Kabuki syndrome

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Kabuki syndrome
A child with Kabuki syndrome displaying the typical facial features
Classification and external resources
ICD-10 Q87.0
ICD-9 759.89
OMIM 147920
DiseasesDB 32161

Kabuki syndrome, also previously known as Kabuki makeup syndrome, KMS or Niikawa–Kuroki Syndrome, is a pediatric congenital disorder of suspected genetic origin [1][2] with multiple congenital anomalies and intellectual disabilities. It is quite rare, affecting roughly one in 32,000 births.[1] It was identified and described in 1981 by two Japanese groups, led by the scientists Norio Niikawa and Yoshikazu Kuroki.[2] It is named Kabuki Syndrome because of the facial resemblance of affected individuals with white Kabuki makeup, a Japanese traditional theatrical form. On the Kabuki Syndrome listserv, children with this syndrome are called Kabuki Kids, or KKs.


There is a wide range of congenital problems associated with Kabuki syndrome with large differences between affected individuals. Some of the common problems are heart defects (30%), urinary tract anomalies, hearing loss (50%), hypotonia, and postnatal growth deficiency (83%). Other characteristics include skeletal abnormality, joint laxity, short stature, and unusual dermatoglyphic patterns.[3] They often suffer from recurrent ear infections in infancy.

In terms of development, mild to moderate intellectual disability is a common feature, seen in 92% of patients. Also, children with Kabuki syndrome often have distinctive behavioural features. For example, 50% are described as unusually sociable, 30% as engaging in only minimal interaction with others, 74% as liking routine and 87% as having a happy disposition. A few have normal intelligence, most of whom have learning difficulties such as struggling with fine motor, speech skills, and memory.

There is no indication that the life expectancy of individuals with Kabuki syndrome is shortened. Most medical issues are resolved with medical intervention. The fact that there are relatively few adults known with this syndrome is probably related to its recent discovery in 1980 in Japan and around 1990 in Europe and America.


A young patient displaying the facial phenotype typical of Kabuki syndrome

The facial appearance of individuals with this syndrome include long eyelids with turning up of the lateral third of the lower eyelid, a broad and depressed nasal tip, large prominent earlobes, and a cleft or high-arched palate.[4]

Other clinical features often include scoliosis, short fifth finger, persistence of fingerpads, and X-ray abnormalities of the vertebrae, hands, and hip joints.


Kabuki Syndrome can be caused by a loss-of-function mutation in gene MLL2, which is located on Chromosome 12q13.12. 9 out of 10 of these cases are due to de novo mutations (those present in the subject but not in the parents). The discovery of the genomic ethiology was possible by using Exome sequencing, and published in August 2010 by Sarah Ng et al.[5] Authors concluded that their "results strongly suggest that mutations in MLL2 are a major cause of Kabuki syndrome". The etiology of KS is unclear. The majority of cases occur sporadically with no predominance of parental consanguinity, sex, or birth order.[6]


Several authors have recommended that the term 'make-up' be removed from the designation of this syndrome because some families considered the term objectionable.[7][8]

See also[edit]


  1. ^ "Kabuki syndrome". Genetics Home Reference. Retrieved 11 February 2013. 
  2. ^ Yoshikazu Kuroki, Yasuyuki Suzuki, Hiroyuki Chyo, Akira Hata, Ichiro Matsui (October 1981). "A new malformation syndrome of long palpebralfissures, large ears, depressed nasal tip, and skeletal anomalies associated with postnatal dwarfism and mental retardation". The Journal of Pediatrics 99 (4): 570–573. doi:10.1016/S0022-3476(81)80256-9. PMID 7277097. 
  3. ^ den Biggelaar AM, Kuijpers-Jagtman AM, Bergé SJ, Katsaros C (December 2006). "Kabuki-syndroom, een congenitaal syndroom met multipele anomalieën (Kabuki syndrome, a congenital syndrome with multiple anomalies)". Nederlands Tijdschrift Voor Tandheelkunde (in Dutch) 113 (12): 516–9. PMID 17193989. Retrieved 2009-05-07. 
  4. ^ Suarez Guerrero JL, Ordonez Suarez AA, Contreras Garcia GA (2012). "Kabuki Syndrome". Anales de Pediatria 77 (1): 51–56. doi:10.1016/j.anpedi.2012.01.016. PMID 22387331. 
  5. ^ Ng SB; Bigham AW; Buckingham KJ; Hannibal MC; McMillin MJ; Gildersleeve HI et al. (2010). "Exome sequencing identifies MLL2 mutations as a cause of Kabuki syndrome". Nat Genet 42 (9): 790–3. doi:10.1038/ng.646. PMC 2930028. PMID 20711175. 
  6. ^ Prado Sobra, Samantha. "Craniofacial and Dentai Features in Kabuki Syndrome Patients". The Cleft Palate-Craniofacial Journal. 50(4): 440^47. 
  7. ^ Hughes HE, Davies SJ (June 1994). "Coarctation of the aorta in Kabuki syndrome". Archives of Disease in Childhood 70 (6): 512–4. doi:10.1136/adc.70.6.512. PMC 1029872. PMID 8048822. 
  8. ^ Burke LW, Jones MC (January 1995). "Kabuki syndrome: underdiagnosed recognizable pattern in cleft palate patients". The Cleft Palate-craniofacial Journal 32 (1): 77–84. doi:10.1597/1545-1569(1995)032<0077:KSURPI>2.3.CO;2. PMID 7727492. 

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