Table 2.
Cardinal | Supportive |
1.Face (at least three of six). | a. Maternal pre-eclampsia. |
a. Highly arched eyebrows. | b. Keloids. |
b. Downslanted palpebral fissures. | c. Hypertrichosis. |
c. Convex nasal ridge. | 1 point if c is positive, or |
d. Columella below alae nasi. | 3 points if a and/or b (with or without c) are positive. |
e. Highly arched palate. | |
f. Typical smile. | |
3 points or | |
4 points if d and/or f are positive. | |
2.Skeletal. | |
a. Angulated thumbs and/or halluces. | |
b. Broad thumbs. | |
c. Broad halluces. | |
3 points if b and/or c is positive, or | |
4 points if a (with or without b/c) is positive. | |
3. Growth. | |
a. Microcephaly. | |
b. Postnatal growth retardation. | |
2 points if a and/or b are positive. | |
4. Development. | |
Delayed development/intellectual disability | |
2 points. |
Cardinal Score is positive only if two of the four groups score positiscores ve and also at least either skeletal or craniofacial scores positive
Definitive clinical diagnosis of Rubinstein-Taybi syndrome: Score ≥12 and positive cardinal score.
Likely clinical diagnosis of Rubinstein-Taybi syndrome: Score 8–11 and positive cardinal score. This score warrants molecular analyses of CREBBP and EP300.
Possible clinical diagnosis of Rubinstein-Taybi syndrome: Score 5–7 and negative cardinal score. This score warrants molecular analyses of CREBBP and EP300.
Unlikely clinical diagnosis of Rubinstein-Taybi syndrome: Score 0–4 and negative cardinal score. Further studies for other aetiologies indicated.