Coffin–Siris syndrome
(Redirected from Coffin-Siris syndrome)
Coffin–Siris syndrome | |
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Synonyms | Dwarfism-Onychodysplasia, Fifth Digit Syndrome, Mental Retardation with Hypoplastic 5th Fingernails and Toenails, Short Stature-Onychodysplasia |
Pronounce | |
Field | Medical genetics, Pediatrics |
Symptoms | Developmental delay, intellectual disability, coarse facial features, hypotonia, absent or hypoplastic nails on the fifth digits |
Complications | Delayed motor and language skills, feeding difficulties, respiratory infections, possible seizures |
Onset | Congenital (present at birth) |
Duration | Lifelong |
Types | Multiple subtypes associated with different gene mutations (e.g. ARID1B, SOX11, ARID2) |
Causes | Genetic mutation (commonly de novo), especially in genes related to the SWI/SNF chromatin remodeling complex |
Risks | Sporadic (de novo) or inherited in an autosomal dominant pattern |
Diagnosis | Clinical diagnosis supported by genetic testing |
Differential diagnosis | Nicolaides–Baraitser syndrome, Brachymorphism-Onychodysplasia-Dysphalangism syndrome |
Prevention | None known |
Treatment | Symptomatic and supportive: physical therapy, occupational therapy, speech therapy, special education |
Medication | As needed for comorbidities (e.g., anticonvulsants for seizures) |
Prognosis | Varies; many children can live into adulthood with supportive care |
Frequency | Fewer than 100 cases reported in literature |
Deaths | Rare; depends on severity and complications |

Coffin–Siris syndrome (CSS) is a rare genetic disorder characterized by developmental delay, intellectual disability, hypoplasia or aplasia of the nails on the fifth fingers and toes, and distinctive facial features. First described in 1970 by Grange S. Coffin and Evelyn Siris, the syndrome has since been linked to mutations in multiple genes, most commonly those encoding components of the SWI/SNF chromatin remodeling complex.
Clinical Features[edit | edit source]
The syndrome has a broad spectrum of symptoms that can range from mild to severe. Common clinical features include:
- Developmental delay or intellectual disability
- Short or absent fifth fingers and toes with nail hypoplasia or aplasia
- Low birth weight
- Feeding difficulties in infancy
- Recurrent respiratory infections
- Hypotonia
- Joint laxity
- Delayed bone age
- Microcephaly
- Coarse facial features:
- Wide nasal bridge and tip
- Wide mouth
- Thick eyebrows and eyelashes
- Hypertrichosis (excessive hair)
Causes[edit | edit source]
Coffin–Siris syndrome is most commonly caused by de novo mutations in genes related to chromatin remodeling. These include:
- ARID1B – the most commonly mutated gene in CSS
- SOX11
- ARID2
- Additional genes include: SMARCA4, SMARCB1, SMARCE1, and SMARCA2
The condition is typically inherited in an autosomal dominant fashion, though most cases are sporadic and arise from a de novo mutation.
Genetics[edit | edit source]
All known causative genes are involved in the function of the SWI/SNF chromatin remodeling complex, which regulates gene expression by altering chromatin structure. Disruption of this complex affects multiple developmental pathways, leading to the wide range of observed symptoms.
Diagnosis[edit | edit source]
Diagnosis is primarily clinical and based on:
- Presence of distinctive phenotypic features
- Developmental and intellectual assessment
- Absent or underdeveloped fifth digit nails
Confirmation is achieved through molecular genetic testing, typically using whole exome sequencing or targeted gene panels for SWI/SNF complex mutations.
Differential Diagnosis[edit | edit source]
Conditions that may mimic Coffin–Siris syndrome and should be considered in the differential include:
- Nicolaides–Baraitser syndrome
- Rubinstein–Taybi syndrome
- Brachymorphism-Onychodysplasia-Dysphalangism syndrome
- DOOR syndrome
Treatment[edit | edit source]
There is no cure for Coffin–Siris syndrome. Treatment is symptomatic and supportive:
- Physical therapy to improve motor function
- Occupational therapy for fine motor skills
- Speech therapy for language development
- Special education services
- Regular screening for complications such as seizures and hearing loss
Prognosis[edit | edit source]
The prognosis depends on the severity of symptoms and associated complications. With appropriate therapies and support, many individuals achieve varying degrees of independence. Severe cases with associated anomalies may have a more guarded prognosis.
Epidemiology[edit | edit source]
Coffin–Siris syndrome is extremely rare. Fewer than 100 cases have been reported in the medical literature. Due to variable expression and overlap with other syndromes, it may be underdiagnosed.
See also[edit | edit source]
- Nicolaides–Baraitser syndrome
- ARID1B
- Developmental disorder
- Genetic testing
- Syndromic intellectual disability
External Links[edit | edit source]
- Orphanet entry on Coffin–Siris syndrome
- GeneReviews: Coffin–Siris Syndrome
- GeneCards entry for ARID1B
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Contributors: Prab R. Tumpati, MD