Renpenning syndrome is an X-linked recessive neurodevelopmental disorder caused by pathogenic PQBP1 variants and characterized by intellectual disability, microcephaly, short stature, and facial dysmorphism.
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name: Renpenning syndrome
creation_date: "2026-04-15T00:00:00Z"
updated_date: "2026-04-16T00:50:38Z"
description: >-
Renpenning syndrome is an X-linked recessive neurodevelopmental disorder
caused by pathogenic PQBP1 variants and characterized by intellectual
disability, microcephaly, short stature, and facial dysmorphism.
category: Mendelian
parents:
- X-linked intellectual disability
- Neurodevelopmental disorder
synonyms:
- RENS1
disease_term:
preferred_term: Renpenning syndrome
term:
id: MONDO:0010653
label: Renpenning syndrome
inheritance:
- name: X-linked recessive inheritance
description: >-
Renpenning syndrome follows X-linked recessive inheritance and primarily
affects hemizygous males.
inheritance_term:
preferred_term: X-linked recessive inheritance
term:
id: HP:0001419
label: X-linked recessive inheritance
evidence:
- reference: PMID:36797465
reference_title: "Identification of a DNA methylation signature for Renpenning syndrome (RENS1), a spliceopathy."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
Renpenning syndrome (RENS1 - OMIM 309500), which is an X-linked
recessive neurodevelopmental disorder caused by variants in
polyglutamine-binding protein 1 (PQBP1) is reported.
explanation: This directly supports X-linked recessive inheritance and PQBP1 causality.
pathophysiology:
- name: PQBP1 spliceopathy
description: >-
Pathogenic PQBP1 variants disrupt transcriptional and post-transcriptional
regulation of gene expression, producing a spliceopathy that alters
neurodevelopmental gene networks.
genes:
- preferred_term: PQBP1
term:
id: hgnc:9330
label: PQBP1
biological_processes:
- preferred_term: RNA splicing
modifier: ABNORMAL
term:
id: GO:0008380
label: RNA splicing
- preferred_term: mRNA processing
modifier: ABNORMAL
term:
id: GO:0006397
label: mRNA processing
evidence:
- reference: PMID:38030819
reference_title: "Molecular consequences of PQBP1 deficiency, involved in the X-linked Renpenning syndrome."
supports: SUPPORT
evidence_source: IN_VITRO
snippet: >-
PQBP1 encodes a protein involved in transcriptional and
post-transcriptional regulation of gene expression.
explanation: This directly supports PQBP1-dependent regulation of gene expression as a core mechanism.
- reference: PMID:36797465
reference_title: "Identification of a DNA methylation signature for Renpenning syndrome (RENS1), a spliceopathy."
supports: PARTIAL
evidence_source: HUMAN_CLINICAL
snippet: >-
Renpenning syndrome (RENS1 - OMIM 309500), which is an X-linked
recessive neurodevelopmental disorder caused by variants in
polyglutamine-binding protein 1 (PQBP1) is reported.
explanation: This supports PQBP1-related disease causality and the authors' characterization of Renpenning syndrome as a spliceopathy.
downstream:
- target: Impaired neural progenitor proliferation and differentiation
description: PQBP1 dysfunction perturbs neural progenitor cell behavior and brain development.
- name: Impaired neural progenitor proliferation and differentiation
description: >-
PQBP1 loss decreases proliferation in human neural stem cells and impairs
progenitor transitions during brain development, providing a cellular basis
for microcephaly and cognitive impairment.
genes:
- preferred_term: PQBP1
term:
id: hgnc:9330
label: PQBP1
cell_types:
- preferred_term: neural progenitor cell
term:
id: CL:0011020
label: neural progenitor cell
biological_processes:
- preferred_term: cell population proliferation
modifier: DECREASED
term:
id: GO:0008283
label: cell population proliferation
- preferred_term: neurogenesis
modifier: ABNORMAL
term:
id: GO:0022008
label: neurogenesis
evidence:
- reference: PMID:38030819
reference_title: "Molecular consequences of PQBP1 deficiency, involved in the X-linked Renpenning syndrome."
supports: SUPPORT
evidence_source: IN_VITRO
snippet: >-
We observed a decrease of cell proliferation, as well as the deregulation
of the expression of 58 genes, comprising genes encoding proteins
associated with neurodegenerative diseases, playing a role in mRNA
regulation or involved in innate immunity.
explanation: This directly supports reduced progenitor proliferation after PQBP1 loss.
- reference: PMID:41507200
reference_title: "The missense mutation Y65C in PQBP1 causes microcephaly and cognitive deficits through a combination of partial loss-of-function and gain-of-function effects."
supports: SUPPORT
evidence_source: MODEL_ORGANISM
snippet: >-
we generated Pqbp1Y65C/Y knock-in male mice and discovered that the Y65C
mutation impairs the proliferation of apical progenitors and their
subsequent transition to basal progenitors, resulting in microcephaly and
cognitive deficits like those observed in Renpenning syndrome patients.
explanation: This directly supports the neural progenitor mechanism linking PQBP1 dysfunction to microcephaly and cognitive impairment.
downstream:
- target: Microcephaly
description: Impaired neural progenitor proliferation contributes to reduced brain growth.
- target: Intellectual disability
description: Abnormal neurodevelopment contributes to the core cognitive phenotype.
- target: Global developmental delay
description: Early neurodevelopmental impairment contributes to delayed milestones.
genetic:
- name: PQBP1
association: Causal hemizygous variant
gene_term:
preferred_term: PQBP1
term:
id: hgnc:9330
label: PQBP1
notes: >-
Renpenning syndrome is caused by hemizygous PQBP1 variants in affected
males; reported alleles include frameshift, missense, splice, and deletion
variants.
evidence:
- reference: PMID:41978772
reference_title: "Renpenning syndrome caused by the c.459_462delAGAG mutation in PQBP1: a case report and literature review."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
Whole exome sequencing identified a hemizygous PQBP1 frameshift variant,
NM_001032382.2:c.459_462delAGAG (p.Arg153fs) (VCV000010980.79), in the
proband.
explanation: This directly supports PQBP1 as the causal gene and illustrates a representative pathogenic allele class.
- reference: PMID:40372223
reference_title: "[Clinical analysis of a child with heterotopic ventricular gray matter Renpenning syndrome caused by PQBP1 gene mutation and a literature review]."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
A hemizygous deletion, c.459_462del (p.Arg153SerfsTer41), was
identified in exon 5 of the PQBP1 gene in patient 1, which was inherited
from his mother by Sanger sequencing.
explanation: This directly supports hemizygous PQBP1 causality and maternal transmission in a male proband.
- reference: PMID:41507200
reference_title: "The missense mutation Y65C in PQBP1 causes microcephaly and cognitive deficits through a combination of partial loss-of-function and gain-of-function effects."
supports: SUPPORT
evidence_source: MODEL_ORGANISM
snippet: >-
The missense mutation Y65C in polyglutamine-binding protein 1 (PQBP1) is
associated with Renpenning syndrome, characterized by X-linked
intellectual disability and microcephaly.
explanation: This supports PQBP1 missense alleles as a recognized causal class in Renpenning syndrome.
- reference: CGGV:assertion_8128f36b-f273-49ee-bfd8-bee64b4df921-2018-11-07T110000.000Z
reference_title: "PQBP1 / Renpenning syndrome (Definitive)"
supports: SUPPORT
evidence_source: OTHER
snippet: "PQBP1 | HGNC:9330 | Renpenning syndrome | MONDO:0010653 | XL | Definitive"
explanation: ClinGen classifies the PQBP1-Renpenning syndrome gene-disease relationship as definitive with X-linked inheritance.
phenotypes:
- name: Intellectual disability
category: Neurodevelopmental
diagnostic: true
description: >-
Intellectual disability is the core clinical manifestation of Renpenning
syndrome.
phenotype_term:
preferred_term: Intellectual disability
term:
id: HP:0001249
label: Intellectual disability
evidence:
- reference: PMID:38030819
reference_title: "Molecular consequences of PQBP1 deficiency, involved in the X-linked Renpenning syndrome."
supports: SUPPORT
evidence_source: IN_VITRO
snippet: >-
Mutations in the PQBP1 gene (polyglutamine-binding protein-1) are
responsible for a syndromic X-linked form of neurodevelopmental disorder
(XL-NDD) with intellectual disability (ID), named Renpenning syndrome.
explanation: This directly supports intellectual disability as the defining neurodevelopmental feature.
- name: Microcephaly
category: Neurologic
diagnostic: true
description: >-
Microcephaly is a recurrent feature in Renpenning syndrome and a key clue
to the diagnosis.
phenotype_term:
preferred_term: Microcephaly
term:
id: HP:0000252
label: Microcephaly
evidence:
- reference: PMID:41978772
reference_title: "Renpenning syndrome caused by the c.459_462delAGAG mutation in PQBP1: a case report and literature review."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
Renpenning syndrome (OMIM: 309500) is a rare X-linked intellectual
disability caused by variations in the polyglutamine-binding protein 1
(PQBP1) gene, characterized by moderate to severe intellectual
disability, microcephaly, short stature, lean body, small testes, and
abnormal facial features.
explanation: This directly supports microcephaly as part of the core clinical syndrome.
- reference: PMID:41507200
reference_title: "The missense mutation Y65C in PQBP1 causes microcephaly and cognitive deficits through a combination of partial loss-of-function and gain-of-function effects."
supports: SUPPORT
evidence_source: MODEL_ORGANISM
snippet: >-
resulting in microcephaly and cognitive deficits like those observed in
Renpenning syndrome patients.
explanation: This supports a mechanistic link between PQBP1 dysfunction and microcephaly.
- name: Microphthalmia
category: Ophthalmologic
description: Ocular underdevelopment has been reported in Renpenning syndrome.
phenotype_term:
preferred_term: Microphthalmia
term:
id: HP:0000568
label: Microphthalmia
evidence:
- reference: PMID:40372223
reference_title: "[Clinical analysis of a child with heterotopic ventricular gray matter Renpenning syndrome caused by PQBP1 gene mutation and a literature review]."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
The main clinical manifestations were unusual facies (microcephaly, long
narrow face, microphthalmos, superior oblique palpebral fissure,
hypertelorism of inner canthus, bulbous nasal columella) and mental
retardation.
explanation: This directly supports microphthalmia as part of the facial-ocular phenotype in Renpenning syndrome.
- name: Small testes
category: Genitourinary
description: >-
Small testes are part of the canonical male phenotype of Renpenning
syndrome.
phenotype_term:
preferred_term: Abnormal testis morphology
term:
id: HP:0000035
label: Abnormal testis morphology
evidence:
- reference: PMID:41978772
reference_title: "Renpenning syndrome caused by the c.459_462delAGAG mutation in PQBP1: a case report and literature review."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
Renpenning syndrome (OMIM: 309500) is a rare X-linked intellectual
disability caused by variations in the polyglutamine-binding protein 1
(PQBP1) gene, characterized by moderate to severe intellectual
disability, microcephaly, short stature, lean body, small testes, and
abnormal facial features.
explanation: This directly supports small testes as part of the core male phenotype.
- name: Gray matter heterotopia
category: Neurologic
description: Gray matter heterotopia has been reported in at least one affected child.
phenotype_term:
preferred_term: Gray matter heterotopia
term:
id: HP:0002282
label: Gray matter heterotopia
evidence:
- reference: PMID:40372223
reference_title: "[Clinical analysis of a child with heterotopic ventricular gray matter Renpenning syndrome caused by PQBP1 gene mutation and a literature review]."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
Auxiliary examination showed than patient 1 had atrial septal defect,
nodular heterotopia in the posterior horn of the left ventricle,
angiodysplasia, and low IQ.
explanation: This directly supports gray matter heterotopia in Renpenning syndrome.
- name: Atrial septal defect
category: Cardiovascular
description: Congenital heart disease has been reported in PQBP1-related disease.
phenotype_term:
preferred_term: Atrial septal defect
term:
id: HP:0001631
label: Atrial septal defect
evidence:
- reference: PMID:40372223
reference_title: "[Clinical analysis of a child with heterotopic ventricular gray matter Renpenning syndrome caused by PQBP1 gene mutation and a literature review]."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
Auxiliary examination showed than patient 1 had atrial septal defect,
nodular heterotopia in the posterior horn of the left ventricle,
angiodysplasia, and low IQ.
explanation: This directly supports congenital cardiac involvement in Renpenning syndrome.
- name: Global developmental delay
category: Neurodevelopmental
description: >-
Severe developmental delay is a common presentation in young affected
children.
phenotype_term:
preferred_term: Global developmental delay
term:
id: HP:0001263
label: Global developmental delay
evidence:
- reference: PMID:41978772
reference_title: "Renpenning syndrome caused by the c.459_462delAGAG mutation in PQBP1: a case report and literature review."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
The proband exhibited typical manifestations of Renpenning syndrome,
including severe global developmental delay, microcephaly, short stature,
and characteristic facial features.
explanation: This directly supports global developmental delay as a clinical manifestation.
- name: Short stature
category: Growth
description: Short stature is a recurrent growth phenotype in Renpenning syndrome.
phenotype_term:
preferred_term: Short stature
term:
id: HP:0004322
label: Short stature
evidence:
- reference: PMID:41978772
reference_title: "Renpenning syndrome caused by the c.459_462delAGAG mutation in PQBP1: a case report and literature review."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
Renpenning syndrome (OMIM: 309500) is a rare X-linked intellectual
disability caused by variations in the polyglutamine-binding protein 1
(PQBP1) gene, characterized by moderate to severe intellectual
disability, microcephaly, short stature, lean body, small testes, and
abnormal facial features.
explanation: This directly supports short stature as part of the described syndrome phenotype.
- name: Abnormal facial shape
category: Craniofacial
description: Facial dysmorphism is a recognizable component of the syndrome.
phenotype_term:
preferred_term: Abnormal facial shape
term:
id: HP:0001999
label: Abnormal facial shape
evidence:
- reference: PMID:41978772
reference_title: "Renpenning syndrome caused by the c.459_462delAGAG mutation in PQBP1: a case report and literature review."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
Renpenning syndrome (OMIM: 309500) is a rare X-linked intellectual
disability caused by variations in the polyglutamine-binding protein 1
(PQBP1) gene, characterized by moderate to severe intellectual
disability, microcephaly, short stature, lean body, small testes, and
abnormal facial features.
explanation: This directly supports a facial-dysmorphism phenotype.
- name: Anal atresia
category: Gastrointestinal
description: Anal atresia is a rare expansion of the Renpenning phenotype.
phenotype_term:
preferred_term: Anal atresia
term:
id: HP:0002023
label: Anal atresia
evidence:
- reference: PMID:41978772
reference_title: "Renpenning syndrome caused by the c.459_462delAGAG mutation in PQBP1: a case report and literature review."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
Additionally, he presented with rare anal atresia and co-occurring
autism spectrum disorder (ASD).
explanation: This directly supports anal atresia as an expanded but documented clinical feature.
- name: Autism
category: Neurodevelopmental
description: Autism spectrum features have been reported in at least one affected child.
phenotype_term:
preferred_term: Autism
term:
id: HP:0000717
label: Autism
evidence:
- reference: PMID:41978772
reference_title: "Renpenning syndrome caused by the c.459_462delAGAG mutation in PQBP1: a case report and literature review."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
Additionally, he presented with rare anal atresia and co-occurring
autism spectrum disorder (ASD).
explanation: This directly supports autism spectrum features in the reported case.
differential_diagnoses: []
diagnosis:
- name: Whole exome sequencing
description: >-
Whole-exome sequencing or targeted exome sequencing is a practical first-line
method to identify pathogenic PQBP1 variants in suspected Renpenning syndrome.
diagnosis_term:
preferred_term: Whole Exome Sequencing
term:
id: NCIT:C101295
label: Whole Exome Sequencing
evidence:
- reference: PMID:40372223
reference_title: "[Clinical analysis of a child with heterotopic ventricular gray matter Renpenning syndrome caused by PQBP1 gene mutation and a literature review]."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
Genomic DNA was extracted from the child and his family members, and
Trios-whole exome sequencing (Trios-WES) was performed.
explanation: This directly supports whole-exome sequencing as a diagnostic approach for PQBP1-related Renpenning syndrome.
- reference: PMID:41978772
reference_title: "Renpenning syndrome caused by the c.459_462delAGAG mutation in PQBP1: a case report and literature review."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
Comprehensive clinical evaluation and whole exome sequencing were
performed to identify the genetic basis of the clinical presentation in
a 4-year-7-month-old male proband from a Chinese family.
explanation: This supports whole-exome sequencing as a practical diagnostic procedure in Renpenning syndrome.
- name: DNA methylation analysis
description: >-
Genome-wide DNA methylation analysis can identify a Renpenning-specific
episignature and may help reclassify variants of uncertain significance.
diagnosis_term:
preferred_term: DNA Methylation Analysis
term:
id: NCIT:C63328
label: DNA Methylation Analysis
evidence:
- reference: PMID:36797465
reference_title: "Identification of a DNA methylation signature for Renpenning syndrome (RENS1), a spliceopathy."
supports: PARTIAL
evidence_source: HUMAN_CLINICAL
snippet: >-
Genome-wide DNA methylation analysis has recently been adapted for
clinical testing of patients with genetic neurodevelopmental disorders.
explanation: This supports DNA methylation analysis as an emerging diagnostic adjunct, although the paper frames the Renpenning episignature as preliminary.
clinical_trials: []
datasets: []
biochemical: []
environmental: []
treatments: []
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