Tetraamelia-multiple malformations…

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Tetraamelia-multiple malformations syndrome

ORPHA:3301Malformation syndrome

Also called PAPPA syndrome · PAPPAS · Zimmer phocomelia

What it is

An extremely rare mostly lethal congenital disorder characterized by absence of all four limbs and frequent associated major malformations involving the head, face, eyes, skeleton, heart, lungs, anus, urogenital, and central nervous systems. The syndrome has been described in fewer than 20 patients mainly of middle Eastern descent.

Key facts

Prevalence
<1 / 1 000 000
Age of onset
Antenatal, Infancy, Neonatal
Inheritance
Autosomal recessive, X-linked recessive
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

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

RSPO2Disease-causing germline mutation(s)
TBX4Disease-causing germline mutation(s)
WNT3Disease-causing germline mutation(s) (loss of function)

ICD-10 codes

Q87.8filed under a broader ICD-10 category — shared with 581 other rare diseases

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

GARD 386MESH C536500MONDO 0010110OMIM 273395OMIM 601360OMIM 618021UMLS C2931218

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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