Group of diseases encompassing a spectrum of disorders characterized by Warburg Micro Syndrome (characterized by eye, nervous system, and endocrine abnormalities) and Martsolf Syndrome phenotypes (characterized by similar – but milder – findings). To date Warburg micro syndrome comprises >96% of reported individuals with genetically defined RAB18 deficiency. The hallmark ophthalmologic findings are bilateral congenital cataracts, usually accompanied by microphthalmia, microcornea (diameter <10), and small atonic pupils. Poor vision despite early cataract surgery likely results from progressive optic atrophy and cortical visual impairment. Individuals with Warburg micro syndrome have severe to profound intellectual disability (ID); those with Martsolf syndrome have mild to moderate ID. Some individuals with RAB18 deficiency also have epilepsy. In Warburg micro syndrome, a progressive ascending spastic paraplegia typically begins with spastic diplegia and contractures during the first year, followed by upper-limb involvement leading to spastic quadriplegia after about age five years, often eventually causing breathing difficulties. In Martsolf syndrome infantile hypotonia is followed primarily by slowly progressive lower-limb spasticity. Hypogonadism – when present – manifests in both syndromes, in males as micropenis and/or cryptorchidism and in females as hypoplastic labia minora, clitoral hypoplasia, and small introitus. [ https://www.clinicalgenome.org/affiliation/40020/ https://www.ncbi.nlm.nih.gov/books/NBK475670/ ]

Synonyms: Warburg micro spectrum

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Term information

Subsets

rare, inferred_rare

IAO 0000233

https://github.com/monarch-initiative/mondo/issues/6942

comment

RAB18 deficiency results from biallelic pathogenic variants in RAB3GAP1, RAB3GAP2, RAB18, or TBC1D20. Studies suggest that variation(s) in these genes affect RAB18 regular function. (https://www.ncbi.nlm.nih.gov/books/NBK475670/)

creator

https://orcid.org/0000-0002-4142-7153

id

MONDO:0700247

Term relations