Cornelia de Lange Syndrome

What is Cornelia de Lange syndrome?
Cornelia de Lange syndrome is a developmental disorder that affects many parts of the body. The features of this disorder vary widely among affected individuals and range from relatively mild to severe.

Cornelia de Lange syndrome is characterized by slow growth before and after birth, mental retardation that is usually severe to profound, abnormalities involving the arms and hands, and distinctive facial features. The facial differences include thin, arched eyebrows; long eyelashes; low-set ears; small, widely spaced teeth; and a small, upturned nose. Many affected individuals also have behavior problems similar to autism, a developmental condition that affects communication and social interaction.

Additional signs and symptoms of Cornelia de Lange syndrome can include excessive body hair (hirsutism), an unusually small head (microcephaly), hearing loss, and problems with the digestive tract. Some people with this condition are born with an opening in the roof of the mouth called a cleft palate. Seizures, heart defects, eye problems, and skeletal abnormalities also have been reported in people with this condition.

How common is Cornelia de Lange syndrome?
Although the exact incidence is unknown, Cornelia de Lange syndrome likely affects 1 in 10,000 to 30,000 newborns.

What genes are related to Cornelia de Lange syndrome?
Mutations in the NIPBL, SMC1A, and SMC3 genes cause Cornelia de Lange syndrome.

Mutations in the NIPBL gene have been identified in about half of all cases of Cornelia de Lange syndrome. This gene provides instructions for making a protein called delangin. Although the exact function of this protein is unknown, it appears to play an essential role in directing development before birth. Delangin regulates the activity of other genes in the developing limbs, face, and other parts of the body. NIPBL mutations lead to the production of an abnormal or nonfunctional version of this protein. These changes disrupt the regulation of genes involved in normal development, leading to the varied signs and symptoms of Cornelia de Lange syndrome.

Mutations in the SMC1A gene appear to be a less common cause of Cornelia de Lange syndrome. Although individuals with mutations in this gene have many of the major features of the condition, the signs and symptoms tend to be milder than those seen with NIPBL mutations. The SMC1A gene provides instructions for making a protein that helps regulate the structure and organization of chromosomes. Like delangin, this protein probably also controls the activity of certain genes that are important for normal development. Mutations in the SMC1A gene may cause features of Cornelia de Lange syndrome by disrupting the regulation of critical genes during early development.

Rare cases of Cornelia de Lange syndrome are caused by mutations in the SMC3 gene. Like mutations in the SMC1A gene, SMC3 mutations tend to cause a relatively mild form of the condition. This gene provides instructions for making a protein that interacts with the SMC1A protein to regulate chromosome structure. Scientists are working to determine how SMC3 mutations result in the developmental problems characteristic of Cornelia de Lange syndrome.

Researchers are looking for additional changes in the NIPBL, SMC1A, and SMC3 genes, as well as mutations in other genes, that may be responsible for this condition.

Read more about the NIPBL, SMC1A, and SMC3 genes.

How do people inherit Cornelia de Lange syndrome?
When Cornelia de Lange syndrome is caused by mutations in the NIPBL or SMC3 gene, this condition is considered to have an autosomal dominant pattern of inheritance. Autosomal dominant inheritance means one copy of the altered gene in each cell is sufficient to cause the disorder. Almost all cases result from new mutations in the gene and occur in people with no history of the condition in their family.

Cases of Cornelia de Lange syndrome caused by SMC1A mutations have an X-linked pattern of inheritance. A condition is considered X-linked if the mutated gene that causes the disorder is located on the X chromosome, one of the two sex chromosomes. Studies of X-linked Cornelia de Lange syndrome indicate that one copy of the altered gene in each cell may be sufficient to cause the condition. Unlike most X-linked conditions, in which males are more frequently affected or experience more severe symptoms than females, X-linked Cornelia de Lange syndrome appears to affect males and females similarly. Most cases result from new mutations in the SMC1A gene and occur in people with no history of the condition in their family.

Where can I find information about treatment for Cornelia de Lange syndrome?
These resources address the management of Cornelia de Lange syndrome and may include treatment providers.


 * [[Gene] Review[[Image:offsiteico.gif|This link leads to a site outside Genetics Home Reference.]]]
 * MedlinePlus Encyclopedia: Mental retardation[[Image:offsiteico.gif|This link leads to a site outside Genetics Home Reference.]]

You might also find information on treatment of Cornelia de Lange syndrome in Educational resources and Patient support.

Where can I find additional information about Cornelia de Lange syndrome?
You may find the following resources about Cornelia de Lange syndrome helpful. These materials are written for the general public.


 * MedlinePlus - Health information (2 links)
 * Additional NIH Resources - National Institutes of HealthNational Institute of Child Health and Human Development[[Image:offsiteico.gif|This link leads to a site outside Genetics Home Reference.]]
 * Educational resources - Information pages (6 links)
 * Patient support - For patients and families (6 links)

You may also be interested in these resources, which are designed for healthcare professionals and researchers.


 * Gene Reviews[[Image:offsiteico.gif|This link leads to a site outside Genetics Home Reference.]] - Clinical summary
 * Gene Tests[[Image:offsiteico.gif|This link leads to a site outside Genetics Home Reference.]] - DNA tests ordered by healthcare professionals
 * PubMed[[Image:offsiteico.gif|This link leads to a site outside Genetics Home Reference.]] - Recent literature
 * OMIM - Genetic disorder catalog (2 links)

What other names do people use for Cornelia de Lange syndrome?

 * BDLS
 * Brachmann-De Lange Syndrome
 * CDLS
 * De Lange Syndrome

See How are genetic conditions and genes named? in the Handbook.

What if I still have specific questions about Cornelia de Lange syndrome?

 * See How can I find a genetics professional in my area? in the Handbook.
 * Ask the Genetic and Rare Diseases Information Center[[Image:offsiteico.gif|This link leads to a site outside Genetics Home Reference.]].
 * Submit your question to Ask the Geneticist[[Image:offsiteico.gif|This link leads to a site outside Genetics Home Reference.]].

Where can I find general information about genetic conditions?
The Handbook provides basic information about genetics in clear language.


 * What does it mean if a disorder seems to run in my family?
 * What are the different ways in which a genetic condition can be inherited?
 * If a genetic disorder runs in my family, what are the chances that my children will have the condition?
 * Why are some genetic conditions more common in particular ethnic groups?

These links provide additional genetics resources that may be useful.


 * Genetics and health
 * Resources for Patients and Families
 * Resources for Health Professionals