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Start free with EleplanCombined immunodeficiency with facio-oculo-skeletal anomalies
ORPHA:221139Disease
Also called Roifman-Chitayat syndrome
What it is
A rare combined immunodeficiency disorder characterized by primary immunodeficiency manifesting with repeated bacterial, viral and fungal infections, in association with neurological manifestations (hypotonia, cerebellar ataxia, myoclonic seizures), developmental delay, optic atrophy, facial dysmorphism (high forehead, hypoplastic supraorbital ridges, palpebral edema, hypertelorism, flat nasal bridge, broad nasal root and tip, anteverted nares, thin lower lip overlapped by upper lip, square chin) and skeletal anomalies (short metacarpals/metatarsals with cone-shaped epiphyses, osteopenia).
Key facts
- Prevalence
- <1 / 1 000 000
- Age of onset
- Neonatal
- Inheritance
- Multigenic/multifactorial
- Classified as
- Disease
Prevalence figures describe populations, not individuals, and are often estimates from a single study. Where the figure is an incidence or a birth prevalence, it says so.
Signs and symptoms
Common30–79%
66- Abnormal facial shape
- Abnormality of the chin
- Abnormality of the skeletal system
- Abnormal T cell subset distribution
- Anteverted nares
- Arteria lusoria
- Arthritis
- Ataxia
- Broad middle phalanx of finger
- Broad nasal tip
- Chronic oral candidiasis
- Clinodactyly of the 2nd finger
- Clinodactyly of the 3rd finger
- Clinodactyly of the 4th finger
- Combined immunodeficiency
- Cone-shaped epiphysis
- Decreased circulating antibody level
- Decreased circulating total IgA
- Decreased circulating total IgG
- Decreased circulating total IgM
- Decreased lymphocyte proliferation in response to anti-CD3
- Decreased lymphocyte proliferation in response to mitogen
- Decreased proportion of CD4-positive T cells
- Decreased specific antibody response to vaccination
- Decreased total B cell count
- Deeply set eye
- Depressed nasal bridge
- Dermatochalasis
- Gastroesophageal reflux
- Generalized myoclonic seizure
- Global developmental delay
- High forehead
- Hyperlordosis
- Hyperpigmentation of the skin
- Hypertelorism
- Hypertrichosis
- Intellectual disability
- Intention tremor
- Lacrimal duct stenosis
- Low posterior hairline
- Myopathic facies
- Nasogastric tube feeding
- Neonatal hypotonia
- Neonatal respiratory distress
- Optic nerve hypoplasia
- Osteopenia
- Palpebral edema
- Pes cavus
- Positive Romberg sign
- Protruding ear
- Psoriasiform dermatitis
- Recurrent aspiration pneumonia
- Recurrent bacterial infections
- Recurrent ear infections
- Recurrent fungal infections
- Recurrent urinary tract infections
- Recurrent viral infections
- Reduced natural killer cell count
- Short distal phalanx of the thumb
- Thin lower lip vermilion
- Umbilical hernia
- Underdeveloped supraorbital ridges
- Unilateral renal agenesis
- Ventriculomegaly
- Wide intermamillary distance
- Wide nasal bridge
These ranges are how often a sign appears across everyone diagnosed, not a prediction for one person — most people have some of these and not others. Orphanet also records findings that are specifically absent in this disease; those are in the data but not listed here.
Genes
ICD-10 codes
ICD-10 has no distinct code for most rare diseases, so many are filed under the nearest available one. A shared code identifies the group, not this disease — the ORPHAcode above is what identifies it.
Related health topics
Reached through the ICD-10 categories this disease is filed under, so these describe the broader group rather than this disease specifically.
Cross-references
Orphadata Science: Free access data from Orphanet. © INSERM 1999. Data version 2026-06-23. Available under CC BY 4.0. This is a reference, not medical advice.
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