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Living with Even-plus syndrome

A rare genetic condition with differences in the bones, ears, and nose, and sometimes other organs, noted before birth.

Understanding Even-plus syndrome

EVEN-plus syndrome is a rare genetic condition with bone and spine differences, very small or missing ears, and a small nose.

Signs can be seen during pregnancy. Other features vary and can include short stature, patches of missing skin, fewer teeth, differences in the brain, and heart, gut, or urinary and genital differences. Development may be delayed.

Signs & symptoms

Symptoms vary from person to person. GARD lists these among the most common:

  • Small ears (microtia) or missing ears
  • Differences in the spine and bone ends
  • Cleft nose tip
  • Global developmental delay
  • Patches of missing skin at birth
  • Hole in the heart wall (atrial septal defect)

Not everyone has every symptom. GARD's list comes from the Human Phenotype Ontology.

Diagnosis

  1. Talk with your doctor

    Share the symptoms you've noticed, when they started and your family health history. Notes and photos can help.

  2. See a specialist

    Specialists who may be involved include bone and joint specialists, digestive system specialists and genetic specialists.

  3. Consider genetic testing

    Changes in HSPA9 are linked to this condition. Genetic testing and counseling can help confirm a diagnosis and explain what it means for your family.

Care & treatment

Care team
Bone and joint specialists (orthopedists or orthopedic surgeons); Digestive system specialists (gastroenterologists); Genetic specialists (geneticists)
Expert care
Ask about multidisciplinary care centers for rare conditions
Treatment
GARD doesn't list specific treatments for this condition. Your care team will tailor care to your symptoms.
Research
Clinical trials and observational studies may be options. See the research section below.

General information, not medical advice. Your care team makes the decisions.

Everyday life

Living with a rare condition is easier with support.

  • Connect with rare disease patient organizations for support
  • Keep notes on symptoms, changes and questions for appointments
  • Ask about patient registries that help research
  • Look into financial aid and travel resources for care visits
Bring these questions to your next doctor visit
Can genetic testing for the HSPA9 gene confirm this diagnosis?
Which organs should be checked, such as the heart and kidneys?
Which specialists should be on my child's care team?

Quick facts

Symptoms usually startduring Pregnancy
InheritanceAutosomal Recessive
GenesHSPA9

Changes in the HSPA9 gene cause this condition. It is autosomal recessive, which means a child inherits a changed copy of the gene from each parent.

GeneticGastrointestinal

Also known as: epiphyseal and vertebral dysplasia, microtia, and flat nose, plus associated malformations; epiphyseal, vertebral, ear dysplasia, nose plus associated findings syndrome; epiphysial-vertebral-ear dysplasia-nose-plus associated findings syndrome; even (epiphyseal, vertebral, ear dysplasia, nose) plus associated findings syndrome; evpls

Patient organizations

Rare-disease groups that can help

Source: NIH GARD · Even-plus syndromeGARD ID 17913 · GARD page updated September 2026 · Plain-language summary by Know Rare; editorial review pending. General information, not medical advice.

You are more than your diagnosis

Perspectives from people navigating life with Even-plus syndrome.

Explore the Even-plus syndrome blog

Explore research for Even-plus syndrome

Explore actively recruiting Even-plus syndrome studies with HealthSpark.

HealthSpark

Find actively recruiting studies for Even-plus syndrome with HealthSpark. Share your city to explore research near you.

  • Recruiting studies from ClinicalTrials.gov
  • Share your city to look for research near you
  • Eligibility is confirmed by the study team

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Powered by HealthSpark, our AI chat helper · Study information from ClinicalTrials.gov · Eligibility is confirmed by the study team.

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