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Peters plus syndrome

Reviewed March 2008

What is Peters plus syndrome?

Peters plus syndrome is an inherited condition that is characterized by eye abnormalities, short stature, developmental delay, an opening in the lip (cleft lip) with or without an opening in the roof of the mouth (cleft palate), and distinctive facial features.

The eye problems seen in Peters plus syndrome occur in an area at the front part of the eye known as the anterior chamber. The anterior chamber is the fluid-filled space between the clear covering of the eye (cornea) and the colored part of the eye (iris). An eye problem called Peters anomaly is the most common anterior chamber abnormality seen in Peters plus syndrome. Peters anomaly involves thinning and clouding of the cornea and attachment of the iris to the cornea, which causes blurred vision. It may also be associated with clouding of the lens of the eye (cataracts) or other lens abnormalities. The severity of eye symptoms can vary between individuals with Peters plus syndrome, even among members of the same family.

Peters plus syndrome is characterized by Peters anomaly plus other typical signs and symptoms. All people with Peters plus syndrome have short stature. Individuals with this condition are typically shorter than average at birth. The height of adult males with this condition ranges from 141 centimeters to 155 centimeters (4 feet, 7 inches to 5 feet, 1 inch), and the height of adult females ranges from 128 centimeters to 151 centimeters (4 feet, 2 inches to 4 feet, 11 inches). Individuals with Peters plus syndrome also have shortened upper limbs (rhizomelia) and shortened fingers and toes (brachydactyly).

Developmental delay is present in most children with Peters plus syndrome. The extent of intellectual disability typically ranges from mild to severe, although some individuals have normal intelligence. The severity of physical features does not predict the level of developmental delay.

The characteristic facial features of Peters plus syndrome include a prominent forehead, narrow eyes, a long area between the nose and mouth (philtrum), a pronounced double curve of the upper lip (Cupid's bow), and a broad neck. A cleft lip with or without a cleft palate is present in about half of people with this condition.

Less common signs and symptoms of Peters plus syndrome include heart defects, structural brain abnormalities, hearing loss, reduced thyroid activity (hypothyroidism), and kidney or genital abnormalities.

How common is Peters plus syndrome?

Peters plus syndrome is a rare genetic disorder; its incidence is unknown. Fewer than 70 people with this condition have been reported worldwide.

What genes are related to Peters plus syndrome?

Mutations in the B3GALTL gene cause Peters plus syndrome. The B3GALTL gene provides instructions for making an enzyme called beta-1,3-glucosyltransferase (B3Glc-T), which is involved in the complex process of adding sugar molecules to proteins (glycosylation). Glycosylation allows proteins to perform a wider variety of functions. Most mutations in the B3GALTL gene lead to the production of an abnormally short, nonfunctional version of the B3Glc-T enzyme, which disrupts glycosylation. It is unclear how the loss of functional B3Glc-T enzyme leads to the signs and symptoms of Peters plus syndrome.

Related Gene(s)

Changes in this gene are associated with Peters plus syndrome.

  • B3GALTL

How do people inherit Peters plus syndrome?

This condition is inherited in an autosomal recessive pattern, which means both copies of the gene in each cell have mutations. The parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition.

Where can I find information about diagnosis or management of Peters plus syndrome?

These resources address the diagnosis or management of Peters plus syndrome and may include treatment providers.

  • Gene Review: Peters Plus Syndrome (http://www.ncbi.nlm.nih.gov/books/NBK1464/)
  • Genetic Testing Registry: Peters plus syndrome (http://www.ncbi.nlm.nih.gov/gtr/conditions/C0796012)

You might also find information on the diagnosis or management of Peters plus syndrome in Educational resources (http://www.ghr.nlm.nih.gov/condition/peters-plus-syndrome/show/Educational+resources) and Patient support (http://www.ghr.nlm.nih.gov/condition/peters-plus-syndrome/show/Patient+support).

General information about the diagnosis (http://ghr.nlm.nih.gov/handbook/consult/diagnosis) and management (http://ghr.nlm.nih.gov/handbook/consult/treatment) of genetic conditions is available in the Handbook. Read more about genetic testing (http://ghr.nlm.nih.gov/handbook/testing), particularly the difference between clinical tests and research tests (http://ghr.nlm.nih.gov/handbook/testing/researchtesting).

To locate a healthcare provider, see How can I find a genetics professional in my area? (http://ghr.nlm.nih.gov/handbook/consult/findingprofessional) in the Handbook.

Where can I find additional information about Peters plus syndrome?

You may find the following resources about Peters plus syndrome helpful. These materials are written for the general public.

  • MedlinePlus - Health information

    • Health Topic: Cleft Lip and Palate (http://www.nlm.nih.gov/medlineplus/cleftlipandpalate.html)
    • Health Topic: Eye Diseases (http://www.nlm.nih.gov/medlineplus/eyediseases.html)
  • Genetic and Rare Diseases Information Center - Information about genetic conditions and rare diseases (http://rarediseases.info.nih.gov/gard/8422/resources/resources/1)

  • Additional NIH Resources - National Institutes of Health

    • National Eye Institute: Diagram of the Eye (http://www.nei.nih.gov/health/eyediagram/)
    • National Eye Institute: Facts About the Cornea and Corneal Disease (http://www.nei.nih.gov/health/cornealdisease/)
    • National Institute of Diabetes and Digestive and Kidney Diseases: Hypothyroidism (http://www.endocrine.niddk.nih.gov/pubs/Hypothyroidism/)

  • Educational resources - Information pages

    • Cleveland Clinic: Inherited Eye Diseases (http://my.clevelandclinic.org/disorders/inherited_eye_disease/)
    • Kids Health: Cleft lip and Palate (http://kidshealth.org/parent/medical/ears/cleft_lip_palate.html)
    • Madisons Foundation (http://www.madisonsfoundation.org/index.php?option=com_mpower&task=disease&diseaseID=522)
    • March of Dimes: Cleft Lip and Palate (http://www.marchofdimes.com/baby/birthdefects_cleftpalate.html)
    • Orphanet (http://www.orpha.net/consor/cgi-bin/OC_Exp.php?Lng=EN&Expert=709)

  • Patient support - For patients and families

    • AmeriFace (http://www.ameriface.org/)
    • Cleft Palate Foundation (http://www.cleftline.org/)
    • Foundation Fighting Blindness (http://www.blindness.org/)
    • Human Growth Foundation (http://www.hgfound.org/)
    • Little People of America (http://www.lpaonline.org/)
    • RareConnect (https://www.rareconnect.org/en/community/cdg)
    • The Congenital Disorders of Glycosylation Family Network (http://www.cdgs.com/)
    • The MAGIC Foundation (http://www.magicfoundation.org/)

You may also be interested in these resources, which are designed for healthcare professionals and researchers.

  • Gene Reviews - Clinical summary (http://www.ncbi.nlm.nih.gov/books/NBK1464/)

  • Genetic Testing Registry - Repository of genetic test information

    • Genetic Testing Registry: Peters plus syndrome (http://www.ncbi.nlm.nih.gov/gtr/conditions/C0796012)
  • ClinicalTrials.gov - Linking patients to medical research (http://clinicaltrials.gov/ct2/results?cond=%22Eye%20Diseases%2C%20Hereditary%22%20OR%20%22Peters%20plus%20syndrome%22)
  • PubMed - Recent literature (http://www.ncbi.nlm.nih.gov/pubmed?term=((peters%20plus%20syndrome%5BTIAB%5D)%20OR%20(krause-van%20schooneveld-kivlin%20syndrome%5BTIAB%5D)%20OR%20(krause-kivlin%20syndrome%5BTIAB%5D)%20OR%20(peters'-plus%20syndrome%5BTIAB%5D)%20OR%20(peters'-plus%20syndrome%5BTIAB%5D)%20OR%20(peters'%20plus%20syndrome%5BTIAB%5D)%20OR%20(peters'%20plus%20syndrome%5BTIAB%5D))%20AND%20english%5Bla%5D%20AND%20human%5Bmh%5D%20AND%20%22last%203600%20days%22%5Bdp%5D)
  • OMIM - Genetic disorder catalog (http://omim.org/entry/261540)

What other names do people use for Peters plus syndrome?

  • Krause-Kivlin syndrome
  • Krause-van Schooneveld-Kivlin syndrome
  • Peters anomaly-short limb dwarfism syndrome
  • Peters'-plus syndrome
  • Peters' plus syndrome

For more information about naming genetic conditions, see the Genetics Home Reference Condition Naming Guidelines (http://ghr.nlm.nih.gov/ConditionNameGuide) and How are genetic conditions and genes named? (http://ghr.nlm.nih.gov/handbook/mutationsanddisorders/naming) in the Handbook.

What if I still have specific questions about Peters plus syndrome?

Ask the Genetic and Rare Diseases Information Center (http://rarediseases.info.nih.gov/GARD/).

What glossary definitions help with understanding Peters plus syndrome?

anterior ; autosomal ; autosomal recessive ; brachydactyly ; cell ; cleft palate ; congenital ; cornea ; developmental delay ; dwarfism ; enzyme ; gene ; glycosylation ; hypothyroidism ; incidence ; kidney ; palate ; philtrum ; recessive ; short stature ; stature ; syndrome ; thyroid

You may find definitions for these and many other terms in the Genetics Home Reference Glossary (http://www.ghr.nlm.nih.gov/glossary).

References

  • Gene Review: Peters Plus Syndrome (http://www.ncbi.nlm.nih.gov/books/NBK1464/)
  • Hess D, Keusch JJ, Oberstein SA, Hennekam RC, Hofsteenge J. Peters Plus syndrome is a new congenital disorder of glycosylation and involves defective Omicron-glycosylation of thrombospondin type 1 repeats. J Biol Chem. 2008 Mar 21;283(12):7354-60. doi: 10.1074/jbc.M710251200. Epub 2008 Jan 16. (http://www.ncbi.nlm.nih.gov/pubmed/18199743?dopt=Abstract)
  • Lesnik Oberstein SA, Kriek M, White SJ, Kalf ME, Szuhai K, den Dunnen JT, Breuning MH, Hennekam RC. Peters Plus syndrome is caused by mutations in B3GALTL, a putative glycosyltransferase. Am J Hum Genet. 2006 Sep;79(3):562-6. Epub 2006 Jul 19. Erratum in: Am J Hum Genet. 2006 Nov;79(5):985. (http://www.ncbi.nlm.nih.gov/pubmed/16909395?dopt=Abstract)
  • Maillette de Buy Wenniger-Prick LJ, Hennekam RC. The Peters' plus syndrome: a review. Ann Genet. 2002 Apr-Jun;45(2):97-103. Review. (http://www.ncbi.nlm.nih.gov/pubmed/12119218?dopt=Abstract)

 

The resources on this site should not be used as a substitute for professional medical care or advice. Users seeking information about a personal genetic disease, syndrome, or condition should consult with a qualified healthcare professional. See How can I find a genetics professional in my area? (http://ghr.nlm.nih.gov/handbook/consult/findingprofessional) in the Handbook.

 
Reviewed: March 2008
Published: May 20, 2013