et al. (18 February 2019).
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Pitt–Hopkins patients with a TCF4 deletion can lack the syndrome's characteristic facial features.
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features, which are important when diagnosing PTHS, become more visible as the person gets older.
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mutations. The risk in siblings is low, but higher than the general population due to parental
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Around 50% of those affected show abnormalities on brain imaging. These include a hypoplastic
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Watkins A, Bissell S, Moss J, Oliver C, Clayton-Smith J, Haye L, et al. (October 2019).
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Zweier C, Peippo MM, Hoyer J, Sousa S, Bottani A, Clayton-Smith J, et al. (May 2007).
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A Pitt–Hopkins-like phenotype has been assigned to autosomal recessive mutations of the
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thumb ankylosis. In one individual an absent thumb tendon was found during surgery .
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Amiel J, Rio M, de Pontual L, Redon R, Malan V, Boddaert N, et al. (May 2007).
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The genetic cause of this disorder was described in 2007. This disorder is due to a
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Malformations in the CNS can be seen in about 60 to 70% of patients on MRI scans.
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Goodspeed K, Newsom C, Morris MA, Powell C, Evans P, Golla S (10 January 2018).
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Sweetser DA, Elsharkawi I, Yonker L, Steeves M, Parkin K, Thibert R (1993).
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Boy with Pitt–Hopkins syndrome showing the characteristic facial features.
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The earliest signs in infants is the lower face and the high nasal root.
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is difficult to measure given motor and speech difficulties. Thanks to
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According to the clinical diagnosis. PTHS is in the same group as
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PTHS is estimated to occur in 1:11,000 to 1:41,000 people.
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Adults who have PTHS may have trouble with their speech.
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From the ages 5–21 the child's school may create an
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The facial features are characteristic and include:
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In MP, Ardinger HH, Pagon RA, Wallace SE (eds.). 477:, Seattle (WA): University of Washington, Seattle, 449:, Melbourne, Australia) in two unrelated patients. 144:PTHS has traditionally been associated with severe 2304:Ectrodactyly–ectodermal dysplasia–cleft syndrome 3 2409: 1148: 1146: 1144: 787: 785: 783: 781: 779: 777: 775: 773: 1200: 1198: 1152: 1098: 78:) is a rare genetic disorder characterized by 2196:Yemenite deaf-blind hypopigmentation syndrome 1384: 836:National Center for Biotechnology Information 680:National Center for Biotechnology Information 1141: 819: 817: 815: 770: 137:which causes insufficient expression of the 1253: 1195: 693: 495: 266:) gene which is located on the long arm of 1391: 1377: 1043: 544: 40: 1247: 1230: 1178: 1124: 1075: 985: 936: 912: 812: 727: 717: 637: 527: 372: 1800:Posterior polymorphous corneal dystrophy 1630:Autoimmune polyendocrine syndrome type 1 433: 199: 168:PTHS can be seen as early as childhood. 1991:Anterior segment mesenchymal dysgenesis 1153:Marangi G, Zollino M (September 2015). 706:Journal of Neurodevelopmental Disorders 14: 2410: 1204: 1523:X-linked adrenal hypoplasia congenita 1372: 1211:Experimental & Molecular Medicine 955: 953: 951: 949: 947: 857: 855: 853: 800:. University of Washington, Seattle. 163: 1575:Greig cephalopolysyndactyly syndrome 823: 599: 597: 595: 593: 591: 464: 462: 1949:Iridogoniodysgenesis, dominant type 1099:Peippo M, Ignatius J (April 2012). 377:PTHS is symptomatically similar to 359:show an excess of slow components. 353:bulging towards the frontal horns. 222: 178:Broad nasal bridge with bulbous tip 24: 2233: 1056:American Journal of Human Genetics 944: 850: 508:American Journal of Human Genetics 25: 2454: 2418:Transcription factor deficiencies 1294: 664:. Daniel R. Weinberger. May 2019. 588: 459: 364:Pervasive Developmental Disorders 2395: 1963:Lymphedema–distichiasis syndrome 1559:Tricho–rhino–phalangeal syndrome 1533:Familial partial lipodystrophy 3 2227:(0) Other transcription factors 1518:Estrogen insensitivity syndrome 1486:Androgen insensitivity syndrome 1092: 1010: 920: 896: 262:of the transcription factor 4 ( 231: 2108:Hyperimmunoglobulin E syndrome 1513:PHA1AD pseudohypoaldosteronism 744: 668: 654: 13: 1: 2370:Atrichia with papular lesions 1256:Australian Paediatric Journal 1159:Journal of Pediatric Genetics 452: 2077:Popliteal pterygium syndrome 2019:Enlarged vestibular aqueduct 1858:Waardenburg syndrome 1&3 1643:(3) Helix-turn-helix domains 1402:relating to deficiencies of 399: 314: 90:, and possible intermittent 7: 2423:Syndromes affecting the eye 2177:Premature ovarian failure 7 2033:Premature ovarian failure 3 1905:Congenital hypothyroidism 2 931:, Qeios, 10 February 2020, 907:, Qeios, 10 February 2020, 301:) gene on the short arm of 285:associated protein like 2 ( 253: 88:distinctive facial features 10: 2459: 2428:Disorders causing seizures 2324:Transcription coregulators 2094:with minor groove contacts 1481:Thyroid hormone resistance 869:. Qeios. 2 February 2020. 831:Medical Genetics Summaries 610:Journal of Child Neurology 429: 345:and posterior part of the 289:) gene on the long arm of 154:augmentative communication 2356: 2346:Rubinstein–Taybi syndrome 2331: 2322: 2253: 2226: 2206: 2172:SRY XY gonadal dysgenesis 2142: 2116: 2100: 2091: 2057: 1977:Bamforth–Lazarus syndrome 1929: 1829: 1649: 1642: 1622: 1589:Duane-radial ray syndrome 1567: 1546: 1538:SF1 XY gonadal dysgenesis 1468: 1459: 1439: 1418: 1411: 1342: 1302: 1268:10.1111/jpc.1978.14.3.182 927:"Pitt-Hopkins syndrome", 903:"Pitt-Hopkins syndrome", 846:. Bookshelf ID: NBK66129. 719:10.1186/s11689-019-9282-0 447:Royal Children's Hospital 53: 48: 39: 34: 2214:Cleidocranial dysostosis 1431:Saethre–Chotzen syndrome 622:10.1177/0883073817750490 2191:Waardenburg syndrome 4c 1891:Coloboma of optic nerve 1739:Tooth and nail syndrome 1579:Pallister–Hall syndrome 1101:"Pitt-Hopkins Syndrome" 1019:"Pitt-Hopkins Syndrome" 863:"Pitt-Hopkins Syndrome" 826:"Pitt-Hopkins Syndrome" 794:"Pitt-Hopkins Syndrome" 471:"Pitt-Hopkins Syndrome" 322:intellectual disability 84:intellectual disability 2134:Ulnar–mammary syndrome 2092:(4) β-Scaffold factors 2072:Van der Woude syndrome 1604:Townes–Brocks syndrome 1477:Intracellular receptor 1205:Sweatt JD (May 2013). 1171:10.1055/s-0035-1564570 1105:Molecular Syndromology 442: 373:Differential diagnosis 204: 2308:Limb–mammary syndrome 2296:Rapp–Hodgkin syndrome 2268:Pitt–Hopkins syndrome 1844:Papillorenal syndrome 1819:Mowat–Wilson syndrome 1725:Nail–patella syndrome 1609:Acrocallosal syndrome 437: 387:Mowat–Wilson syndrome 357:Electroencephalograms 203: 112:Mowat Wilson syndrome 82:, moderate to severe 72:Pitt–Hopkins syndrome 35:Pitt–Hopkins syndrome 18:Pitt-Hopkins syndrome 2150:Campomelic dysplasia 2129:Li–Fraumeni syndrome 1614:Myotonic dystrophy 2 1584:Denys–Drash syndrome 1404:transcription factor 184:Cupid's bow philtrum 146:cognitive impairment 2443:Syndromes with ADHD 1944:Axenfeld syndrome 3 1758:Axenfeld syndrome 1 1697:SPD1 synpolydactyly 1462:DNA-binding domains 1223:10.1038/emm.2013.32 293:(7q33-q36) and the 80:developmental delay 2300:Hay–Wells syndrome 2124:Holt–Oram syndrome 1886:Gillespie syndrome 1805:Fuchs' dystrophy 3 1683:Currarino syndrome 1343:External resources 566:10.1002/humu.21639 443: 439:Peter the Wild Boy 276:germline mosaicism 260:haploinsufficiency 205: 164:Signs and symptoms 2383: 2382: 2379: 2378: 2249: 2248: 2222: 2221: 2087: 2086: 1664:Ohtahara syndrome 1638: 1637: 1508:Kennedy's disease 1455: 1454: 1426:Feingold syndrome 1412:(1) Basic domains 1400:Genetic disorders 1366: 1365: 1117:10.1159/000335287 978:10.1111/cge.13506 966:Clinical Genetics 379:Angelman syndrome 104:Angelman syndrome 69: 68: 29:Medical condition 16:(Redirected from 2450: 2433:Syndromic autism 2400: 2399: 2398: 2391: 2329: 2328: 2231: 2230: 2098: 2097: 1669:Lissencephaly X2 1647: 1646: 1554:Barakat syndrome 1466: 1465: 1416: 1415: 1393: 1386: 1379: 1370: 1369: 1300: 1299: 1288: 1287: 1251: 1245: 1244: 1234: 1202: 1193: 1192: 1182: 1150: 1139: 1138: 1128: 1111:(3–5): 171–180. 1096: 1090: 1089: 1079: 1047: 1041: 1040: 1039: 1037: 1014: 1008: 1007: 989: 957: 942: 941: 940: 924: 918: 917: 916: 900: 894: 893: 891: 889: 859: 848: 847: 821: 810: 809: 789: 768: 767: 765: 763: 756:The Conversation 748: 742: 741: 731: 721: 697: 691: 690: 688: 686: 672: 666: 665: 658: 652: 651: 641: 601: 586: 585: 548: 542: 541: 531: 499: 493: 492: 491: 489: 466: 245:Musculoskeletal. 223:Gastrointestinal 92:hyperventilation 64:Medical genetics 44: 32: 31: 21: 2458: 2457: 2453: 2452: 2451: 2449: 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nuclei 316: 313: 255: 252: 233: 230: 224: 221: 192: 191: 188: 187:Prominent ears 185: 182: 179: 165: 162: 116:ATR-X syndrome 67: 66: 57: 51: 50: 46: 45: 37: 36: 28: 9: 6: 4: 3: 2: 2455: 2444: 2441: 2439: 2438:Rare diseases 2436: 2434: 2431: 2429: 2426: 2424: 2421: 2419: 2416: 2415: 2413: 2403: 2393: 2392: 2389: 2371: 2367: 2366: 2362: 2361: 2359: 2355: 2347: 2344: 2343: 2342: 2341: 2337: 2336: 2334: 2330: 2327: 2325: 2321: 2313: 2309: 2305: 2301: 2297: 2294: 2293: 2292: 2291: 2287: 2283: 2280: 2279: 2278: 2277: 2273: 2269: 2266: 2265: 2264: 2263: 2259: 2258: 2256: 2252: 2242: 2239: 2238: 2236: 2232: 2229: 2225: 2215: 2212: 2211: 2209: 2205: 2197: 2194: 2192: 2189: 2188: 2187: 2186: 2182: 2178: 2175: 2173: 2170: 2169: 2168: 2167: 2163: 2161: 2158: 2156: 2153: 2151: 2148: 2147: 2145: 2141: 2135: 2132: 2130: 2127: 2125: 2122: 2121: 2119: 2115: 2109: 2106: 2105: 2103: 2099: 2096: 2090: 2078: 2075: 2073: 2070: 2069: 2068: 2067: 2063: 2062: 2060: 2056: 2048: 2045: 2044: 2043: 2042: 2038: 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1628: 1627: 1625: 1621: 1615: 1612: 1610: 1607: 1605: 1602: 1600: 1597: 1595: 1592: 1590: 1587: 1585: 1582: 1580: 1576: 1573: 1572: 1570: 1566: 1560: 1557: 1555: 1552: 1551: 1549: 1545: 1539: 1536: 1534: 1531: 1529: 1526: 1524: 1521: 1519: 1516: 1514: 1511: 1509: 1506: 1502: 1499: 1497: 1494: 1492: 1489: 1488: 1487: 1484: 1482: 1478: 1474: 1473: 1471: 1467: 1464: 1458: 1448: 1445: 1444: 1442: 1438: 1432: 1429: 1427: 1424: 1423: 1421: 1417: 1414: 1410: 1405: 1401: 1394: 1389: 1387: 1382: 1380: 1375: 1374: 1371: 1358: 1354: 1353: 1349: 1348: 1345: 1341: 1334: 1330: 1329: 1325: 1323: 1319: 1318: 1314: 1313: 1310: 1305: 1301: 1285: 1281: 1277: 1273: 1269: 1265: 1261: 1257: 1250: 1242: 1238: 1233: 1228: 1224: 1220: 1216: 1212: 1208: 1201: 1199: 1190: 1186: 1181: 1176: 1172: 1168: 1164: 1160: 1156: 1149: 1147: 1145: 1136: 1132: 1127: 1122: 1118: 1114: 1110: 1106: 1102: 1095: 1087: 1083: 1078: 1073: 1069: 1065: 1061: 1057: 1053: 1046: 1032: 1028: 1024: 1020: 1013: 1005: 1001: 997: 993: 988: 983: 979: 975: 971: 967: 963: 956: 954: 952: 950: 948: 939: 934: 930: 923: 915: 910: 906: 899: 884: 880: 876: 872: 868: 864: 858: 856: 854: 845: 841: 837: 833: 832: 827: 820: 818: 816: 807: 803: 799: 795: 788: 786: 784: 782: 780: 778: 776: 774: 757: 753: 747: 739: 735: 730: 725: 720: 715: 711: 707: 703: 696: 681: 677: 671: 663: 657: 649: 645: 640: 635: 631: 627: 623: 619: 615: 611: 607: 600: 598: 596: 594: 592: 583: 579: 575: 571: 567: 563: 559: 555: 547: 539: 535: 530: 525: 521: 517: 513: 509: 505: 498: 484: 480: 476: 472: 465: 463: 458: 450: 448: 440: 436: 424: 420: 417: 414: 413: 412: 409: 406: 397: 395: 390: 388: 384: 383:Rett syndrome 380: 370: 367: 365: 360: 358: 354: 352: 348: 344: 340: 335: 332: 329: 325: 323: 312: 309: 306: 304: 300: 296: 292: 288: 284: 279: 277: 273: 269: 268:chromosome 18 265: 261: 251: 247: 246: 242: 238: 229: 220: 216: 214: 209: 202: 198: 195: 190:Thin eyebrows 189: 186: 183: 180: 177: 176: 175: 172: 169: 161: 158: 155: 151: 147: 142: 140: 136: 135:chromosome 18 132: 128: 124: 119: 117: 113: 109: 108:Rett-syndrome 105: 101: 97: 93: 89: 85: 81: 77: 73: 65: 61: 58: 56: 52: 47: 43: 38: 33: 27: 19: 2363: 2357:Corepressor: 2338: 2332:Coactivator: 2288: 2274: 2267: 2260: 2183: 2164: 2064: 2039: 2025: 2011: 1997: 1983: 1969: 1955: 1936: 1911: 1897: 1878: 1864: 1850: 1836: 1811: 1792: 1778: 1764: 1750: 1731: 1717: 1703: 1689: 1675: 1656: 1350: 1326: 1315: 1262:(3): 182–4. 1259: 1255: 1249: 1214: 1210: 1162: 1158: 1108: 1104: 1094: 1059: 1055: 1045: 1034:, retrieved 1023:GeneReviews® 1022: 1012: 969: 965: 928: 922: 904: 898: 886:. Retrieved 866: 830: 797: 760:. Retrieved 746: 709: 705: 695: 683:. Retrieved 670: 656: 613: 609: 560:(1): 64–72. 557: 553: 546: 511: 507: 497: 486:, retrieved 475:GeneReviews® 474: 444: 410: 407: 403: 391: 376: 368: 361: 355: 336: 333: 330: 326: 318: 310: 307: 303:chromosome 2 291:chromosome 7 280: 271: 257: 248: 244: 243: 239: 235: 232:Neurological 226: 217: 213:Craniofacial 210: 206: 196: 193: 173: 170: 167: 159: 150:intelligence 143: 120: 94:followed by 75: 71: 70: 26: 987:2066/201958 929:Definitions 905:Definitions 867:Definitions 798:GeneReviews 2412:Categories 1217:(5): e21. 888:16 October 685:8 December 453:References 305:(2p16.3). 181:Wide mouth 60:Psychiatry 2254:Ungrouped 996:0009-9163 883:161843893 712:(1): 24. 630:0883-0738 400:Treatment 315:Diagnosis 297:1 alpha ( 283:contactin 55:Specialty 2402:Medicine 1352:Orphanet 1284:45629810 1241:23640545 1189:27617128 1135:22670138 1086:17436254 1031:22934316 1004:30677142 844:28520343 838:(NCBI). 806:22934316 738:31586495 648:29318938 574:22045651 538:17436255 483:22934316 347:splenium 295:neurexin 254:Genetics 100:Epilepsy 2005:ACD/MPV 1333:C537403 1232:3674405 1180:4918722 1126:3366706 1077:1852736 1036:26 July 762:10 July 729:6778364 639:5922265 582:9559486 529:1852727 488:17 July 430:History 343:rostrum 287:CNTNAP2 272:de novo 123:anxiety 2388:Portal 2340:CREBBP 2160:MODY 5 2155:MODY 3 1919:STHAG3 1872:MODY 9 1780:POU3F4 1772:DFNA15 1766:POU4F3 1711:MODY 4 1691:HOXD13 1599:MRX 89 1594:MODY 7 1528:MODY 1 1322:610954 1282:  1276:728011 1274:  1239:  1229:  1187:  1177:  1133:  1123:  1084:  1074:  1029:  1002:  994:  881:  842:  804:  736:  726:  646:  636:  628:  580:  572:  536:  526:  481:  127:autism 114:, and 2282:TNDM1 2276:ZFP57 2185:SOX10 2041:FOXP3 2027:FOXL2 2013:FOXI1 1999:FOXF1 1985:FOXE3 1971:FOXE1 1957:FOXC2 1938:FOXC1 1786:DFNX2 1752:PITX2 1719:LMX1B 1280:S2CID 879:S2CID 578:S2CID 299:NRXN1 228:age. 96:apnea 2312:OFC8 2290:TP63 2262:TCF4 2207:4.11 2066:IRF6 2047:IPEX 1913:PAX9 1899:PAX8 1880:PAX6 1866:PAX4 1852:PAX3 1838:PAX2 1813:ZEB2 1794:ZEB1 1744:OFC5 1733:MSX1 1705:PDX1 1677:MNX1 1501:CAIS 1496:MAIS 1491:PAIS 1357:2896 1328:MeSH 1317:OMIM 1272:PMID 1237:PMID 1185:PMID 1131:PMID 1082:PMID 1038:2024 1027:PMID 1000:PMID 992:ISSN 890:2022 840:PMID 802:PMID 764:2019 734:PMID 687:2009 644:PMID 626:ISSN 570:PMID 534:PMID 490:2024 479:PMID 385:and 264:TCF4 139:TCF4 131:ADHD 76:PTHS 2234:0.6 2166:SF1 2143:4.7 2117:4.3 2101:4.2 2058:3.5 1930:3.3 1830:3.2 1658:ARX 1650:3.1 1623:2.5 1568:2.3 1547:2.2 1479:): 1469:2.1 1440:1.3 1419:1.2 1264:doi 1227:PMC 1219:doi 1175:PMC 1167:doi 1121:PMC 1113:doi 1072:PMC 1064:doi 982:hdl 974:doi 933:doi 909:doi 871:doi 724:PMC 714:doi 634:PMC 618:doi 562:doi 524:PMC 516:doi 423:IEP 118:. 2414:: 2365:HR 1355:: 1331:: 1320:: 1278:. 1270:. 1260:14 1258:. 1235:. 1225:. 1215:45 1213:. 1209:. 1197:^ 1183:. 1173:. 1161:. 1157:. 1143:^ 1129:. 1119:. 1107:. 1103:. 1080:. 1070:. 1060:80 1058:. 1054:. 1021:, 998:. 990:. 980:. 970:95 968:. 964:. 946:^ 877:. 865:. 852:^ 834:. 814:^ 772:^ 754:. 732:. 722:. 710:11 708:. 704:. 678:. 642:. 632:. 624:. 614:33 612:. 608:. 590:^ 576:. 568:. 558:33 556:. 532:. 522:. 512:80 510:. 506:. 473:, 461:^ 389:. 381:, 366:. 278:. 129:, 125:, 110:, 106:, 98:. 86:, 62:, 2390:: 2372:) 2368:( 2310:/ 2306:/ 2302:/ 2298:/ 1577:/ 1475:( 1392:e 1385:t 1378:v 1309:D 1286:. 1266:: 1243:. 1221:: 1191:. 1169:: 1163:4 1137:. 1115:: 1109:2 1088:. 1066:: 1006:. 984:: 976:: 935:: 911:: 892:. 873:: 808:. 766:. 740:. 716:: 689:. 650:. 620:: 584:. 564:: 540:. 518:: 74:( 20:)

Index

Pitt-Hopkins syndrome

Specialty
Psychiatry
Medical genetics
developmental delay
intellectual disability
distinctive facial features
hyperventilation
apnea
Epilepsy
Angelman syndrome
Rett-syndrome
Mowat Wilson syndrome
ATR-X syndrome
anxiety
autism
ADHD
chromosome 18
TCF4
cognitive impairment
intelligence
augmentative communication

Craniofacial
haploinsufficiency
TCF4
chromosome 18
germline mosaicism
contactin

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