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Start free with EleplanCostello syndrome
ORPHA:3071Malformation syndrome
Also called FCS syndrome · Faciocutaneoskeletal syndrome
What it is
A rare syndrome with intellectual disability, characterized by failure to thrive, short stature, joint laxity, soft skin, and distinctive facial features. Cardiac and neurological involvement is common and there is an increased lifetime risk of certain tumors. Costello syndrome belongs to the RASopathies, a group of conditions resulting from germline derived point mutations affecting the RAS-mitogen activated protein kinase pathway.
Key facts
- Prevalence
- <1 / 1 000 000
- Age of onset
- Antenatal, Neonatal
- Inheritance
- Autosomal dominant, Not applicable
- Classified as
- Malformation syndrome
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
Very common80–99%
20- Abnormal fingernail morphology
- Abnormality of the skin
- Acanthosis nigricans
- Concave nail
- Deep-set nails
- Delayed skeletal maturation
- Depressed nasal bridge
- Failure to thrive in infancy
- Feeding difficulties in infancy
- Hyperkeratosis
- Lack of skin elasticity
- Macrocephaly
- Narrow palate
- Ptosis
- Pulmonic stenosis
- Redundant skin
- Short neck
- Short stature
- Ventricular septal defect
- Woolly hair
Common30–79%
26- Abnormal dermatoglyphics
- Abnormality of dental enamel
- Abnormality of the dentition
- Astigmatism
- Cerebral cortical atrophy
- Cryptorchidism
- Epicanthus
- Full cheeks
- Gastroesophageal reflux
- Hypertrophic cardiomyopathy
- Hypoplastic toenails
- Intellectual disability
- Joint hypermobility
- Keratoconus
- Macroglossia
- Mitral valve prolapse
- Myopia
- Nystagmus
- Optic disc pallor
- Papilloma
- Polyhydramnios
- Strabismus
- Thickened Achilles tendon
- Thickened nuchal skin fold
- Thick lower lip vermilion
- Ulnar deviation of finger
Sometimes5–29%
9- Abnormality of the hair
- Coarse facial features
- Compensatory head posture
- Generalized hyperpigmentation
- Hypermetropia
- Large earlobe
- Large face
- Poor suck
and 1 more in this range
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.
Gene
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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