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1
Inheritance
3
Pathophys.
9
Phenotypes
4
Pathograph
1
Genes
1
Treatments
11
References
1
Deep Research
👪

Inheritance

1
Autosomal dominant HP:0000006
Autosomal dominant inheritance

Pathophysiology

3
Constitutive PDGFRB Activation
Activating PDGFRB mutations cause ligand-independent constitutive receptor signaling.
PDGFRB link
platelet-derived growth factor beta-receptor activity link
Show evidence (1 reference)
PMID:26455322 SUPPORT In Vitro
"the PDGFRB mutations previously identified in familial IM and overgrowth syndrome activate the receptor in the absence of ligand, supporting the hypothesis that these mutations cause the diseases."
Confirms constitutive PDGFRB activation underlies the disease.
STAT5-IGF1 Axis Activation
Mutant PDGFRβ causes increased STAT5 phosphorylation and overexpression of IGF1, activating the STAT5-IGF1 axis locally in the skeleton.
Show evidence (1 reference)
PMID:34738614 SUPPORT Model Organism
"Increased STAT5 phosphorylation and overexpression of Igf1 and Socs2 in PDGFRβD849V cells suggests that overgrowth in mice involves PDGFRβD849V activating the STAT5-IGF1 axis locally in the skeleton."
Mouse model demonstrates the STAT5-IGF1 mechanism underlying skeletal overgrowth.
Skeletal Overgrowth
Skeletal stem cells from mutant mice show alterations in osteogenic and chondrogenic precursors with promotion of chondrogenesis over osteogenesis, leading to the overgrowth phenotype.
Show evidence (1 reference)
PMID:34738614 SUPPORT Model Organism
"Autosomal dominant PDGFRβ gain-of-function mutations in mice and humans cause a spectrum of wasting and overgrowth disorders afflicting the skeleton and other connective tissues"
Establishes the skeletal overgrowth phenotype from PDGFRB gain-of-function.

Pathograph

Use the checkboxes to hide or show graph categories. Hover nodes for evidence and cross-linked metadata.
Pathograph: causal mechanism network for Kosaki_Overgrowth_Syndrome Interactive directed graph showing how pathophysiology mechanisms, phenotypes, genetic factors and variants, experimental models, environmental triggers, and treatments relate through causal and linked edges.

Phenotypes

9
Head and Neck 1
Coarse Facial Features VERY_FREQUENT Coarse facial features (HP:0000280)
Show evidence (1 reference)
PMID:35221873 SUPPORT Human Clinical
"The coarsening of the facial features, enlargement of the hands/feet, and progressive scoliosis started to appear after an average age of 6."
Coarsening of facial features is a defining feature of KOGS.
Integument 1
Hyperelastic Fragile Skin VERY_FREQUENT Hyperextensible skin (HP:0000974)
Show evidence (2 references)
PMID:31710779 SUPPORT Human Clinical
"Presence of skeletal overgrowth, distinctive facial features, characteristic hyperelastic and fragile skin, and cerebral white matter lesions with neuropsychiatric symptoms should prompt genetic analysis of the PDGFRB."
Hyperelastic and fragile skin is named as part of the characteristic KOGS diagnostic gestalt.
DOI:10.1111/cge.13752 SUPPORT Human Clinical
"The KOGS phenotype includes characteristic facial features, tall stature, scoliosis, hyperelastic thin skin, lipodystrophy, variable intellectual and neurological deterioration, and abnormalities on brain imaging."
The 2020 case series supports hyperelastic thin skin as a KOGS phenotype.
Musculoskeletal 3
Scoliosis FREQUENT Scoliosis (HP:0002650)
Show evidence (1 reference)
PMID:35221873 SUPPORT Human Clinical
"enlargement of the hands/feet, and progressive scoliosis started to appear after an average age of 6."
Progressive scoliosis is a key feature of KOGS.
Skeletal Dysplasia FREQUENT Skeletal dysplasia (HP:0002652)
Show evidence (1 reference)
PMID:34738614 SUPPORT Model Organism
"Autosomal dominant PDGFRβ gain-of-function mutations in mice and humans cause a spectrum of wasting and overgrowth disorders afflicting the skeleton and other connective tissues"
Skeletal manifestations are a core feature of PDGFRB gain-of-function disorders.
Lipodystrophy FREQUENT Lipodystrophy (HP:0009125)
Show evidence (2 references)
PMID:31710779 SUPPORT Human Clinical
"In addition to skeletal overgrowth, these patients exhibit hyperelastic, translucent, and fragile skin, scoliosis, progressive loss of subcutaneous adipose tissue, skull deformity, infantile myofibromas, neuropsychiatric symptoms, and arachnoid cysts in the posterior fossa and periventricular..."
Progressive loss of subcutaneous adipose tissue supports lipodystrophy as a recurrent KOGS feature.
DOI:10.1111/cge.13752 SUPPORT Human Clinical
"The KOGS phenotype includes characteristic facial features, tall stature, scoliosis, hyperelastic thin skin, lipodystrophy, variable intellectual and neurological deterioration, and abnormalities on brain imaging."
The 2020 phenotype-expansion series explicitly includes lipodystrophy in the KOGS phenotype.
Nervous System 1
Periventricular White Matter Signal Abnormalities VERY_FREQUENT Abnormal cerebral white matter morphology (HP:0002500)
Show evidence (1 reference)
PMID:31710779 SUPPORT Human Clinical
"In addition to skeletal overgrowth, these patients exhibit hyperelastic, translucent, and fragile skin, scoliosis, progressive loss of subcutaneous adipose tissue, skull deformity, infantile myofibromas, neuropsychiatric symptoms, and arachnoid cysts in the posterior fossa and periventricular..."
The 2019 KOGS review identifies periventricular white matter signal abnormalities as part of the reported phenotype constellation.
Growth 1
Overgrowth VERY_FREQUENT Overgrowth (HP:0001548)
Show evidence (1 reference)
PMID:35221873 SUPPORT Human Clinical
"enlargement of the hands/feet, and progressive scoliosis started to appear after an average age of 6."
Overgrowth is a defining feature of KOGS.
Other 2
Posterior Fossa Arachnoid Cysts FREQUENT Arachnoid cyst (HP:0100702)
Show evidence (1 reference)
PMID:31710779 SUPPORT Human Clinical
"arachnoid cysts in the posterior fossa and periventricular white matter signal abnormalities on neuroimaging."
The 2019 KOGS review identifies posterior fossa arachnoid cysts as part of the recurrent neuroimaging phenotype.
Cerebrovascular Artery Dilation and Aneurysm OCCASIONAL Dilatation of the cerebral artery (HP:0004944)
Show evidence (2 references)
DOI:10.1111/cge.13752 SUPPORT Human Clinical
"Importantly, we report fusiform aneurysm of the basilar artery in two patients."
This phenotype-expansion series directly reports basilar artery fusiform aneurysms in KOGS patients.
DOI:10.1002/ajmg.a.62027 SUPPORT Human Clinical
"The analysis showed the progressive dilation of basilar and vertebral arteries and coronary arteries commencing during the teenage years and early 20s."
Serial imaging of the original KOGS patients supports progressive cerebral-artery dilation as part of the vascular phenotype.
🧬

Genetic Associations

1
PDGFRB Gain-of-Function Mutations (Causative)
Show evidence (2 references)
PMID:26455322 SUPPORT In Vitro
"the germline mutant identified in overgrowth syndrome, P584R, was a stronger oncogene than the germline R561C mutant associated with myofibromatosis."
Functional characterization shows P584R is a potent activating variant.
PMID:35221873 SUPPORT Human Clinical
"Heterozygous activating missense variants of PDGFRB are associated with the phenotype of Kosaki overgrowth syndrome (KOGS)."
Confirms activating PDGFRB variants cause KOGS.
💊

Treatments

1
Imatinib
Action: targeted therapy Ontology label: Targeted Therapy NCIT:C93352
Tyrosine kinase inhibitor that targets constitutively activated PDGFRB. Preclinical data and case reports support its use in PDGFRB gain-of-function disorders.
Show evidence (2 references)
PMID:26455322 SUPPORT In Vitro
"Importantly, all activated mutants were sensitive to tyrosine kinase inhibitors such as imatinib, nilotinib and ponatinib."
In vitro evidence of sensitivity to imatinib.
PMID:32500973 SUPPORT Human Clinical
"Three patients were treated with imatinib and had robust and rapid response"
Clinical evidence of imatinib efficacy in PDGFRB spectrum disorders.
{ }

Source YAML

click to show
name: Kosaki_Overgrowth_Syndrome
creation_date: '2026-04-04T00:00:00Z'
updated_date: '2026-05-09T21:17:09Z'
category: Genetic
parents:
- Overgrowth Syndrome
- Skeletal Dysplasia
disease_term:
  preferred_term: Kosaki overgrowth syndrome
  term:
    id: MONDO:0014704
    label: skeletal overgrowth-craniofacial dysmorphism-hyperelastic skin-white matter lesions syndrome
description: >-
  Kosaki overgrowth syndrome (KOGS) is an extremely rare autosomal dominant
  disorder caused by heterozygous activating missense variants in PDGFRB.
  Clinical features include skeletal overgrowth, coarsening of
  facial features, enlargement of hands and feet, progressive scoliosis,
  and may include white matter abnormalities. Features typically begin to appear after
  age 6. The condition shares overlapping features with other PDGFRB
  gain-of-function disorders including Penttinen premature aging syndrome
  and infantile myofibromatosis, but is distinguished by prominent
  overgrowth and skeletal findings. Vascular complications including
  cerebral vasculopathy may arise with age.
prevalence:
- population: Global
  percentage: Rare
  notes: >-
    Extremely rare; fewer than 25 cases reported worldwide.
inheritance:
- name: Autosomal dominant
  inheritance_term:
    preferred_term: Autosomal dominant inheritance
    term:
      id: HP:0000006
      label: Autosomal dominant inheritance
genetic:
- name: PDGFRB Gain-of-Function Mutations
  gene_term:
    preferred_term: PDGFRB
    term:
      id: hgnc:8804
      label: PDGFRB
  association: Causative
  features: >-
    Heterozygous activating missense variants in PDGFRB cause constitutive receptor
    activation. The germline P584R mutant identified in overgrowth syndrome is a
    stronger oncogene than the germline R561C mutant associated with myofibromatosis,
    and this difference in potency may explain the distinct overgrowth phenotype.
  evidence:
  - reference: PMID:26455322
    supports: SUPPORT
    evidence_source: IN_VITRO
    snippet: "the germline mutant identified in overgrowth syndrome, P584R, was a stronger oncogene than the germline R561C mutant associated with myofibromatosis."
    explanation: Functional characterization shows P584R is a potent activating variant.
  - reference: PMID:35221873
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: "Heterozygous activating missense variants of PDGFRB are associated with the phenotype of Kosaki overgrowth syndrome (KOGS)."
    explanation: Confirms activating PDGFRB variants cause KOGS.
phenotypes:
- name: Overgrowth
  category: Growth
  frequency: VERY_FREQUENT
  phenotype_term:
    preferred_term: Overgrowth
    term:
      id: HP:0001548
      label: Overgrowth
  evidence:
  - reference: PMID:35221873
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: "enlargement of the hands/feet, and progressive scoliosis started to appear after an average age of 6."
    explanation: Overgrowth is a defining feature of KOGS.
- name: Scoliosis
  category: Musculoskeletal
  frequency: FREQUENT
  phenotype_term:
    preferred_term: Scoliosis
    term:
      id: HP:0002650
      label: Scoliosis
  evidence:
  - reference: PMID:35221873
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: "enlargement of the hands/feet, and progressive scoliosis started to appear after an average age of 6."
    explanation: Progressive scoliosis is a key feature of KOGS.
- name: Coarse Facial Features
  category: Craniofacial
  frequency: VERY_FREQUENT
  phenotype_term:
    preferred_term: Coarse facial features
    term:
      id: HP:0000280
      label: Coarse facial features
  evidence:
  - reference: PMID:35221873
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: "The coarsening of the facial features, enlargement of the hands/feet, and progressive scoliosis started to appear after an average age of 6."
    explanation: Coarsening of facial features is a defining feature of KOGS.
- name: Skeletal Dysplasia
  category: Musculoskeletal
  frequency: FREQUENT
  phenotype_term:
    preferred_term: Skeletal dysplasia
    term:
      id: HP:0002652
      label: Skeletal dysplasia
  evidence:
  - reference: PMID:34738614
    supports: SUPPORT
    evidence_source: MODEL_ORGANISM
    snippet: "Autosomal dominant PDGFRβ gain-of-function mutations in mice and humans cause a spectrum of wasting and overgrowth disorders afflicting the skeleton and other connective tissues"
    explanation: Skeletal manifestations are a core feature of PDGFRB gain-of-function disorders.
- name: Periventricular White Matter Signal Abnormalities
  category: Neurologic
  frequency: VERY_FREQUENT
  phenotype_term:
    preferred_term: Periventricular white matter signal abnormalities
    term:
      id: HP:0002500
      label: Abnormal cerebral white matter morphology
  evidence:
  - reference: PMID:31710779
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      In addition to skeletal overgrowth, these patients exhibit hyperelastic,
      translucent, and fragile skin, scoliosis, progressive loss of subcutaneous
      adipose tissue, skull deformity, infantile myofibromas, neuropsychiatric
      symptoms, and arachnoid cysts in the posterior fossa and periventricular
      white matter signal abnormalities on neuroimaging.
    explanation: >-
      The 2019 KOGS review identifies periventricular white matter signal
      abnormalities as part of the reported phenotype constellation.
- name: Posterior Fossa Arachnoid Cysts
  category: Neurologic
  frequency: FREQUENT
  phenotype_term:
    preferred_term: Posterior fossa arachnoid cysts
    term:
      id: HP:0100702
      label: Arachnoid cyst
  evidence:
  - reference: PMID:31710779
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: "arachnoid cysts in the posterior fossa and periventricular white matter signal abnormalities on neuroimaging."
    explanation: >-
      The 2019 KOGS review identifies posterior fossa arachnoid cysts as part
      of the recurrent neuroimaging phenotype.
- name: Lipodystrophy
  category: Connective Tissue
  frequency: FREQUENT
  phenotype_term:
    preferred_term: Lipodystrophy
    term:
      id: HP:0009125
      label: Lipodystrophy
  evidence:
  - reference: PMID:31710779
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      In addition to skeletal overgrowth, these patients exhibit hyperelastic,
      translucent, and fragile skin, scoliosis, progressive loss of subcutaneous
      adipose tissue, skull deformity, infantile myofibromas, neuropsychiatric
      symptoms, and arachnoid cysts in the posterior fossa and periventricular
      white matter signal abnormalities on neuroimaging.
    explanation: >-
      Progressive loss of subcutaneous adipose tissue supports lipodystrophy as
      a recurrent KOGS feature.
  - reference: DOI:10.1111/cge.13752
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      The KOGS phenotype includes characteristic facial features, tall stature,
      scoliosis, hyperelastic thin skin, lipodystrophy, variable intellectual
      and neurological deterioration, and abnormalities on brain imaging.
    explanation: >-
      The 2020 phenotype-expansion series explicitly includes lipodystrophy in
      the KOGS phenotype.
- name: Hyperelastic Fragile Skin
  category: Integument
  frequency: VERY_FREQUENT
  phenotype_term:
    preferred_term: Hyperelastic fragile skin
    term:
      id: HP:0000974
      label: Hyperextensible skin
  evidence:
  - reference: PMID:31710779
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Presence of skeletal overgrowth, distinctive facial features,
      characteristic hyperelastic and fragile skin, and cerebral white matter
      lesions with neuropsychiatric symptoms should prompt genetic analysis of
      the PDGFRB.
    explanation: >-
      Hyperelastic and fragile skin is named as part of the characteristic KOGS
      diagnostic gestalt.
  - reference: DOI:10.1111/cge.13752
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      The KOGS phenotype includes characteristic facial features, tall stature,
      scoliosis, hyperelastic thin skin, lipodystrophy, variable intellectual
      and neurological deterioration, and abnormalities on brain imaging.
    explanation: The 2020 case series supports hyperelastic thin skin as a KOGS phenotype.
- name: Cerebrovascular Artery Dilation and Aneurysm
  category: Cardiovascular
  frequency: OCCASIONAL
  phenotype_term:
    preferred_term: Cerebrovascular artery dilation and aneurysm
    term:
      id: HP:0004944
      label: Dilatation of the cerebral artery
  evidence:
  - reference: DOI:10.1111/cge.13752
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      Importantly, we report fusiform aneurysm of the basilar artery in two
      patients.
    explanation: >-
      This phenotype-expansion series directly reports basilar artery fusiform
      aneurysms in KOGS patients.
  - reference: DOI:10.1002/ajmg.a.62027
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: >-
      The analysis showed the progressive dilation of basilar and vertebral
      arteries and coronary arteries commencing during the teenage years and
      early 20s.
    explanation: >-
      Serial imaging of the original KOGS patients supports progressive
      cerebral-artery dilation as part of the vascular phenotype.
pathophysiology:
- name: Constitutive PDGFRB Activation
  description: >-
    Activating PDGFRB mutations cause ligand-independent constitutive receptor
    signaling.
  genes:
  - preferred_term: PDGFRB
    term:
      id: hgnc:8804
      label: PDGFRB
  molecular_functions:
  - preferred_term: platelet-derived growth factor beta-receptor activity
    term:
      id: GO:0005019
      label: platelet-derived growth factor beta-receptor activity
  downstream:
  - target: STAT5-IGF1 Axis Activation
    description: Constitutive PDGFRB signaling activates the STAT5-IGF1 axis.
  evidence:
  - reference: PMID:26455322
    supports: SUPPORT
    evidence_source: IN_VITRO
    snippet: "the PDGFRB mutations previously identified in familial IM and overgrowth syndrome activate the receptor in the absence of ligand, supporting the hypothesis that these mutations cause the diseases."
    explanation: Confirms constitutive PDGFRB activation underlies the disease.
- name: STAT5-IGF1 Axis Activation
  description: >-
    Mutant PDGFRβ causes increased STAT5 phosphorylation and overexpression of
    IGF1, activating the STAT5-IGF1 axis locally in the skeleton.
  downstream:
  - target: Skeletal Overgrowth
    description: STAT5-IGF1 signaling alters skeletal stem cell fate, promoting chondrogenesis.
  evidence:
  - reference: PMID:34738614
    supports: SUPPORT
    evidence_source: MODEL_ORGANISM
    snippet: "Increased STAT5 phosphorylation and overexpression of Igf1 and Socs2 in PDGFRβD849V cells suggests that overgrowth in mice involves PDGFRβD849V activating the STAT5-IGF1 axis locally in the skeleton."
    explanation: Mouse model demonstrates the STAT5-IGF1 mechanism underlying skeletal overgrowth.
- name: Skeletal Overgrowth
  description: >-
    Skeletal stem cells from mutant mice show alterations in osteogenic and
    chondrogenic precursors with promotion of chondrogenesis over osteogenesis,
    leading to the overgrowth phenotype.
  evidence:
  - reference: PMID:34738614
    supports: SUPPORT
    evidence_source: MODEL_ORGANISM
    snippet: "Autosomal dominant PDGFRβ gain-of-function mutations in mice and humans cause a spectrum of wasting and overgrowth disorders afflicting the skeleton and other connective tissues"
    explanation: Establishes the skeletal overgrowth phenotype from PDGFRB gain-of-function.
treatments:
- name: Imatinib
  description: >-
    Tyrosine kinase inhibitor that targets constitutively activated PDGFRB.
    Preclinical data and case reports support its use in PDGFRB gain-of-function
    disorders.
  treatment_term:
    preferred_term: targeted therapy
    term:
      id: NCIT:C93352
      label: Targeted Therapy
  evidence:
  - reference: PMID:26455322
    supports: SUPPORT
    evidence_source: IN_VITRO
    snippet: "Importantly, all activated mutants were sensitive to tyrosine kinase inhibitors such as imatinib, nilotinib and ponatinib."
    explanation: In vitro evidence of sensitivity to imatinib.
  - reference: PMID:32500973
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: "Three patients were treated with imatinib and had robust and rapid response"
    explanation: Clinical evidence of imatinib efficacy in PDGFRB spectrum disorders.
notes: >-
  Macrocephaly is sometimes listed as a feature of KOGS in clinical descriptions,
  but none of the available reference abstracts (PMID:35221873, PMID:26455322,
  PMID:34738614, PMID:32500973) contain the term "macrocephaly". The phenotype
  was removed pending a citable reference with an explicit quotable snippet.
references:
- reference: DOI:10.1002/ajmg.a.38310
  title: Expansion of the phenotype of Kosaki overgrowth syndrome
  found_in:
  - Kosaki_Overgrowth_Syndrome-deep-research-falcon.md
  findings:
  - statement: Skeletal overgrowth is a characteristic of several genetic disorders that are linked to specific molecular signaling cascades.
    supporting_text: Skeletal overgrowth is a characteristic of several genetic disorders that are linked to specific molecular signaling cascades.
    evidence:
    - reference: DOI:10.1002/ajmg.a.38310
      reference_title: Expansion of the phenotype of Kosaki overgrowth syndrome
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: Skeletal overgrowth is a characteristic of several genetic disorders that are linked to specific molecular signaling cascades.
      explanation: Deep research cited this publication as relevant literature for Kosaki Overgrowth Syndrome.
- reference: DOI:10.1002/ajmg.a.61615
  title: Activating variants in <scp><i>PDGFRB</i></scp> result in a spectrum of disorders responsive to imatinib monotherapy
  found_in:
  - Kosaki_Overgrowth_Syndrome-deep-research-falcon.md
  findings:
  - statement: Activating variants in <scp><i>PDGFRB</i></scp> result in a spectrum of disorders responsive to imatinib monotherapy
    supporting_text: More than 50 individuals with activating variants in the receptor tyrosine kinase PDGFRB have been reported, separated based on clinical features into solitary myofibromas, infantile myofibromatosis, Penttinen syndrome with premature aging and osteopenia, Kosaki overgrowth syndrome, and fusiform aneurysms.
    evidence:
    - reference: DOI:10.1002/ajmg.a.61615
      reference_title: Activating variants in <scp><i>PDGFRB</i></scp> result in a spectrum of disorders responsive to imatinib monotherapy
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: More than 50 individuals with activating variants in the receptor tyrosine kinase PDGFRB have been reported, separated based on clinical features into solitary myofibromas, infantile myofibromatosis, Penttinen syndrome with premature aging and osteopenia, Kosaki overgrowth syndrome, and fusiform aneurysms.
      explanation: Deep research cited this publication as relevant literature for Kosaki Overgrowth Syndrome.
- reference: DOI:10.1002/ajmg.a.62027
  title: Progressive cerebral and coronary aneurysms in the original two patients with Kosaki overgrowth syndrome
  found_in:
  - Kosaki_Overgrowth_Syndrome-deep-research-falcon.md
  findings:
  - statement: 'Skeletal overgrowth accompanied by de novo heterozygous activating mutations in PDGFRB (platelet‐derived growth factor receptor beta), that is, p.Pro584Arg and p.Trp566Arg, defines Kosaki overgrowth syndrome (OMIM #616592).'
    supporting_text: 'Skeletal overgrowth accompanied by de novo heterozygous activating mutations in PDGFRB (platelet‐derived growth factor receptor beta), that is, p.Pro584Arg and p.Trp566Arg, defines Kosaki overgrowth syndrome (OMIM #616592).'
    evidence:
    - reference: DOI:10.1002/ajmg.a.62027
      reference_title: Progressive cerebral and coronary aneurysms in the original two patients with Kosaki overgrowth syndrome
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: 'Skeletal overgrowth accompanied by de novo heterozygous activating mutations in PDGFRB (platelet‐derived growth factor receptor beta), that is, p.Pro584Arg and p.Trp566Arg, defines Kosaki overgrowth syndrome (OMIM #616592).'
      explanation: Deep research cited this publication as relevant literature for Kosaki Overgrowth Syndrome.
- reference: DOI:10.1002/ajmg.a.62126
  title: Segmental overgrowth and aneurysms due to mosaic <scp><i>PDGFRB</i></scp> p.(<scp>Tyr562Cys</scp>)
  found_in:
  - Kosaki_Overgrowth_Syndrome-deep-research-falcon.md
  findings:
  - statement: Activating variants in the platelet‐derived growth factor receptor β gene (PDGFRB) have been associated with Kosaki overgrowth syndrome, infantile myofibromatosis, and Penttinen premature aging syndrome.
    supporting_text: Activating variants in the platelet‐derived growth factor receptor β gene (PDGFRB) have been associated with Kosaki overgrowth syndrome, infantile myofibromatosis, and Penttinen premature aging syndrome.
    evidence:
    - reference: DOI:10.1002/ajmg.a.62126
      reference_title: Segmental overgrowth and aneurysms due to mosaic <scp><i>PDGFRB</i></scp> p.(<scp>Tyr562Cys</scp>)
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: Activating variants in the platelet‐derived growth factor receptor β gene (PDGFRB) have been associated with Kosaki overgrowth syndrome, infantile myofibromatosis, and Penttinen premature aging syndrome.
      explanation: Deep research cited this publication as relevant literature for Kosaki Overgrowth Syndrome.
- reference: DOI:10.1002/ajmg.c.31755
  title: 'Kosaki overgrowth syndrome: A newly identified entity caused by pathogenic variants in platelet‐derived growth factor receptor‐beta'
  found_in:
  - Kosaki_Overgrowth_Syndrome-deep-research-falcon.md
  findings:
  - statement: 'Specific classes of de novo heterozygous gain‐of‐function pathogenic variants of the PDGFRB (platelet‐derived growth factor receptor‐beta) cause a distinctive overgrowth syndrome, named the Kosaki overgrowth syndrome (KOGS) (OMIM #616592).'
    supporting_text: 'Specific classes of de novo heterozygous gain‐of‐function pathogenic variants of the PDGFRB (platelet‐derived growth factor receptor‐beta) cause a distinctive overgrowth syndrome, named the Kosaki overgrowth syndrome (KOGS) (OMIM #616592).'
    evidence:
    - reference: DOI:10.1002/ajmg.c.31755
      reference_title: 'Kosaki overgrowth syndrome: A newly identified entity caused by pathogenic variants in platelet‐derived growth factor receptor‐beta'
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: 'Specific classes of de novo heterozygous gain‐of‐function pathogenic variants of the PDGFRB (platelet‐derived growth factor receptor‐beta) cause a distinctive overgrowth syndrome, named the Kosaki overgrowth syndrome (KOGS) (OMIM #616592).'
      explanation: Deep research cited this publication as relevant literature for Kosaki Overgrowth Syndrome.
- reference: DOI:10.1007/s00018-020-03753-y
  title: PDGF receptor mutations in human diseases
  found_in:
  - Kosaki_Overgrowth_Syndrome-deep-research-falcon.md
  findings:
  - statement: PDGF receptor mutations in human diseases
    supporting_text: PDGF receptor mutations in human diseases
- reference: DOI:10.1101/gad.300384.117
  title: STAT1 modulates tissue wasting or overgrowth downstream from PDGFRβ
  found_in:
  - Kosaki_Overgrowth_Syndrome-deep-research-falcon.md
  findings:
  - statement: 'Platelet-derived growth factor (PDGF) acts through two conserved receptor tyrosine kinases: PDGFRα and PDGFRβ.'
    supporting_text: 'Platelet-derived growth factor (PDGF) acts through two conserved receptor tyrosine kinases: PDGFRα and PDGFRβ.'
    evidence:
    - reference: DOI:10.1101/gad.300384.117
      reference_title: STAT1 modulates tissue wasting or overgrowth downstream from PDGFRβ
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: 'Platelet-derived growth factor (PDGF) acts through two conserved receptor tyrosine kinases: PDGFRα and PDGFRβ.'
      explanation: Deep research cited this publication as relevant literature for Kosaki Overgrowth Syndrome.
- reference: DOI:10.1111/cge.13192
  title: Phenotype expansion and development in Kosaki overgrowth syndrome
  found_in:
  - Kosaki_Overgrowth_Syndrome-deep-research-falcon.md
  findings:
  - statement: We expand the Kosaki overgrowth syndrome (KOGS) phenotype by over 70% to include 24 unreported KOGS symptoms, in a first male patient, the third overall associated with the PDGFRB c.1751C>G p.(Pro584Arg) mutation.
    supporting_text: We expand the Kosaki overgrowth syndrome (KOGS) phenotype by over 70% to include 24 unreported KOGS symptoms, in a first male patient, the third overall associated with the PDGFRB c.1751C>G p.(Pro584Arg) mutation.
    evidence:
    - reference: DOI:10.1111/cge.13192
      reference_title: Phenotype expansion and development in Kosaki overgrowth syndrome
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: We expand the Kosaki overgrowth syndrome (KOGS) phenotype by over 70% to include 24 unreported KOGS symptoms, in a first male patient, the third overall associated with the PDGFRB c.1751C>G p.(Pro584Arg) mutation.
      explanation: Deep research cited this publication as relevant literature for Kosaki Overgrowth Syndrome.
- reference: DOI:10.1111/cge.13752
  title: 'Kosaki overgrowth syndrome: A novel pathogenic variant in <scp><i>PDGFRB</i></scp> and expansion of the phenotype including cerebrovascular complications'
  found_in:
  - Kosaki_Overgrowth_Syndrome-deep-research-falcon.md
  findings:
  - statement: Heterozygous activating variants in platelet‐derived growth factor, beta (PDGFRB) are associated with phenotypes including Kosaki overgrowth syndrome (KOGS), Penttinen syndrome and infantile myofibromatosis (IM).
    supporting_text: Heterozygous activating variants in platelet‐derived growth factor, beta (PDGFRB) are associated with phenotypes including Kosaki overgrowth syndrome (KOGS), Penttinen syndrome and infantile myofibromatosis (IM).
    evidence:
    - reference: DOI:10.1111/cge.13752
      reference_title: 'Kosaki overgrowth syndrome: A novel pathogenic variant in <scp><i>PDGFRB</i></scp> and expansion of the phenotype including cerebrovascular complications'
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: Heterozygous activating variants in platelet‐derived growth factor, beta (PDGFRB) are associated with phenotypes including Kosaki overgrowth syndrome (KOGS), Penttinen syndrome and infantile myofibromatosis (IM).
      explanation: Deep research cited this publication as relevant literature for Kosaki Overgrowth Syndrome.
- reference: DOI:10.1159/000484532
  title: A Clinical Review of Generalized Overgrowth Syndromes in the Era of Massively Parallel Sequencing
  found_in:
  - Kosaki_Overgrowth_Syndrome-deep-research-falcon.md
  findings:
  - statement: The overgrowth syndromes are important to diagnose, not just for accurate genetic counseling, but also for knowledge surrounding cancer surveillance and prognosis.
    supporting_text: The overgrowth syndromes are important to diagnose, not just for accurate genetic counseling, but also for knowledge surrounding cancer surveillance and prognosis.
    evidence:
    - reference: DOI:10.1159/000484532
      reference_title: A Clinical Review of Generalized Overgrowth Syndromes in the Era of Massively Parallel Sequencing
      supports: SUPPORT
      evidence_source: OTHER
      snippet: The overgrowth syndromes are important to diagnose, not just for accurate genetic counseling, but also for knowledge surrounding cancer surveillance and prognosis.
      explanation: Deep research cited this publication as relevant literature for Kosaki Overgrowth Syndrome.
- reference: DOI:10.3389/fgene.2024.1382371
  title: 'Molecular mechanisms of human overgrowth and use of omics in its diagnostics: chances and challenges'
  found_in:
  - Kosaki_Overgrowth_Syndrome-deep-research-falcon.md
  findings:
  - statement: Overgrowth disorders comprise a group of entities with a variable phenotypic spectrum ranging from tall stature to isolated or lateralized overgrowth of body parts and or organs.
    supporting_text: Overgrowth disorders comprise a group of entities with a variable phenotypic spectrum ranging from tall stature to isolated or lateralized overgrowth of body parts and or organs.
    evidence:
    - reference: DOI:10.3389/fgene.2024.1382371
      reference_title: 'Molecular mechanisms of human overgrowth and use of omics in its diagnostics: chances and challenges'
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: Overgrowth disorders comprise a group of entities with a variable phenotypic spectrum ranging from tall stature to isolated or lateralized overgrowth of body parts and or organs.
      explanation: Deep research cited this publication as relevant literature for Kosaki Overgrowth Syndrome.
📚

References & Deep Research

References

11
Expansion of the phenotype of Kosaki overgrowth syndrome
1 finding
Skeletal overgrowth is a characteristic of several genetic disorders that are linked to specific molecular signaling cascades.
"Skeletal overgrowth is a characteristic of several genetic disorders that are linked to specific molecular signaling cascades."
Show evidence (1 reference)
DOI:10.1002/ajmg.a.38310 SUPPORT Human Clinical
"Skeletal overgrowth is a characteristic of several genetic disorders that are linked to specific molecular signaling cascades."
Deep research cited this publication as relevant literature for Kosaki Overgrowth Syndrome.
Activating variants in <scp><i>PDGFRB</i></scp> result in a spectrum of disorders responsive to imatinib monotherapy
1 finding
Activating variants in <scp><i>PDGFRB</i></scp> result in a spectrum of disorders responsive to imatinib monotherapy
"More than 50 individuals with activating variants in the receptor tyrosine kinase PDGFRB have been reported, separated based on clinical features into solitary myofibromas, infantile myofibromatosis, Penttinen syndrome with premature aging and osteopenia, Kosaki overgrowth syndrome, and fusiform..."
Show evidence (1 reference)
DOI:10.1002/ajmg.a.61615 SUPPORT Human Clinical
"More than 50 individuals with activating variants in the receptor tyrosine kinase PDGFRB have been reported, separated based on clinical features into solitary myofibromas, infantile myofibromatosis, Penttinen syndrome with premature aging and osteopenia, Kosaki overgrowth syndrome, and fusiform..."
Deep research cited this publication as relevant literature for Kosaki Overgrowth Syndrome.
Progressive cerebral and coronary aneurysms in the original two patients with Kosaki overgrowth syndrome
1 finding
Skeletal overgrowth accompanied by de novo heterozygous activating mutations in PDGFRB (platelet‐derived growth factor receptor beta), that is, p.Pro584Arg and p.Trp566Arg, defines Kosaki overgrowth syndrome (OMIM #616592).
"Skeletal overgrowth accompanied by de novo heterozygous activating mutations in PDGFRB (platelet‐derived growth factor receptor beta), that is, p.Pro584Arg and p.Trp566Arg, defines Kosaki overgrowth syndrome (OMIM #616592)."
Show evidence (1 reference)
DOI:10.1002/ajmg.a.62027 SUPPORT Human Clinical
"Skeletal overgrowth accompanied by de novo heterozygous activating mutations in PDGFRB (platelet‐derived growth factor receptor beta), that is, p.Pro584Arg and p.Trp566Arg, defines Kosaki overgrowth syndrome (OMIM #616592)."
Deep research cited this publication as relevant literature for Kosaki Overgrowth Syndrome.
Segmental overgrowth and aneurysms due to mosaic <scp><i>PDGFRB</i></scp> p.(<scp>Tyr562Cys</scp>)
1 finding
Activating variants in the platelet‐derived growth factor receptor β gene (PDGFRB) have been associated with Kosaki overgrowth syndrome, infantile myofibromatosis, and Penttinen premature aging syndrome.
"Activating variants in the platelet‐derived growth factor receptor β gene (PDGFRB) have been associated with Kosaki overgrowth syndrome, infantile myofibromatosis, and Penttinen premature aging syndrome."
Show evidence (1 reference)
DOI:10.1002/ajmg.a.62126 SUPPORT Human Clinical
"Activating variants in the platelet‐derived growth factor receptor β gene (PDGFRB) have been associated with Kosaki overgrowth syndrome, infantile myofibromatosis, and Penttinen premature aging syndrome."
Deep research cited this publication as relevant literature for Kosaki Overgrowth Syndrome.
Kosaki overgrowth syndrome: A newly identified entity caused by pathogenic variants in platelet‐derived growth factor receptor‐beta
1 finding
Specific classes of de novo heterozygous gain‐of‐function pathogenic variants of the PDGFRB (platelet‐derived growth factor receptor‐beta) cause a distinctive overgrowth syndrome, named the Kosaki overgrowth syndrome (KOGS) (OMIM #616592).
"Specific classes of de novo heterozygous gain‐of‐function pathogenic variants of the PDGFRB (platelet‐derived growth factor receptor‐beta) cause a distinctive overgrowth syndrome, named the Kosaki overgrowth syndrome (KOGS) (OMIM #616592)."
Show evidence (1 reference)
DOI:10.1002/ajmg.c.31755 SUPPORT Human Clinical
"Specific classes of de novo heterozygous gain‐of‐function pathogenic variants of the PDGFRB (platelet‐derived growth factor receptor‐beta) cause a distinctive overgrowth syndrome, named the Kosaki overgrowth syndrome (KOGS) (OMIM #616592)."
Deep research cited this publication as relevant literature for Kosaki Overgrowth Syndrome.
PDGF receptor mutations in human diseases
1 finding
PDGF receptor mutations in human diseases
"PDGF receptor mutations in human diseases"
STAT1 modulates tissue wasting or overgrowth downstream from PDGFRβ
1 finding
Platelet-derived growth factor (PDGF) acts through two conserved receptor tyrosine kinases: PDGFRα and PDGFRβ.
"Platelet-derived growth factor (PDGF) acts through two conserved receptor tyrosine kinases: PDGFRα and PDGFRβ."
Show evidence (1 reference)
DOI:10.1101/gad.300384.117 SUPPORT Human Clinical
"Platelet-derived growth factor (PDGF) acts through two conserved receptor tyrosine kinases: PDGFRα and PDGFRβ."
Deep research cited this publication as relevant literature for Kosaki Overgrowth Syndrome.
Phenotype expansion and development in Kosaki overgrowth syndrome
1 finding
We expand the Kosaki overgrowth syndrome (KOGS) phenotype by over 70% to include 24 unreported KOGS symptoms, in a first male patient, the third overall associated with the PDGFRB c.1751C>G p.(Pro584Arg) mutation.
"We expand the Kosaki overgrowth syndrome (KOGS) phenotype by over 70% to include 24 unreported KOGS symptoms, in a first male patient, the third overall associated with the PDGFRB c.1751C>G p.(Pro584Arg) mutation."
Show evidence (1 reference)
DOI:10.1111/cge.13192 SUPPORT Human Clinical
"We expand the Kosaki overgrowth syndrome (KOGS) phenotype by over 70% to include 24 unreported KOGS symptoms, in a first male patient, the third overall associated with the PDGFRB c.1751C>G p.(Pro584Arg) mutation."
Deep research cited this publication as relevant literature for Kosaki Overgrowth Syndrome.
Kosaki overgrowth syndrome: A novel pathogenic variant in <scp><i>PDGFRB</i></scp> and expansion of the phenotype including cerebrovascular complications
1 finding
Heterozygous activating variants in platelet‐derived growth factor, beta (PDGFRB) are associated with phenotypes including Kosaki overgrowth syndrome (KOGS), Penttinen syndrome and infantile myofibromatosis (IM).
"Heterozygous activating variants in platelet‐derived growth factor, beta (PDGFRB) are associated with phenotypes including Kosaki overgrowth syndrome (KOGS), Penttinen syndrome and infantile myofibromatosis (IM)."
Show evidence (1 reference)
DOI:10.1111/cge.13752 SUPPORT Human Clinical
"Heterozygous activating variants in platelet‐derived growth factor, beta (PDGFRB) are associated with phenotypes including Kosaki overgrowth syndrome (KOGS), Penttinen syndrome and infantile myofibromatosis (IM)."
Deep research cited this publication as relevant literature for Kosaki Overgrowth Syndrome.
A Clinical Review of Generalized Overgrowth Syndromes in the Era of Massively Parallel Sequencing
1 finding
The overgrowth syndromes are important to diagnose, not just for accurate genetic counseling, but also for knowledge surrounding cancer surveillance and prognosis.
"The overgrowth syndromes are important to diagnose, not just for accurate genetic counseling, but also for knowledge surrounding cancer surveillance and prognosis."
Show evidence (1 reference)
DOI:10.1159/000484532 SUPPORT Other
"The overgrowth syndromes are important to diagnose, not just for accurate genetic counseling, but also for knowledge surrounding cancer surveillance and prognosis."
Deep research cited this publication as relevant literature for Kosaki Overgrowth Syndrome.
Molecular mechanisms of human overgrowth and use of omics in its diagnostics: chances and challenges
1 finding
Overgrowth disorders comprise a group of entities with a variable phenotypic spectrum ranging from tall stature to isolated or lateralized overgrowth of body parts and or organs.
"Overgrowth disorders comprise a group of entities with a variable phenotypic spectrum ranging from tall stature to isolated or lateralized overgrowth of body parts and or organs."
Show evidence (1 reference)
DOI:10.3389/fgene.2024.1382371 SUPPORT Human Clinical
"Overgrowth disorders comprise a group of entities with a variable phenotypic spectrum ranging from tall stature to isolated or lateralized overgrowth of body parts and or organs."
Deep research cited this publication as relevant literature for Kosaki Overgrowth Syndrome.

Deep Research

1
Falcon
Kosaki Overgrowth Syndrome (KOGS) — Comprehensive Disease Characteristics Report
Edison Scientific Literature 37 citations 2026-05-09T10:36:01.538337

Kosaki Overgrowth Syndrome (KOGS) — Comprehensive Disease Characteristics Report

Target Disease

  • Disease name: Kosaki overgrowth syndrome (KOGS)
  • Category: Genetic overgrowth/connective-tissue disorder
  • Causal gene: PDGFRB (platelet-derived growth factor receptor beta)
  • Ontology mapping: MONDO MONDO_0014704 (“skeletal overgrowth–craniofacial dysmorphism–hyperelastic skin–white matter lesions syndrome”), used as an ontology-style label for the same entity in OpenTargets (OpenTargets Search: Kosaki overgrowth syndrome).
Disease name Synonyms / alternate names MONDO ID OMIM disease ID Causal gene (symbol; OMIM) Notes on terminology Sources
Kosaki overgrowth syndrome KOGS; PDGFRB-related overgrowth syndrome; skeletal overgrowth-craniofacial dysmorphism-hyperelastic skin-white matter lesions syndrome MONDO:0014704 OMIM:616592 PDGFRB; OMIM:173410 Current disease label in case series/reviews is Kosaki overgrowth syndrome. Open Targets maps PDGFRB to the MONDO disease name skeletal overgrowth-craniofacial dysmorphism-hyperelastic skin-white matter lesions syndrome, which appears to represent the same entity in ontology-oriented resources. (foster2020kosakiovergrowthsyndrome pages 1-2, minatogawa2017expansionofthe pages 1-2, gawlinski2018phenotypeexpansionand pages 1-4, OpenTargets Search: Kosaki overgrowth syndrome)
Skeletal overgrowth-craniofacial dysmorphism-hyperelastic skin-white matter lesions syndrome Kosaki overgrowth syndrome; KOGS MONDO:0014704 OMIM:616592 PDGFRB; OMIM:173410 Descriptive/ontology-style synonym emphasizing the core phenotype: skeletal overgrowth, craniofacial dysmorphism, hyperelastic skin, and white matter lesions. Useful for cross-resource harmonization. (OpenTargets Search: Kosaki overgrowth syndrome, takenouchi2019kosakiovergrowthsyndrome pages 1-3)
PDGFRB-related disorder spectrum entry relevant to KOGS PDGFRB-activating variant spectrum (broader umbrella); overlaps with Penttinen syndrome and infantile myofibromatosis Not disease-specific in cited sources KOGS within OMIM:616592 PDGFRB; OMIM:173410 Several reviews argue that KOGS is part of a broader PDGFRB activating variant spectrum, but KOGS remains a clinically recognizable syndrome with its own OMIM entry. (foster2020kosakiovergrowthsyndrome pages 1-2, takenouchi2021progressivecerebraland pages 4-5, wenger2020activatingvariantsin pages 2-4, wenger2020activatingvariantsin pages 14-15)

Table: This table summarizes the main disease names, cross-resource identifiers, and terminology mappings used for Kosaki overgrowth syndrome. It is useful for harmonizing OMIM/MONDO naming with the PDGFRB-related disease spectrum in a knowledge base.


1. Disease Information

Overview / definition

Kosaki overgrowth syndrome is an ultra-rare, clinically recognizable overgrowth/connective-tissue syndrome caused by heterozygous activating (gain-of-function) PDGFRB variants, classically presenting with postnatal skeletal overgrowth, hyperelastic/fragile skin with poor wound healing, lipodystrophy/progeroid features, scoliosis/joint contractures, and a characteristic neuroimaging pattern of periventricular white matter lesions and posterior fossa anomalies; an important recent expansion of the phenotype includes progressive, potentially fatal cerebrovascular and coronary aneurysms (foster2020kosakiovergrowthsyndrome pages 1-2, takenouchi2021progressivecerebraland pages 2-4, takenouchi2019kosakiovergrowthsyndrome pages 3-4).

Key identifiers (best available from accessible corpus)

  • OMIM disease: 616592 (Kosaki overgrowth syndrome) (foster2020kosakiovergrowthsyndrome pages 1-2, minatogawa2017expansionofthe pages 1-2, gawlinski2018phenotypeexpansionand pages 1-4)
  • OMIM gene: PDGFRB 173410 (foster2020kosakiovergrowthsyndrome pages 1-2, minatogawa2017expansionofthe pages 1-2)
  • MONDO: MONDO_0014704 (OpenTargets mapping) (OpenTargets Search: Kosaki overgrowth syndrome)

Not found in the currently accessible full-text corpus: Orphanet ID, MeSH ID, ICD-10/ICD-11 codes.

Synonyms / alternative names

  • “KOGS” (common abbreviation) (foster2020kosakiovergrowthsyndrome pages 1-2)
  • “PDGFRB-related overgrowth syndrome” / part of a “PDGFRB activating variant spectrum” (broader umbrella across overlapping phenotypes) (wenger2020activatingvariantsin pages 2-4, wenger2020activatingvariantsin pages 14-15)
  • Ontology-style name emphasizing core features: “skeletal overgrowth–craniofacial dysmorphism–hyperelastic skin–white matter lesions syndrome” (OpenTargets Search: Kosaki overgrowth syndrome)

Evidence type

The KOGS knowledge base is primarily derived from individual patients in case reports/case series and subsequent synthesis reviews (e.g., 2017 expansion; 2019 clinical review; 2020 case series with vascular complications; 2021 longitudinal imaging of original patients) (minatogawa2017expansionofthe pages 1-2, takenouchi2019kosakiovergrowthsyndrome pages 3-4, foster2020kosakiovergrowthsyndrome pages 1-2, takenouchi2021progressivecerebraland pages 2-4).


2. Etiology

Disease causal factors

Primary cause: germline gain-of-function PDGFRB variants (typically missense) leading to constitutive receptor tyrosine kinase signaling (minatogawa2017expansionofthe pages 1-2, takenouchi2019kosakiovergrowthsyndrome pages 1-3, foster2020kosakiovergrowthsyndrome pages 10-11).

A mechanistic genotype contrast is explicitly described: “hypermorphic mutations in PDGFRB lead to Kosaki overgrowth syndrome… whereas hypomorphic mutations lead to idiopathic basal ganglia calcification” (minatogawa2017expansionofthe pages 1-2).

Risk factors

  • Genetic: presence of a germline activating PDGFRB variant; de novo occurrence is common in classic KOGS (minatogawa2017expansionofthe pages 1-2, foster2020kosakiovergrowthsyndrome pages 1-2, gawlinski2018phenotypeexpansionand pages 1-4).
  • Age-related progression risk: vascular complications appear progressive and may emerge with age; Foster et al. note that features are progressive and it is “probably that vascular complications may develop with age” (foster2020kosakiovergrowthsyndrome pages 10-11).

No environmental risk modifiers have been established in the accessible literature.

Protective factors / Gene–environment interaction

No protective factors or gene–environment interaction evidence specific to KOGS was identified in the accessible corpus.


3. Phenotypes

Phenotypic spectrum (with suggested HPO terms)

Phenotypic feature Clinical category Reported frequency / count Phenotype details Suggested HPO term(s) Key source(s)
Periventricular white matter lesions / signal abnormalities Neuroimaging abnormality 100% (all reported patients in 2019 review) Best detected on FLAIR; described as periventricular white matter hyperintensities/signal abnormalities and considered a core radiologic hallmark HP:0002500 Cerebral white matter abnormality; HP:0007054 Periventricular white matter abnormalities (takenouchi2019kosakiovergrowthsyndrome pages 3-4)
Posterior fossa arachnoid cysts / posterior fossa protrusion Neuroimaging structural abnormality ~83% (5/6) Enlarged posterior fossa subarachnoid space/arachnoid cysts; part of recurrent CNS imaging pattern HP:0002276 Arachnoid cyst; HP:0002280 Dandy-Walker malformation (when present) (takenouchi2019kosakiovergrowthsyndrome pages 3-4, takenouchi2019kosakiovergrowthsyndrome pages 1-3)
Lipodystrophy / progressive loss of subcutaneous fat Connective tissue / body composition ~83% Progressive periorbital and generalized subcutaneous fat loss contributes to prematurely aged/progeroid appearance HP:0009125 Lipodystrophy; HP:0007495 Prematurely aged appearance (foster2020kosakiovergrowthsyndrome pages 1-2, minatogawa2017expansionofthe pages 1-2, takenouchi2019kosakiovergrowthsyndrome pages 3-4)
Hyperelastic, thin, fragile, translucent skin with poor wound healing Dermatologic / connective tissue Common; described as universal in small review cohort for hyperelastic/thin/fragile skin Includes velvety/translucent skin, widened scarring, skin hyperextensibility, poor wound healing HP:0000974 Hyperelastic skin; HP:0008066 Thin skin; HP:0001030 Fragile skin; HP:0001058 Poor wound healing (minatogawa2017expansionofthe pages 1-2, takenouchi2019kosakiovergrowthsyndrome pages 4-5, takenouchi2019kosakiovergrowthsyndrome pages 3-4)
Postnatal skeletal overgrowth / tall stature Growth abnormality Hallmark feature; frequency not numerically stated in accessible texts Height >2 SD, large hands/feet or palms/soles; overgrowth is postnatal rather than clearly prenatal HP:0000098 Tall stature; HP:0001161 Broad hand or HP:0100807 Large hand; HP:0001173 Broad foot or HP:0001833 Large foot (foster2020kosakiovergrowthsyndrome pages 1-2, minatogawa2017expansionofthe pages 1-2, takenouchi2019kosakiovergrowthsyndrome pages 4-5, takenouchi2019kosakiovergrowthsyndrome pages 3-4)
Macrocephaly Growth / craniofacial Reported; frequency not available in accessible texts May be pronounced from birth in some patients HP:0000256 Macrocephaly (gawlinski2018phenotypeexpansionand pages 1-4)
Craniosynostosis Craniofacial / skeletal ~33% Can involve multiple sutures; cranial deformity and skull radiograph abnormalities reported HP:0001363 Craniosynostosis (foster2020kosakiovergrowthsyndrome pages 1-2, takenouchi2019kosakiovergrowthsyndrome pages 3-4, takenouchi2019kosakiovergrowthsyndrome pages 1-3)
Distinctive craniofacial dysmorphism Craniofacial Frequent, but no pooled % in accessible texts Frontal prominence, supraorbital ridges, ptosis/proptosis, apparent hypertelorism, wide nasal bridge, high columella, triangular face, long palpebral fissures with lateral ectropion HP:0002007 Frontal bossing; HP:0009912 Hypertelorism; HP:0000508 Ptosis; HP:0000589 Narrow palpebral fissure / HP:0000637 Long palpebral fissure; HP:0000601 Facial asymmetry not specific; HP:0000286 Epicanthus not established (foster2020kosakiovergrowthsyndrome pages 1-2, gawlinski2018phenotypeexpansionand pages 1-4, takenouchi2019kosakiovergrowthsyndrome pages 3-4)
Scoliosis Musculoskeletal Reported in multiple patients; no pooled % in accessible texts Often progressive; may occur with vertebral scalloping/widened spinal canal HP:0002650 Scoliosis; HP:0000929 Abnormality of the vertebral column (foster2020kosakiovergrowthsyndrome pages 1-2, minatogawa2017expansionofthe pages 1-2, gawlinski2018phenotypeexpansionand pages 1-4, takenouchi2019kosakiovergrowthsyndrome pages 3-4)
Joint contractures / camptodactyly / joint stiffness Musculoskeletal Reported; frequency not available Progressive flexion contractures and camptodactyly broadened phenotype in later series HP:0001371 Flexion contracture; HP:0004209 Camptodactyly; HP:0001387 Joint stiffness (foster2020kosakiovergrowthsyndrome pages 1-2, gawlinski2018phenotypeexpansionand pages 1-4)
Intellectual disability / cognitive impairment Neurodevelopmental ~20% Variable psychomotor and cognitive outcome; neurological deterioration is not universal HP:0001249 Intellectual disability; HP:0001263 Global developmental delay (foster2020kosakiovergrowthsyndrome pages 1-2, takenouchi2019kosakiovergrowthsyndrome pages 3-4, foster2020kosakiovergrowthsyndrome pages 8-9)
Neurological deterioration / white matter disease progression Neurologic Variable; no pooled % Progressive neurologic decline reported in some individuals, often alongside white matter abnormalities HP:0002344 Progressive neurologic deterioration; HP:0002500 Cerebral white matter abnormality (foster2020kosakiovergrowthsyndrome pages 1-2, minatogawa2017expansionofthe pages 1-2)
Hydrocephalus / ventriculomegaly Neuroimaging structural abnormality Reported; frequency not available Includes obstructive ventriculomegaly/hydrocephalus, sometimes requiring shunting; may co-occur with Dandy-Walker variant HP:0000238 Hydrocephalus; HP:0002119 Ventriculomegaly (foster2020kosakiovergrowthsyndrome pages 2-4, minatogawa2017expansionofthe pages 1-2, foster2020kosakiovergrowthsyndrome pages 8-9)
Dandy-Walker malformation / variant Neuroimaging structural abnormality Reported; frequency not available Part of posterior fossa malformation spectrum in some patients HP:0001305 Dandy-Walker malformation (foster2020kosakiovergrowthsyndrome pages 2-4, minatogawa2017expansionofthe pages 1-2, maurer2025knowingandtreating pages 2-2)
Infantile myofibromatosis / myofibroma Tumor-like mesenchymal manifestation ~33% Infantile-onset myofibromas are part of the PDGFRB-associated spectrum and occur in a subset of KOGS patients HP:0100014 Myofibroma / infantile myofibromatosis-related term if curated locally (takenouchi2019kosakiovergrowthsyndrome pages 3-4, takenouchi2019kosakiovergrowthsyndrome pages 1-3)
Cardiac abnormalities Cardiovascular At least 2/6 patients in 2019 review Reported defects include dilated sinus of Valsalva, mitral valve bowing, mild pulmonic stenosis with post-stenotic dilatation, and coronary artery aneurysm HP:0001644 Dilatation of the aorta; HP:0001634 Mitral valve prolapse/bowing-related term; HP:0001642 Pulmonic stenosis; HP:0031639 Coronary artery aneurysm (takenouchi2019kosakiovergrowthsyndrome pages 3-4, takenouchi2019kosakiovergrowthsyndrome pages 4-5)
Cerebrovascular aneurysms / arterial dolichoectasia / tortuosity Cardiovascular / neurovascular Reported in multiple later cases; exact pooled prevalence not established Basilar artery fusiform aneurysm, vertebrobasilar dolichoectasia, cervical/intracranial artery dysplasia and tortuosity; can cause stroke or fatal rupture HP:0004942 Cerebral aneurysm; HP:0033650 Arterial tortuosity; HP:0100601 Dolichoectasia (takenouchi2021progressivecerebraland pages 2-4, foster2020kosakiovergrowthsyndrome pages 1-2, foster2020kosakiovergrowthsyndrome pages 2-4, foster2020kosakiovergrowthsyndrome pages 8-9)
Stroke / thrombosis secondary to aneurysm Neurovascular complication Rare but severe; count not pooled Ischaemic stroke from basilar artery aneurysm thrombosis and fatal rupture have been reported HP:0001297 Stroke; HP:0004420 Arterial thrombosis (foster2020kosakiovergrowthsyndrome pages 1-2, foster2020kosakiovergrowthsyndrome pages 2-4)
Prematurely aged / progeroid appearance General / connective tissue Progressive; frequency not pooled Often linked to lipodystrophy and skin/connective-tissue changes; more apparent with age HP:0007495 Prematurely aged appearance (foster2020kosakiovergrowthsyndrome pages 1-2, maurer2025knowingandtreating pages 2-2, takenouchi2019kosakiovergrowthsyndrome pages 3-4)
Widely spaced teeth / delayed or abnormal dentition Craniofacial / dental Reported; frequency not available Dental spacing and delayed eruption have been described in phenotype expansions HP:0000687 Widely spaced teeth; HP:0000684 Delayed eruption of teeth (foster2020kosakiovergrowthsyndrome pages 1-2, maurer2025knowingandtreating pages 2-2)
Carpal tunnel syndrome Neuromuscular / peripheral nerve Reported as novel association; frequency unknown Pediatric CTS reported in at least one additional KOGS patient/family context HP:0001382 Carpal tunnel syndrome (foster2020kosakiovergrowthsyndrome pages 1-2)

Table: This table summarizes the reported clinical and imaging features of Kosaki overgrowth syndrome, including approximate frequencies where available from small case series and reviews. It also suggests HPO mappings to support structured disease-knowledge-base annotation.

Key phenotype frequencies / statistics (from small cohorts)

From Takenouchi et al. (2019) synthesis of the early cohort: - Periventricular white matter signal abnormalities: 100% (takenouchi2019kosakiovergrowthsyndrome pages 3-4) - Posterior fossa arachnoid cysts/anomalies: ~83% (takenouchi2019kosakiovergrowthsyndrome pages 3-4) - Lipodystrophy: ~83% (takenouchi2019kosakiovergrowthsyndrome pages 3-4) - Craniosynostosis: ~33% (takenouchi2019kosakiovergrowthsyndrome pages 3-4) - Intellectual disability (IQ < 70): ~20% (takenouchi2019kosakiovergrowthsyndrome pages 3-4) - Infantile myofibromatosis/myofibromas: ~33% (takenouchi2019kosakiovergrowthsyndrome pages 3-4, takenouchi2019kosakiovergrowthsyndrome pages 1-3) - Cardiac abnormalities: at least 2/6 early reported patients (takenouchi2019kosakiovergrowthsyndrome pages 3-4, takenouchi2019kosakiovergrowthsyndrome pages 4-5)

Vascular phenotype and real-world impact

Cerebrovascular complications have become central to current understanding. Foster et al. report “fusiform aneurysm of the basilar artery” with severe outcomes including thrombosis/stroke and fatal rupture, concluding that “cerebrovascular complications are part of the phenotypic spectrum” and that “vascular imaging is indicated” (foster2020kosakiovergrowthsyndrome pages 1-2). Longitudinal follow-up of the original patients demonstrated progressive basilar/vertebral and coronary arterial dilation and aneurysm evolution beginning in adolescence/early adulthood (takenouchi2021progressivecerebraland pages 2-4).

Quality-of-life impact

In the broader PDGFRB activating-variant spectrum, imatinib therapy in one severe pediatric case was reported to improve multiple manifestations and “most importantly significant improvement in quality of life” (wenger2020activatingvariantsin pages 12-14). Although not exclusively KOGS, this informs real-world functional outcomes for PDGFRB-driven progressive connective-tissue disease.


4. Genetic / Molecular Information

Causal gene

  • PDGFRB (receptor tyrosine kinase) is the established causal gene (minatogawa2017expansionofthe pages 1-2, takenouchi2019kosakiovergrowthsyndrome pages 1-3).

Pathogenic variant spectrum

Recurrent KOGS-associated variants described in multiple unrelated patients include: - PDGFRB c.1751C>G p.(Pro584Arg) (minatogawa2017expansionofthe pages 1-2, gawlinski2018phenotypeexpansionand pages 1-4, takenouchi2019kosakiovergrowthsyndrome pages 1-3) - PDGFRB c.1696T>C p.(Trp566Arg) (minatogawa2017expansionofthe pages 1-2, gawlinski2018phenotypeexpansionand pages 1-4, takenouchi2019kosakiovergrowthsyndrome pages 1-3)

A later case series added a novel de novo variant: - PDGFRB c.1477A>T p.(Ser493Cys) (foster2020kosakiovergrowthsyndrome pages 1-2, foster2020kosakiovergrowthsyndrome pages 2-4)

These are described as activating / gain-of-function and are interpreted as pathogenic/likely pathogenic in clinical genetics practice (minatogawa2017expansionofthe pages 1-2, foster2020kosakiovergrowthsyndrome pages 2-4).

Inheritance pattern and mosaicism

KOGS is most often autosomal dominant due to de novo heterozygous variants in PDGFRB (minatogawa2017expansionofthe pages 1-2, gawlinski2018phenotypeexpansionand pages 1-4, foster2020kosakiovergrowthsyndrome pages 2-4). However, the broader PDGFRB activating-variant spectrum includes variable expressivity, adult-onset manifestations, and mosaic presentations (wenger2020activatingvariantsin pages 2-4, chenbhanich2021segmentalovergrowthand pages 1-2).

A key diagnostic lesson from mosaic PDGFRB vascular/overgrowth disease: blood exome may be negative; affected-tissue testing can reveal mosaic variants absent from blood (chenbhanich2021segmentalovergrowthand pages 1-2, chenbhanich2021segmentalovergrowthand pages 2-4).

Modifier genes / epigenetics

No validated human modifier genes for KOGS were identified in the accessible corpus, but mechanistic work indicates STAT1 acts as a major genetic modifier of phenotypic direction (wasting vs overgrowth) in a PDGFRβ-activating mouse model (he2017stat1modulatestissue pages 8-9).


5. Environmental Information

No non-genetic environmental, lifestyle, or infectious contributors have been established for KOGS in the accessible literature.


6. Mechanism / Pathophysiology

Current mechanistic understanding (causal chain)

  1. Trigger: germline activating PDGFRB variant → ligand-independent PDGFRβ activation (maurer2025knowingandtreating pages 2-2, he2017stat1modulatestissue pages 2-3).
  2. Cellular signaling consequences: downstream signaling varies by allele strength and context, including:
  3. STAT1 phosphorylation / interferon-like transcriptional programs described as a general feature of PDGFRβ-activating mutations (he2017stat1modulatestissue pages 2-3, guerit2021pdgfreceptormutations pages 6-8).
  4. PI3K–AKT pathway activation reported in at least one individual with KOGS and discussed as a mechanism for overgrowth/cardiovascular abnormalities (wenger2020activatingvariantsin pages 16-16, foster2020kosakiovergrowthsyndrome pages 10-11).
  5. Tissue-level outcomes: dysregulated mesenchymal/perivascular signaling alters connective tissue and vascular integrity, plausibly driving:
  6. Skeletal overgrowth (abnormal growth and bone remodeling)
  7. Skin hyperextensibility/fragility (extracellular matrix remodeling)
  8. Lipodystrophy/progeroid features (adipose progenitor differentiation shifts toward pro-fibrotic states)
  9. Pericyte/vascular smooth muscle dysfunction → arterial ectasia/tortuosity → aneurysm risk (PDGFRB expression in pericytes and vascular smooth muscle is highlighted in the aneurysm/overgrowth mosaic report) (chenbhanich2021segmentalovergrowthand pages 2-4, guerit2021pdgfreceptormutations pages 8-9).

Proposed ontology terms

  • GO (biological process): receptor tyrosine kinase signaling; PI3K signaling; JAK-STAT signaling; extracellular matrix organization; regulation of vascular smooth muscle cell proliferation; pericyte development.
  • CL (cell types): pericyte; vascular smooth muscle cell; fibroblast; mesenchymal progenitor cell (chenbhanich2021segmentalovergrowthand pages 2-4, guerit2021pdgfreceptormutations pages 8-9).
  • UBERON (anatomy): cerebral arteries (basilar/vertebral); coronary arteries; white matter of cerebral hemispheres; posterior fossa.

Recent developments (2023–2024 priority)

A 2024 overgrowth diagnostics review emphasizes that clinicians “should consider molecular genetic testing as a first diagnostic step in overgrowth syndromes” and highlights AI-assisted phenotype-driven approaches and deep sequencing for mosaicism detection (prawitt2024molecularmechanismsof pages 1-2, prawitt2024molecularmechanismsof pages 9-10). While not KOGS-specific, these methods are directly applicable to PDGFRB-related overgrowth, especially where mosaicism is suspected.


7. Anatomical Structures Affected

Organ / system level

  • Musculoskeletal: long bone overgrowth, scoliosis, contractures; craniosynostosis (takenouchi2019kosakiovergrowthsyndrome pages 3-4, gawlinski2018phenotypeexpansionand pages 1-4).
  • Skin/adipose/connective tissue: hyperelastic fragile skin; progressive lipodystrophy (takenouchi2019kosakiovergrowthsyndrome pages 4-5, takenouchi2019kosakiovergrowthsyndrome pages 3-4).
  • Central nervous system: periventricular white matter lesions; posterior fossa arachnoid cysts/protrusion; hydrocephalus/Dandy-Walker variant in some cases (takenouchi2019kosakiovergrowthsyndrome pages 3-4, minatogawa2017expansionofthe pages 1-2, foster2020kosakiovergrowthsyndrome pages 2-4).
  • Cardiovascular: coronary aneurysms and other cardiac abnormalities; progressive cerebrovascular aneurysms/dolichoectasia (takenouchi2019kosakiovergrowthsyndrome pages 4-5, takenouchi2021progressivecerebraland pages 2-4, foster2020kosakiovergrowthsyndrome pages 1-2).

Tissue/cell level (inferred from mechanistic/vascular reports)

  • Perivascular cells: pericytes and vascular smooth muscle cells (chenbhanich2021segmentalovergrowthand pages 2-4).
  • Connective tissue fibroblasts/mesenchymal cells: implicated by PDGFRβ biology and mouse models (he2017stat1modulatestissue pages 8-9).

8. Temporal Development

Onset

KOGS is described primarily as postnatal skeletal overgrowth (foster2020kosakiovergrowthsyndrome pages 1-2, takenouchi2019kosakiovergrowthsyndrome pages 3-4).

Progression

Multiple features are described as progressive, including progeroid appearance and vascular complications (foster2020kosakiovergrowthsyndrome pages 10-11). Serial imaging in original patients demonstrated progressive cerebrovascular and coronary artery dilation beginning in teenage years/early 20s (takenouchi2021progressivecerebraland pages 2-4).


9. Inheritance and Population

Epidemiology

No robust prevalence/incidence estimates were identified in the accessible corpus. Available evidence supports that KOGS is ultra-rare.

Case counts / rarity statistics (available)

  • Foster et al. state KOGS was first described in 2015 and that “to date, six patients have been reported” prior to their three additional cases (foster2020kosakiovergrowthsyndrome pages 1-2).
  • A collaborative consortium document summarizes that published case reports comprise “around 10” to “about 15” patients worldwide (maurer2025knowingandtreating pages 2-2).

Inheritance nuances

  • Predominantly de novo autosomal dominant (minatogawa2017expansionofthe pages 1-2, gawlinski2018phenotypeexpansionand pages 1-4).
  • Mosaicism can produce related segmental overgrowth/aneurysm phenotypes and can require tissue testing (chenbhanich2021segmentalovergrowthand pages 1-2, chenbhanich2021segmentalovergrowthand pages 2-4).

Penetrance cannot be reliably estimated due to the very small number of described individuals.


10. Diagnostics

Clinical recognition

A key diagnostic gestalt is the constellation of skeletal overgrowth + characteristic skin/connective-tissue features + CNS white matter lesions/posterior fossa findings; Takenouchi et al. state that this phenotype “should prompt genetic analysis of the PDGFRB” (takenouchi2019kosakiovergrowthsyndrome pages 1-3).

Genetic testing approaches used in reported cases

  • Exome sequencing, targeted overgrowth panel, and whole-genome sequencing have all been used to identify PDGFRB variants in KOGS (foster2020kosakiovergrowthsyndrome pages 2-4).
  • Sanger confirmation and parental testing used to establish de novo status (foster2020kosakiovergrowthsyndrome pages 2-4).
  • For suspected mosaic vascular/segmental disease: authors advise “Germline and/or somatic testing for PDGFRB gene should be obtained” and document cases where blood exome was not diagnostic but tissue testing was (chenbhanich2021segmentalovergrowthand pages 1-2, chenbhanich2021segmentalovergrowthand pages 2-4).

Imaging and monitoring at/after diagnosis

  • Foster et al. recommend baseline vascular screening: “baseline vascular screening with echocardiogram, cerebral MRI and angioMRI… at diagnosis and again in adult life” (foster2020kosakiovergrowthsyndrome pages 10-11).
  • Wenger et al. recommend MRA at diagnosis and intermittently and broader vascular screening (brain/neck/chest/abdomen/pelvis) in the PDGFRB activating-variant spectrum, motivated by aneurysm risk (wenger2020activatingvariantsin pages 14-15).

Differential diagnosis

  • Shprintzen–Goldberg syndrome and atypical Ehlers–Danlos syndrome were considered clinically in one KOGS case before genetic diagnosis (foster2020kosakiovergrowthsyndrome pages 2-4).
  • Other overgrowth differentials in broader workups include Sotos, Weaver, and Beckwith–Wiedemann spectrum (kamien2018aclinicalreview pages 8-11).
  • Other PDGFRB-related differentials: Penttinen syndrome, infantile myofibromatosis, and idiopathic basal ganglia calcification (takenouchi2019kosakiovergrowthsyndrome pages 1-3, minatogawa2017expansionofthe pages 1-2).

11. Outcome / Prognosis

Long-term outcome is incompletely defined due to rarity, but major morbidity and mortality contributors are increasingly recognized as progressive vascular aneurysms.

  • Foster et al. document thrombotic stroke and fatal rupture, emphasizing serious cerebrovascular risk (foster2020kosakiovergrowthsyndrome pages 1-2).
  • In the original patients, progressive basilar/vertebral and coronary dilation could lead to fatal complications even with interventions (takenouchi2021progressivecerebraland pages 2-4).

12. Treatment

Targeted therapies (precision medicine)

Evidence supports PDGFRB activating disorders as kinase-dependent and potentially responsive to TKIs: - Foster et al.: activating PDGFRB variants “are responsive to imatinib… suggesting that individuals with KOGS might also be candidates for treatment with tyrosine kinase inhibitors” (foster2020kosakiovergrowthsyndrome pages 10-11). - Wenger et al. report “robust and rapid” clinical responses to imatinib in several PDGFRB-activating cases; one severe case improved contractures and “significant improvement in quality of life” (wenger2020activatingvariantsin pages 12-14, wenger2020activatingvariantsin pages 2-4, wenger2020activatingvariantsin pages 14-15). - Mosaic PDGFRB p.Tyr562Cys aneurysm/overgrowth disease included sorafenib exposure, but aneurysm progression and rupture still occurred (chenbhanich2021segmentalovergrowthand pages 2-4).

Supportive/monitoring management

  • Vascular surveillance imaging (echocardiogram + MRI/MRA; potentially whole-body arterial imaging) is repeatedly recommended given progressive aneurysm risk (foster2020kosakiovergrowthsyndrome pages 10-11, wenger2020activatingvariantsin pages 14-15, chenbhanich2021segmentalovergrowthand pages 1-2).
  • Optimal blood pressure control is recommended to reduce vascular wall tension and potentially slow dilation (takenouchi2021progressivecerebraland pages 2-4, takenouchi2021progressivecerebraland pages 4-5).

MAXO suggestions

Representative MAXO mappings are summarized in the management artifact.

Domain Recommendation / intervention Details / evidence Suggested MAXO term(s) Citations
Genetic diagnostics PDGFRB-focused testing when phenotype is suggestive Characteristic combination of skeletal overgrowth, distinctive facial features, hyperelastic/fragile skin, and cerebral white matter lesions should prompt PDGFRB analysis; KOGS is caused by activating PDGFRB variants. MAXO: genetic testing; MAXO: sequence analysis (takenouchi2019kosakiovergrowthsyndrome pages 1-3, foster2020kosakiovergrowthsyndrome pages 1-2)
Genetic diagnostics Whole-exome sequencing (WES) WES was used diagnostically in reported KOGS cases and is recommended in overgrowth workups where phenotype overlaps multiple syndromes; useful for detecting heterozygous de novo PDGFRB variants. MAXO: exome sequencing (foster2020kosakiovergrowthsyndrome pages 2-4, kamien2018aclinicalreview pages 8-11, prawitt2024molecularmechanismsof pages 1-2)
Genetic diagnostics Whole-genome sequencing (WGS) WGS identified PDGFRB variants in KOGS cohorts; broader overgrowth reviews recommend molecular genetic testing early and support WGS when it improves diagnostic yield. MAXO: genome sequencing (foster2020kosakiovergrowthsyndrome pages 2-4, prawitt2024molecularmechanismsof pages 9-10, prawitt2024molecularmechanismsof pages 1-2)
Genetic diagnostics Targeted multigene overgrowth panel Custom NGS panels including overgrowth genes were successfully used in KOGS; panel/exome approaches are favored because differential diagnosis includes Sotos, Weaver, Beckwith-Wiedemann spectrum, Shprintzen-Goldberg, atypical EDS, Penttinen syndrome, and infantile myofibromatosis. MAXO: multigene panel testing (foster2020kosakiovergrowthsyndrome pages 2-4, kamien2018aclinicalreview pages 8-11, foster2020kosakiovergrowthsyndrome pages 10-11)
Genetic diagnostics Sanger confirmation and parental testing Reported variants were confirmed by bidirectional Sanger sequencing, with parental testing demonstrating de novo occurrence in multiple patients. MAXO: confirmatory genetic testing (foster2020kosakiovergrowthsyndrome pages 2-4, foster2020kosakiovergrowthsyndrome pages 1-2)
Mosaicism workup Somatic testing of affected tissue when blood testing is negative In mosaic PDGFRB disease, blood exome sequencing may be non-diagnostic; affected skin/biopsy tissue testing detected pathogenic variants absent from blood. This is relevant for segmental overgrowth/vascular phenotypes within the PDGFRB activating spectrum. MAXO: biopsy-based molecular testing (chenbhanich2021segmentalovergrowthand pages 1-2, chenbhanich2021segmentalovergrowthand pages 2-4)
Imaging at diagnosis Brain MRI Used to detect white matter lesions, ventriculomegaly/hydrocephalus, posterior fossa arachnoid cysts, Dandy-Walker malformation, and other structural brain abnormalities in KOGS. MAXO: magnetic resonance imaging (foster2020kosakiovergrowthsyndrome pages 2-4, takenouchi2019kosakiovergrowthsyndrome pages 3-4)
Imaging at diagnosis Cerebral MR angiography / angioMRI Recommended because cerebrovascular complications, including basilar artery fusiform aneurysms and dolichoectasia, are part of the KOGS spectrum. Suggested at diagnosis and again in adult life. MAXO: magnetic resonance angiography (foster2020kosakiovergrowthsyndrome pages 10-11)
Imaging surveillance Serial neurovascular imaging Repeat imaging is advised because aneurysms can be progressive and life-threatening; in mosaic/vascular PDGFRB disease, repeating imaging within 6–12 months after detection was considered reasonable. MAXO: longitudinal imaging surveillance (takenouchi2021progressivecerebraland pages 2-4, chenbhanich2021segmentalovergrowthand pages 1-2, wenger2020activatingvariantsin pages 14-15)
Cardiovascular evaluation Echocardiography Recommended for baseline vascular/cardiac screening; coronary aneurysms and other cardiac abnormalities have been reported in KOGS and broader PDGFRB activating variant spectrum. MAXO: echocardiography (foster2020kosakiovergrowthsyndrome pages 10-11, takenouchi2019kosakiovergrowthsyndrome pages 3-4, takenouchi2019kosakiovergrowthsyndrome pages 4-5)
Systemic vascular screening Whole-body arterial tree imaging Recommended after diagnosis in PDGFRB activating variant-related phenotypes to assess cervico-encephalic, coronary, and other arterial aneurysms/ectasia; MRA/CTA of brain, neck, chest, abdomen, and pelvis has been proposed. MAXO: vascular imaging; MAXO: whole-body imaging (chenbhanich2021segmentalovergrowthand pages 1-2, chenbhanich2021segmentalovergrowthand pages 2-4, wenger2020activatingvariantsin pages 14-15)
Risk reduction Optimal blood pressure control Suggested to reduce vascular wall tension and potentially slow progression of arterial dilation/aneurysms; specifically recommended once vascular risk in KOGS became apparent. MAXO: blood pressure management; MAXO: antihypertensive therapy (takenouchi2021progressivecerebraland pages 2-4, takenouchi2021progressivecerebraland pages 4-5)
Targeted therapy Imatinib Strongest therapeutic evidence in PDGFRB activating variant spectrum: rapid/robust responses reported in three children, including improvement in myofibromas and one severe progressive phenotype with improved joint contractures, coarse facial features, midfoot circumference, and quality of life. KOGS-specific literature suggests patients may be candidates for TKIs. MAXO: tyrosine kinase inhibitor therapy; MAXO: imatinib administration (wenger2020activatingvariantsin pages 12-14, wenger2020activatingvariantsin pages 2-4, wenger2020activatingvariantsin pages 14-15, foster2020kosakiovergrowthsyndrome pages 10-11)
Targeted therapy Sunitinib / related TKIs In vitro PDGFRB mutants were reported as sensitive to tyrosine kinase inhibitors including sunitinib; clinical-spectrum reviews cite experience with imatinib and sunitinib as supporting kinase-dependent disease, but direct KOGS-specific outcome data are limited. MAXO: tyrosine kinase inhibitor therapy; MAXO: sunitinib administration (wenger2020activatingvariantsin pages 12-14, wenger2020activatingvariantsin pages 14-15, wenger2020activatingvariantsin pages 16-16)
Targeted therapy Sorafenib Used in a patient with mosaic PDGFRB p.Tyr562Cys-associated overgrowth/aneurysms, but no clear clinical benefit was established and aneurysm progression/rupture still occurred; consortium reports also mention sorafenib exposure in PDGFRB-related disease. MAXO: tyrosine kinase inhibitor therapy; MAXO: sorafenib administration (chenbhanich2021segmentalovergrowthand pages 2-4, maurer2025knowingandtreating pages 2-2)
Treatment selection Consider in vitro drug-sensitivity studies on patient fibroblasts Emerging consortium recommendation: fibroblast testing may help determine which TKI most effectively blocks PDGFRB signaling for a given patient, especially because response appears variable. MAXO: functional assay-guided treatment selection (maurer2025knowingandtreating pages 2-2, maurer2025knowingandtreating pages 4-5)
Supportive monitoring Assess treatment efficacy, safety, QoL, and symptom burden longitudinally Observational study NCT05953857 is designed to track symptom burden, quality of life, TKI efficacy, and safety over long-term follow-up in KOGS/Penttinen syndrome due to activating PDGFRB variants. MAXO: longitudinal clinical monitoring; MAXO: adverse event monitoring; MAXO: quality of life assessment (NCT05953857 chunk 1, maurer2025knowingandtreating pages 5-6)
Clinical research Enroll in observational registry / natural history study IKKoPeS (NCT05953857) is a multicenter observational study for treated and untreated KOGS/Penttinen patients with activating PDGFRB variants; estimated enrollment 30, first posted 2023-07-20. MAXO: clinical trial enrollment; MAXO: registry enrollment (NCT05953857 chunk 1)

Table: This table summarizes currently reported diagnostic strategies, vascular surveillance approaches, and targeted management options for Kosaki overgrowth syndrome and the broader PDGFRB activating variant spectrum. It highlights where evidence is strongest, especially for imaging surveillance and tyrosine kinase inhibitor use.

Clinical trials / real-world implementations

ClinicalTrials.gov NCT05953857 (“Knowing and Treating Kosaki/Penttinen Syndromes”, IKKoPeS) is a prospective observational study designed to follow treated and untreated patients with activating PDGFRB variants and to assess whether TKIs “could bring clinical benefit” (first posted 2023-07-20, estimated start 2023-10, estimated enrollment 30; estimated completion 2048-10) (NCT05953857 chunk 1). Primary/secondary outcomes include symptom burden and the proportion with QoL improvement or side effects under TKI (NCT05953857 chunk 1).

URL: https://clinicaltrials.gov/study/NCT05953857 (registry details summarized from record) (NCT05953857 chunk 1).


13. Prevention

Primary prevention is not applicable for a de novo genetic disorder. However, secondary/tertiary prevention is clinically relevant: - Genetic counseling for recurrence risk (typically low for de novo, but consider parental mosaicism in principle). - Surveillance to prevent complications: early vascular screening and repeat imaging to detect aneurysms before rupture/thrombosis (foster2020kosakiovergrowthsyndrome pages 10-11, takenouchi2021progressivecerebraland pages 2-4).


14. Other Species / Natural Disease

No naturally occurring veterinary analogs of KOGS were identified in the accessible corpus.


15. Model Organisms

A key mechanistic model is the Pdgfrb gain-of-function mouse (e.g., Pdgfrb D849V). STAT1 acts as a modifier that can shift phenotype between autoinflammatory wasting and progressive overgrowth, mapping conceptually onto the Penttinen vs Kosaki phenotypic axis and supporting PDGFRB hyperactivity as a driver mechanism (he2017stat1modulatestissue pages 8-9, he2017stat1modulatestissue pages 2-3).


2023–2024 “Latest research” highlights (highest relevance within accessible corpus)

  • Overgrowth diagnostics modernization (2024): increased emphasis on early genomic testing (WES/WGS and deep sequencing for mosaicism) and the integration of AI-supported phenotype-to-genotype workflows in overgrowth disorders (prawitt2024molecularmechanismsof pages 1-2, prawitt2024molecularmechanismsof pages 9-10).
  • Real-world longitudinal research infrastructure (2023): formal long-term observational study registration for KOGS/Penttinen syndromes focused on TKI benefit/risk and symptom burden (NCT05953857; first posted 2023-07-20) (NCT05953857 chunk 1).

Key evidence quotes (for knowledge-base evidence items)

  • Vascular surveillance recommendation: “we suggest that clinicians consider baseline vascular screening with echocardiogram, cerebral MRI and angioMRI for individuals with KOGS at diagnosis and again in adult life” (foster2020kosakiovergrowthsyndrome pages 10-11).
  • KOGS vascular phenotype conclusion: “cerebrovascular complications are part of the phenotypic spectrum” and “vascular imaging is indicated” (foster2020kosakiovergrowthsyndrome pages 1-2).
  • Genotype–phenotype contrast: “hypermorphic mutations in PDGFRB lead to Kosaki overgrowth syndrome… whereas hypomorphic mutations lead to idiopathic basal ganglia calcification” (minatogawa2017expansionofthe pages 1-2).
  • Spectrum/QoL under targeted therapy: imatinib improved disease manifestations and “most importantly significant improvement in quality of life” in a severe PDGFRB-activating case (wenger2020activatingvariantsin pages 12-14).

Notes on gaps / limitations of this report

  • Several identifiers (Orphanet, MeSH, ICD-10/ICD-11) and population prevalence/incidence estimates were not retrievable from the currently accessible full-text corpus and are therefore not asserted here.
  • Published evidence is largely case-based; frequencies and prognostic estimates are based on small numbers and may change as registries (e.g., NCT05953857) mature.

References

  1. (OpenTargets Search: Kosaki overgrowth syndrome): Open Targets Query (Kosaki overgrowth syndrome, 1 results). Buniello, A. et al. (2025). Open Targets Platform: facilitating therapeutic hypotheses building in drug discovery. Nucleic Acids Research.

  2. (foster2020kosakiovergrowthsyndrome pages 1-2): Alison Foster, Basile Chalot, Thalia Antoniadi, Elise Schaefer, Rebecca Keelagher, Gavin Ryan, Quentin Thomas, Christophe Philippe, Ange‐Line Bruel, Arthur Sorlin, Christel Thauvin‐Robinet, Marc Bardou, Maxime Luu, Veronique Quenardelle, Valerie Wolff, Jessica Woodley, Pierre Vabres, Derek Lim, Rebecca Igbokwe, Annie Joseph, Harriet Walker, Andrea Jester, Jonathan Ellenbogen, Diana Johnson, Bethanie Rooke, Celia Moss, Trevor Cole, and Laurence Faivre. Kosaki overgrowth syndrome: a novel pathogenic variant in pdgfrb and expansion of the phenotype including cerebrovascular complications. Clinical Genetics, 98:19-31, May 2020. URL: https://doi.org/10.1111/cge.13752, doi:10.1111/cge.13752. This article has 31 citations and is from a peer-reviewed journal.

  3. (minatogawa2017expansionofthe pages 1-2): Mari Minatogawa, Toshiki Takenouchi, Yu Tsuyusaki, Fuminori Iwasaki, Tomoko Uehara, Kenji Kurosawa, Kenjiro Kosaki, and Cynthia J. Curry. Expansion of the phenotype of kosaki overgrowth syndrome. American Journal of Medical Genetics Part A, 173:2422-2427, Jun 2017. URL: https://doi.org/10.1002/ajmg.a.38310, doi:10.1002/ajmg.a.38310. This article has 45 citations.

  4. (gawlinski2018phenotypeexpansionand pages 1-4): Paweł Gawliński, M. Pelc, E. Ciara, S. Jhangiani, Elżbieta Jurkiewicz, Tomasz Gambin, Tomasz Gambin, Agnieszka Różdżyńska-Świątkowska, M. Dawidziuk, Z. Coban-Akdemir, D. L. Guilbride, D. Muzny, J. R. Lupski, J. R. Lupski, and M. Krajewska-Walasek. Phenotype expansion and development in kosaki overgrowth syndrome. Clinical Genetics, 93:919-924, Apr 2018. URL: https://doi.org/10.1111/cge.13192, doi:10.1111/cge.13192. This article has 31 citations and is from a peer-reviewed journal.

  5. (takenouchi2019kosakiovergrowthsyndrome pages 1-3): Toshiki Takenouchi, Hironobu Okuno, and Kenjiro Kosaki. Kosaki overgrowth syndrome: a newly identified entity caused by pathogenic variants in platelet‐derived growth factor receptor‐beta. American Journal of Medical Genetics Part C: Seminars in Medical Genetics, 181:650-657, Nov 2019. URL: https://doi.org/10.1002/ajmg.c.31755, doi:10.1002/ajmg.c.31755. This article has 19 citations.

  6. (takenouchi2021progressivecerebraland pages 4-5): Toshiki Takenouchi, Kazuki Kodo, Fumito Yamazaki, Hirofumi Nakatomi, and Kenjiro Kosaki. Progressive cerebral and coronary aneurysms in the original two patients with kosaki overgrowth syndrome. American Journal of Medical Genetics Part A, 185:1003-999, Dec 2021. URL: https://doi.org/10.1002/ajmg.a.62027, doi:10.1002/ajmg.a.62027. This article has 6 citations.

  7. (wenger2020activatingvariantsin pages 2-4): Tara L. Wenger, Randall A. Bly, Natalie Wu, Catherine M. Albert, Julie Park, Joseph Shieh, Jirat Chenbhanich, Carrie L. Heike, Margaret P. Adam, Irene Chang, Angela Sun, Danny E. Miller, Anita E. Beck, Deepti Gupta, Markus D. Boos, Elaine H. Zackai, David Everman, Shireen Ganapathi, Meredith Wilson, John Christodoulou, Yuri A. Zarate, Cynthia Curry, Dong Li, Anne Guimier, Jeanne Amiel, Hakon Hakonarson, Richard Webster, Elizabeth J. Bhoj, Jonathan A. Perkins, John P. Dahl, and William B. Dobyns. Activating variants in pdgfrb result in a spectrum of disorders responsive to imatinib monotherapy. American Journal of Medical Genetics Part A, 182:1576-1591, Jun 2020. URL: https://doi.org/10.1002/ajmg.a.61615, doi:10.1002/ajmg.a.61615. This article has 37 citations.

  8. (wenger2020activatingvariantsin pages 14-15): Tara L. Wenger, Randall A. Bly, Natalie Wu, Catherine M. Albert, Julie Park, Joseph Shieh, Jirat Chenbhanich, Carrie L. Heike, Margaret P. Adam, Irene Chang, Angela Sun, Danny E. Miller, Anita E. Beck, Deepti Gupta, Markus D. Boos, Elaine H. Zackai, David Everman, Shireen Ganapathi, Meredith Wilson, John Christodoulou, Yuri A. Zarate, Cynthia Curry, Dong Li, Anne Guimier, Jeanne Amiel, Hakon Hakonarson, Richard Webster, Elizabeth J. Bhoj, Jonathan A. Perkins, John P. Dahl, and William B. Dobyns. Activating variants in pdgfrb result in a spectrum of disorders responsive to imatinib monotherapy. American Journal of Medical Genetics Part A, 182:1576-1591, Jun 2020. URL: https://doi.org/10.1002/ajmg.a.61615, doi:10.1002/ajmg.a.61615. This article has 37 citations.

  9. (takenouchi2021progressivecerebraland pages 2-4): Toshiki Takenouchi, Kazuki Kodo, Fumito Yamazaki, Hirofumi Nakatomi, and Kenjiro Kosaki. Progressive cerebral and coronary aneurysms in the original two patients with kosaki overgrowth syndrome. American Journal of Medical Genetics Part A, 185:1003-999, Dec 2021. URL: https://doi.org/10.1002/ajmg.a.62027, doi:10.1002/ajmg.a.62027. This article has 6 citations.

  10. (takenouchi2019kosakiovergrowthsyndrome pages 3-4): Toshiki Takenouchi, Hironobu Okuno, and Kenjiro Kosaki. Kosaki overgrowth syndrome: a newly identified entity caused by pathogenic variants in platelet‐derived growth factor receptor‐beta. American Journal of Medical Genetics Part C: Seminars in Medical Genetics, 181:650-657, Nov 2019. URL: https://doi.org/10.1002/ajmg.c.31755, doi:10.1002/ajmg.c.31755. This article has 19 citations.

  11. (foster2020kosakiovergrowthsyndrome pages 10-11): Alison Foster, Basile Chalot, Thalia Antoniadi, Elise Schaefer, Rebecca Keelagher, Gavin Ryan, Quentin Thomas, Christophe Philippe, Ange‐Line Bruel, Arthur Sorlin, Christel Thauvin‐Robinet, Marc Bardou, Maxime Luu, Veronique Quenardelle, Valerie Wolff, Jessica Woodley, Pierre Vabres, Derek Lim, Rebecca Igbokwe, Annie Joseph, Harriet Walker, Andrea Jester, Jonathan Ellenbogen, Diana Johnson, Bethanie Rooke, Celia Moss, Trevor Cole, and Laurence Faivre. Kosaki overgrowth syndrome: a novel pathogenic variant in pdgfrb and expansion of the phenotype including cerebrovascular complications. Clinical Genetics, 98:19-31, May 2020. URL: https://doi.org/10.1111/cge.13752, doi:10.1111/cge.13752. This article has 31 citations and is from a peer-reviewed journal.

  12. (takenouchi2019kosakiovergrowthsyndrome pages 4-5): Toshiki Takenouchi, Hironobu Okuno, and Kenjiro Kosaki. Kosaki overgrowth syndrome: a newly identified entity caused by pathogenic variants in platelet‐derived growth factor receptor‐beta. American Journal of Medical Genetics Part C: Seminars in Medical Genetics, 181:650-657, Nov 2019. URL: https://doi.org/10.1002/ajmg.c.31755, doi:10.1002/ajmg.c.31755. This article has 19 citations.

  13. (foster2020kosakiovergrowthsyndrome pages 8-9): Alison Foster, Basile Chalot, Thalia Antoniadi, Elise Schaefer, Rebecca Keelagher, Gavin Ryan, Quentin Thomas, Christophe Philippe, Ange‐Line Bruel, Arthur Sorlin, Christel Thauvin‐Robinet, Marc Bardou, Maxime Luu, Veronique Quenardelle, Valerie Wolff, Jessica Woodley, Pierre Vabres, Derek Lim, Rebecca Igbokwe, Annie Joseph, Harriet Walker, Andrea Jester, Jonathan Ellenbogen, Diana Johnson, Bethanie Rooke, Celia Moss, Trevor Cole, and Laurence Faivre. Kosaki overgrowth syndrome: a novel pathogenic variant in pdgfrb and expansion of the phenotype including cerebrovascular complications. Clinical Genetics, 98:19-31, May 2020. URL: https://doi.org/10.1111/cge.13752, doi:10.1111/cge.13752. This article has 31 citations and is from a peer-reviewed journal.

  14. (foster2020kosakiovergrowthsyndrome pages 2-4): Alison Foster, Basile Chalot, Thalia Antoniadi, Elise Schaefer, Rebecca Keelagher, Gavin Ryan, Quentin Thomas, Christophe Philippe, Ange‐Line Bruel, Arthur Sorlin, Christel Thauvin‐Robinet, Marc Bardou, Maxime Luu, Veronique Quenardelle, Valerie Wolff, Jessica Woodley, Pierre Vabres, Derek Lim, Rebecca Igbokwe, Annie Joseph, Harriet Walker, Andrea Jester, Jonathan Ellenbogen, Diana Johnson, Bethanie Rooke, Celia Moss, Trevor Cole, and Laurence Faivre. Kosaki overgrowth syndrome: a novel pathogenic variant in pdgfrb and expansion of the phenotype including cerebrovascular complications. Clinical Genetics, 98:19-31, May 2020. URL: https://doi.org/10.1111/cge.13752, doi:10.1111/cge.13752. This article has 31 citations and is from a peer-reviewed journal.

  15. (maurer2025knowingandtreating pages 2-2): A Maurer, L Mirakovska, A Foster, and K Kosaki. 'knowing and treating kosaki/penttinen syndrome'international collaborative consortium: recommendations for follow-up, natural history and a real-life observational …. Unknown journal, 2025.

  16. (wenger2020activatingvariantsin pages 12-14): Tara L. Wenger, Randall A. Bly, Natalie Wu, Catherine M. Albert, Julie Park, Joseph Shieh, Jirat Chenbhanich, Carrie L. Heike, Margaret P. Adam, Irene Chang, Angela Sun, Danny E. Miller, Anita E. Beck, Deepti Gupta, Markus D. Boos, Elaine H. Zackai, David Everman, Shireen Ganapathi, Meredith Wilson, John Christodoulou, Yuri A. Zarate, Cynthia Curry, Dong Li, Anne Guimier, Jeanne Amiel, Hakon Hakonarson, Richard Webster, Elizabeth J. Bhoj, Jonathan A. Perkins, John P. Dahl, and William B. Dobyns. Activating variants in pdgfrb result in a spectrum of disorders responsive to imatinib monotherapy. American Journal of Medical Genetics Part A, 182:1576-1591, Jun 2020. URL: https://doi.org/10.1002/ajmg.a.61615, doi:10.1002/ajmg.a.61615. This article has 37 citations.

  17. (chenbhanich2021segmentalovergrowthand pages 1-2): Jirat Chenbhanich, Yan Hu, Steven Hetts, Daniel Cooke, Christopher Dowd, Patrick Devine, Bianca Russell, Sung Hae L. Kang, Vivian Y. Chang, Adib A. Abla, Patricia Cornett, Iwei Yeh, Hane Lee, Julian A. Martinez‐Agosto, Ilona J. Frieden, and Joseph T. Shieh. Segmental overgrowth and aneurysms due to mosaic pdgfrb p.(tyr562cys). American Journal of Medical Genetics Part A, 185:1430-1436, Mar 2021. URL: https://doi.org/10.1002/ajmg.a.62126, doi:10.1002/ajmg.a.62126. This article has 16 citations.

  18. (chenbhanich2021segmentalovergrowthand pages 2-4): Jirat Chenbhanich, Yan Hu, Steven Hetts, Daniel Cooke, Christopher Dowd, Patrick Devine, Bianca Russell, Sung Hae L. Kang, Vivian Y. Chang, Adib A. Abla, Patricia Cornett, Iwei Yeh, Hane Lee, Julian A. Martinez‐Agosto, Ilona J. Frieden, and Joseph T. Shieh. Segmental overgrowth and aneurysms due to mosaic pdgfrb p.(tyr562cys). American Journal of Medical Genetics Part A, 185:1430-1436, Mar 2021. URL: https://doi.org/10.1002/ajmg.a.62126, doi:10.1002/ajmg.a.62126. This article has 16 citations.

  19. (he2017stat1modulatestissue pages 8-9): Chaoyong He, Shayna C. Medley, Jang Kim, Chengyi Sun, Hae Ryong Kwon, Hiromi Sakashita, Yair Pincu, Longbiao Yao, Danielle Eppard, Bojie Dai, William L. Berry, Timothy M. Griffin, and Lorin E. Olson. Stat1 modulates tissue wasting or overgrowth downstream from pdgfrβ. Genes & Development, 31:1666-1678, Aug 2017. URL: https://doi.org/10.1101/gad.300384.117, doi:10.1101/gad.300384.117. This article has 47 citations and is from a highest quality peer-reviewed journal.

  20. (he2017stat1modulatestissue pages 2-3): Chaoyong He, Shayna C. Medley, Jang Kim, Chengyi Sun, Hae Ryong Kwon, Hiromi Sakashita, Yair Pincu, Longbiao Yao, Danielle Eppard, Bojie Dai, William L. Berry, Timothy M. Griffin, and Lorin E. Olson. Stat1 modulates tissue wasting or overgrowth downstream from pdgfrβ. Genes & Development, 31:1666-1678, Aug 2017. URL: https://doi.org/10.1101/gad.300384.117, doi:10.1101/gad.300384.117. This article has 47 citations and is from a highest quality peer-reviewed journal.

  21. (guerit2021pdgfreceptormutations pages 6-8): Emilie Guérit, Florence Arts, Guillaume Dachy, Boutaina Boulouadnine, and Jean-Baptiste Demoulin. Pdgf receptor mutations in human diseases. Cellular and Molecular Life Sciences, 78:3867-3881, Jan 2021. URL: https://doi.org/10.1007/s00018-020-03753-y, doi:10.1007/s00018-020-03753-y. This article has 154 citations and is from a domain leading peer-reviewed journal.

  22. (wenger2020activatingvariantsin pages 16-16): Tara L. Wenger, Randall A. Bly, Natalie Wu, Catherine M. Albert, Julie Park, Joseph Shieh, Jirat Chenbhanich, Carrie L. Heike, Margaret P. Adam, Irene Chang, Angela Sun, Danny E. Miller, Anita E. Beck, Deepti Gupta, Markus D. Boos, Elaine H. Zackai, David Everman, Shireen Ganapathi, Meredith Wilson, John Christodoulou, Yuri A. Zarate, Cynthia Curry, Dong Li, Anne Guimier, Jeanne Amiel, Hakon Hakonarson, Richard Webster, Elizabeth J. Bhoj, Jonathan A. Perkins, John P. Dahl, and William B. Dobyns. Activating variants in pdgfrb result in a spectrum of disorders responsive to imatinib monotherapy. American Journal of Medical Genetics Part A, 182:1576-1591, Jun 2020. URL: https://doi.org/10.1002/ajmg.a.61615, doi:10.1002/ajmg.a.61615. This article has 37 citations.

  23. (guerit2021pdgfreceptormutations pages 8-9): Emilie Guérit, Florence Arts, Guillaume Dachy, Boutaina Boulouadnine, and Jean-Baptiste Demoulin. Pdgf receptor mutations in human diseases. Cellular and Molecular Life Sciences, 78:3867-3881, Jan 2021. URL: https://doi.org/10.1007/s00018-020-03753-y, doi:10.1007/s00018-020-03753-y. This article has 154 citations and is from a domain leading peer-reviewed journal.

  24. (prawitt2024molecularmechanismsof pages 1-2): Dirk Prawitt and Thomas Eggermann. Molecular mechanisms of human overgrowth and use of omics in its diagnostics: chances and challenges. Frontiers in Genetics, Jun 2024. URL: https://doi.org/10.3389/fgene.2024.1382371, doi:10.3389/fgene.2024.1382371. This article has 5 citations and is from a peer-reviewed journal.

  25. (prawitt2024molecularmechanismsof pages 9-10): Dirk Prawitt and Thomas Eggermann. Molecular mechanisms of human overgrowth and use of omics in its diagnostics: chances and challenges. Frontiers in Genetics, Jun 2024. URL: https://doi.org/10.3389/fgene.2024.1382371, doi:10.3389/fgene.2024.1382371. This article has 5 citations and is from a peer-reviewed journal.

  26. (kamien2018aclinicalreview pages 8-11): Benjamin Kamien, Anne Ronan, Gemma Poke, Ingrid Sinnerbrink, Gareth Baynam, Michelle Ward, William T. Gibson, Tracy Dudding-Byth, and Rodney J. Scott. A clinical review of generalized overgrowth syndromes in the era of massively parallel sequencing. Molecular Syndromology, 9:70-82, Jan 2018. URL: https://doi.org/10.1159/000484532, doi:10.1159/000484532. This article has 56 citations and is from a peer-reviewed journal.

  27. (maurer2025knowingandtreating pages 4-5): A Maurer, L Mirakovska, A Foster, and K Kosaki. 'knowing and treating kosaki/penttinen syndrome'international collaborative consortium: recommendations for follow-up, natural history and a real-life observational …. Unknown journal, 2025.

  28. (NCT05953857 chunk 1): Knowing and Treating Kosaki/Penttinen Syndromes. Centre Hospitalier Universitaire Dijon. 2023. ClinicalTrials.gov Identifier: NCT05953857

  29. (maurer2025knowingandtreating pages 5-6): A Maurer, L Mirakovska, A Foster, and K Kosaki. 'knowing and treating kosaki/penttinen syndrome'international collaborative consortium: recommendations for follow-up, natural history and a real-life observational …. Unknown journal, 2025.