Floating-Harbor syndrome is a rare SRCAP-related autosomal dominant developmental disorder characterized by short stature, delayed bone age, severe language impairment, and a recognizable craniofacial phenotype. Available evidence supports dominant-negative SRCAP disruption with downstream chromatin and transcriptional dysregulation.
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name: Floating-Harbor syndrome
creation_date: "2026-04-15T15:45:03Z"
description: >-
Floating-Harbor syndrome is a rare SRCAP-related autosomal dominant
developmental disorder characterized by short stature, delayed bone age,
severe language impairment, and a recognizable craniofacial phenotype.
Available evidence supports dominant-negative SRCAP disruption with
downstream chromatin and transcriptional dysregulation.
category: Mendelian
parents:
- hereditary disease
disease_term:
preferred_term: Floating-Harbor syndrome
term:
id: MONDO:0007621
label: Floating-Harbor syndrome
inheritance:
- name: Autosomal dominant inheritance
description: >-
Floating-Harbor syndrome is inherited in an autosomal dominant manner, and
most affected individuals have a de novo SRCAP pathogenic variant.
inheritance_term:
preferred_term: Autosomal dominant inheritance
term:
id: HP:0000006
label: Autosomal dominant inheritance
evidence:
- reference: PMID:23193612
reference_title: SRCAP-Related Floating-Harbor Syndrome.
supports: SUPPORT
evidence_source: OTHER
snippet: >-
GENETIC COUNSELING: SRCAP-FHS is inherited in an autosomal dominant
manner. The majority of affected individuals have a de novo pathogenic
variant.
explanation: This directly supports autosomal dominant inheritance in SRCAP-related Floating-Harbor syndrome.
pathophysiology:
- name: SRCAP truncation-driven chromatin dysregulation
description: >-
Floating-Harbor syndrome is caused by heterozygous truncating SRCAP
variants. Available review evidence supports a dominant-negative model with
disrupted chromatin-associated transcriptional control.
genes:
- preferred_term: SRCAP
term:
id: hgnc:16974
label: SRCAP
biological_processes:
- preferred_term: chromatin remodeling
modifier: ABNORMAL
term:
id: GO:0006338
label: chromatin remodeling
- preferred_term: regulation of transcription by RNA polymerase II
modifier: ABNORMAL
term:
id: GO:0006357
label: regulation of transcription by RNA polymerase II
evidence:
- reference: DOI:10.3389/fgene.2022.846101
reference_title: >-
Molecular Genetics and Pathogenesis of the Floating Harbor Syndrome: Case
Report of Long-Term Growth Hormone Treatment and a Literature Review
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
Finally, we suggested a new model of FHS pathogenesis which provides
possible basis for the dominant negative nature of FHS-causing mutations
and explains limited effects of GH treatment in FHS.
explanation: This supports a dominant-negative SRCAP disease mechanism underlying Floating-Harbor syndrome.
downstream:
- target: Short stature
description: Developmental transcriptional dysregulation contributes to impaired linear growth.
- target: Delayed skeletal maturation
description: Developmental dysregulation contributes to delayed bone age.
- target: Abnormal facial shape
description: Developmental dysregulation contributes to a recognizable craniofacial phenotype.
- target: Brachydactyly
description: Developmental dysregulation contributes to characteristic skeletal anomalies.
- target: Intellectual disability
description: Disrupted chromatin-associated developmental regulation contributes to neurocognitive impairment.
- target: Delayed speech and language development
description: Neurodevelopmental dysregulation contributes to severe speech and language impairment.
- target: Hypernasal speech
description: Developmental dysregulation contributes to the characteristic hypernasal voice quality.
- target: High-pitched voice
description: Developmental dysregulation contributes to the characteristic high-pitched voice quality.
phenotypes:
- name: Short stature
category: Growth
diagnostic: true
description: Postnatal short stature is a defining clinical feature of Floating-Harbor syndrome.
phenotype_term:
preferred_term: Short stature
term:
id: HP:0004322
label: Short stature
evidence:
- reference: PMID:23193612
reference_title: SRCAP-Related Floating-Harbor Syndrome.
supports: SUPPORT
evidence_source: OTHER
snippet: >-
SRCAP-related Floating-Harbor syndrome (SRCAP-FHS) is characterized by
typical craniofacial features; low birth weight, normal head
circumference, and short stature;
explanation: This directly supports short stature as a core phenotype.
- name: Delayed speech and language development
category: Neurologic
diagnostic: true
description: Severe language impairment is one of the major developmental manifestations of Floating-Harbor syndrome.
phenotype_term:
preferred_term: Delayed speech and language development
term:
id: HP:0000750
label: Delayed speech and language development
evidence:
- reference: PMID:23193612
reference_title: SRCAP-Related Floating-Harbor Syndrome.
supports: SUPPORT
evidence_source: OTHER
snippet: >-
SRCAP-related Floating-Harbor syndrome (SRCAP-FHS) is characterized by
typical craniofacial features; low birth weight, normal head
circumference, and short stature; bone age delay that normalizes between
ages six and 12 years; skeletal anomalies (brachydactyly, broad
fingertips, clinodactyly, short thumbs, prominent joints, and clavicular
abnormalities); severe receptive and expressive language impairment;
explanation: This directly supports severe speech and language impairment as a core developmental feature.
- name: Delayed skeletal maturation
category: Growth
diagnostic: true
description: Delayed bone age is a classic diagnostic feature of Floating-Harbor syndrome.
phenotype_term:
preferred_term: Delayed skeletal maturation
term:
id: HP:0002750
label: Delayed skeletal maturation
evidence:
- reference: PMID:23193612
reference_title: SRCAP-Related Floating-Harbor Syndrome.
supports: SUPPORT
evidence_source: OTHER
snippet: >-
SRCAP-related Floating-Harbor syndrome (SRCAP-FHS) is characterized by
typical craniofacial features; low birth weight, normal head
circumference, and short stature; bone age delay that normalizes between
ages six and 12 years; skeletal anomalies (brachydactyly, broad
fingertips, clinodactyly, short thumbs, prominent joints, and clavicular
abnormalities); severe receptive and expressive language impairment;
explanation: This directly supports delayed skeletal maturation as a characteristic feature of Floating-Harbor syndrome.
- name: Abnormal facial shape
category: Morphological
diagnostic: true
description: Typical craniofacial features are a defining part of the Floating-Harbor syndrome phenotype.
phenotype_term:
preferred_term: Abnormal facial shape
term:
id: HP:0001999
label: Abnormal facial shape
evidence:
- reference: PMID:23193612
reference_title: SRCAP-Related Floating-Harbor Syndrome.
supports: SUPPORT
evidence_source: OTHER
snippet: >-
SRCAP-related Floating-Harbor syndrome (SRCAP-FHS) is characterized by
typical craniofacial features; low birth weight, normal head
circumference, and short stature;
explanation: This directly supports a characteristic abnormal facial shape in Floating-Harbor syndrome.
- name: Brachydactyly
category: Morphological
description: Brachydactyly is a representative skeletal anomaly in Floating-Harbor syndrome.
phenotype_term:
preferred_term: Brachydactyly
term:
id: HP:0001156
label: Brachydactyly
evidence:
- reference: PMID:23193612
reference_title: SRCAP-Related Floating-Harbor Syndrome.
supports: SUPPORT
evidence_source: OTHER
snippet: >-
SRCAP-related Floating-Harbor syndrome (SRCAP-FHS) is characterized by
typical craniofacial features; low birth weight, normal head
circumference, and short stature; bone age delay that normalizes between
ages six and 12 years; skeletal anomalies (brachydactyly, broad
fingertips, clinodactyly, short thumbs, prominent joints, and clavicular
abnormalities); severe receptive and expressive language impairment;
explanation: This directly supports brachydactyly as part of the skeletal phenotype in Floating-Harbor syndrome.
- name: Intellectual disability
category: Neurologic
description: Intellectual disability is usually mild to moderate in affected individuals.
phenotype_term:
preferred_term: Intellectual disability
term:
id: HP:0001249
label: Intellectual disability
evidence:
- reference: PMID:23193612
reference_title: SRCAP-Related Floating-Harbor Syndrome.
supports: SUPPORT
evidence_source: OTHER
snippet: >-
SRCAP-related Floating-Harbor syndrome (SRCAP-FHS) is characterized by
typical craniofacial features; low birth weight, normal head
circumference, and short stature; bone age delay that normalizes between
ages six and 12 years; skeletal anomalies (brachydactyly, broad
fingertips, clinodactyly, short thumbs, prominent joints, and clavicular
abnormalities); severe receptive and expressive language impairment;
hypernasality and high-pitched voice; and intellectual disability that is
typically mild to moderate.
explanation: This directly supports intellectual disability as a recurrent phenotype.
- name: Hypernasal speech
category: Otolaryngologic
description: Hypernasality is a characteristic voice and speech feature in Floating-Harbor syndrome.
phenotype_term:
preferred_term: Hypernasal speech
term:
id: HP:0001611
label: Hypernasal speech
evidence:
- reference: PMID:23193612
reference_title: SRCAP-Related Floating-Harbor Syndrome.
supports: SUPPORT
evidence_source: OTHER
snippet: >-
SRCAP-related Floating-Harbor syndrome (SRCAP-FHS) is characterized by
typical craniofacial features; low birth weight, normal head
circumference, and short stature; bone age delay that normalizes between
ages six and 12 years; skeletal anomalies (brachydactyly, broad
fingertips, clinodactyly, short thumbs, prominent joints, and clavicular
abnormalities); severe receptive and expressive language impairment;
hypernasality and high-pitched voice; and intellectual disability that is
typically mild to moderate.
explanation: This directly supports hypernasal speech as a characteristic voice phenotype in Floating-Harbor syndrome.
- name: High-pitched voice
category: Otolaryngologic
description: A high-pitched voice is a characteristic voice phenotype in Floating-Harbor syndrome.
phenotype_term:
preferred_term: High-pitched voice
term:
id: HP:0001620
label: Abnormally high-pitched voice
evidence:
- reference: PMID:23193612
reference_title: SRCAP-Related Floating-Harbor Syndrome.
supports: SUPPORT
evidence_source: OTHER
snippet: >-
SRCAP-related Floating-Harbor syndrome (SRCAP-FHS) is characterized by
typical craniofacial features; low birth weight, normal head
circumference, and short stature; bone age delay that normalizes between
ages six and 12 years; skeletal anomalies (brachydactyly, broad
fingertips, clinodactyly, short thumbs, prominent joints, and clavicular
abnormalities); severe receptive and expressive language impairment;
hypernasality and high-pitched voice; and intellectual disability that is
typically mild to moderate.
explanation: This directly supports a high-pitched voice as a characteristic voice phenotype in Floating-Harbor syndrome.
biochemical: []
genetic:
- name: SRCAP
association: Causal heterozygous truncating variant
gene_term:
preferred_term: SRCAP
term:
id: hgnc:16974
label: SRCAP
notes: >-
Floating-Harbor syndrome is caused by heterozygous pathogenic SRCAP
variants, especially truncating variants in exons 33 and 34.
evidence:
- reference: DOI:10.3389/fgene.2022.846101
reference_title: >-
Molecular Genetics and Pathogenesis of the Floating Harbor Syndrome: Case
Report of Long-Term Growth Hormone Treatment and a Literature Review
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
FHS is caused by heterozygous mutations in the SRCAP gene; however,
little is known about the pathogenesis of FHS or the effectiveness of its
treatment.
explanation: This directly supports SRCAP as the causal gene for Floating-Harbor syndrome.
- reference: CGGV:assertion_5b414014-3a99-48f2-aac1-20903838af0f-2023-08-01T063000.000Z
reference_title: "SRCAP / Floating-Harbor syndrome (Definitive)"
supports: SUPPORT
evidence_source: OTHER
snippet: "SRCAP | HGNC:16974 | Floating-Harbor syndrome | MONDO:0007621 | AD | Definitive"
explanation: ClinGen classifies the SRCAP-Floating-Harbor syndrome gene-disease relationship as definitive with autosomal dominant inheritance.
environmental: []
treatments:
- name: Growth hormone therapy
description: >-
Recombinant human growth hormone has been used for short stature, but
published evidence suggests only limited benefit in Floating-Harbor
syndrome.
treatment_term:
preferred_term: human growth hormone replacement therapy
term:
id: NCIT:C15599
label: Hormone Replacement Therapy
target_phenotypes:
- preferred_term: Short stature
term:
id: HP:0004322
label: Short stature
evidence:
- reference: DOI:10.3389/fgene.2022.846101
reference_title: >-
Molecular Genetics and Pathogenesis of the Floating Harbor Syndrome: Case
Report of Long-Term Growth Hormone Treatment and a Literature Review
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
We report the history of treatment of the proband with GH, which resulted
in modest improvement in growth prior to puberty.
explanation: This supports growth hormone therapy as a used but only modestly effective treatment for short stature.
- name: Developmental supportive care
description: Early intervention, special education, and related supportive services are recommended for developmental disability management.
treatment_term:
preferred_term: supportive care
term:
id: NCIT:C15747
label: Supportive Care
target_phenotypes:
- preferred_term: Delayed speech and language development
term:
id: HP:0000750
label: Delayed speech and language development
- preferred_term: Intellectual disability
term:
id: HP:0001249
label: Intellectual disability
evidence:
- reference: PMID:23193612
reference_title: SRCAP-Related Floating-Harbor Syndrome.
supports: SUPPORT
evidence_source: OTHER
snippet: >-
Early intervention programs, special education, and vocational training to address developmental disabilities; communication rehabilitation with sign language or alternative means of communication; behavior management by a behavioral specialist / psychologist with consideration of medication as needed.
explanation: This directly supports developmental supportive care interventions in Floating-Harbor syndrome.
- name: Speech and communication therapy
description: Communication rehabilitation is recommended for the severe expressive and receptive language phenotype.
therapeutic_modality: BEHAVIORAL
treatment_term:
preferred_term: speech therapy
term:
id: NCIT:C159273
label: Speech Language Therapy
target_phenotypes:
- preferred_term: Delayed speech and language development
term:
id: HP:0000750
label: Delayed speech and language development
evidence:
- reference: PMID:23193612
reference_title: SRCAP-Related Floating-Harbor Syndrome.
supports: SUPPORT
evidence_source: OTHER
snippet: >-
Early intervention programs, special education, and vocational training to address developmental disabilities; communication rehabilitation with sign language or alternative means of communication; behavior management by a behavioral specialist / psychologist with consideration of medication as needed.
explanation: This directly supports communication-focused rehabilitation for language impairment in Floating-Harbor syndrome.
diagnosis:
- name: SRCAP molecular genetic testing
description: Molecular genetic testing for a heterozygous pathogenic SRCAP variant confirms the diagnosis.
presence: Identification of a heterozygous pathogenic SRCAP variant establishes the diagnosis.
diagnosis_term:
preferred_term: molecular genetic testing
term:
id: NCIT:C19770
label: Molecular Analysis
qualifiers:
- predicate:
preferred_term: has participant
term:
id: RO:0000057
label: has participant
value:
preferred_term: SRCAP
term:
id: hgnc:16974
label: SRCAP
evidence:
- reference: PMID:23193612
reference_title: SRCAP-Related Floating-Harbor Syndrome.
supports: SUPPORT
evidence_source: OTHER
snippet: >-
DIAGNOSIS/TESTING: The diagnosis is established in a proband with
suggestive findings and a heterozygous SRCAP pathogenic variant
identified by molecular genetic testing.
explanation: This directly supports molecular genetic testing as the confirmatory diagnostic procedure.
differential_diagnoses: []
clinical_trials: []
datasets: []
notes: >-
Asta deep research was completed for this disorder. Final curation combined
the disease-specific pathogenesis review with GeneReviews for syndrome
definition, diagnosis, and inheritance.
references:
- reference: PMID:23193612
title: "SRCAP-Related Floating-Harbor Syndrome."
tags:
- GeneReviews
findings: []
Deep research results are used as seeds for research; they do not undergo the same validation as the main records and may contain errors. How we use deep research.
Record notes
Asta deep research was completed for this disorder. Final curation combined the disease-specific pathogenesis review with GeneReviews for syndrome definition, diagnosis, and inheritance.
This report is retrieval-only and is generated directly from Asta results.
search_papers_by_relevance with snippet_search.