National Center for Advancing and Translational Sciences Genetic and Rare Diseases Information Center, a program of the National Center for Advancing and Translational Sciences

Waardenburg syndrome type 4



Other Names:
Waardenburg-Shah syndrome; WS4; Waardenburg-Hirschsprung disease; Waardenburg-Shah syndrome; WS4; Waardenburg-Hirschsprung disease; Shah-Waardenburg syndrome; Hirschsprung disease with pigmentary anomaly; Waardenburg-Hirschsprung syndrome See More
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Waardenburg syndrome type 4, also known as Waardenburg-Shah syndrome, is a genetic condition that can cause hearing loss; changes in coloring (pigmentation) of the hair, skin, and eyes; and Hirschsprung disease, an intestinal disorder that causes severe constipation or blockage of the intestine. Waardenburg syndrome type 4 is further divided into types 4A, 4B, and 4C based on their genetic cause. Type 4A is caused by mutations in the EDNRB gene, mutations in EDN3 cause 4B, and mutations in SOX10 cause type 4C. This condition is usually inherited in an autosomal dominant fashion; however, some cases of type 4 appear to have an autosomal recessive pattern of inheritance.[1][2]
Last updated: 4/18/2011

This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom.

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Medical Terms Other Names
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HPO ID
80%-99% of people have these symptoms
Abnormal macular morphology 0001103
Abnormality of vision
Abnormality of sight
Vision issue
[ more ]
0000504
Constipation 0002019
Hearing impairment
Deafness
Hearing defect
[ more ]
0000365
Intestinal obstruction
Bowel obstruction
Intestinal blockage
[ more ]
0005214
30%-79% of people have these symptoms
Abdominal pain
Pain in stomach
Stomach pain
[ more ]
0002027
Olfactory lobe agenesis
Olfactory lobe absence
0001341
Prominent nasal bridge
Elevated nasal bridge
High nasal bridge
Prominent bridge of nose
Prominent nasal root
Protruding bridge of nose
Protruding nasal bridge
[ more ]
0000426
Synophrys
Monobrow
Unibrow
[ more ]
0000664
Underdeveloped nasal alae
Underdeveloped tissue around nostril
0000430
Wide nasal bridge
Broad nasal bridge
Broad nasal root
Broadened nasal bridge
Increased breadth of bridge of nose
Increased breadth of nasal bridge
Increased width of bridge of nose
Increased width of nasal bridge
Nasal bridge broad
Wide bridge of nose
Widened nasal bridge
[ more ]
0000431
5%-29% of people have these symptoms
Abnormality of retinal pigmentation 0007703
Anosmia
Lost smell
0000458
Lacrimal gland hypoplasia
Underdeveloped tear gland
0007732
Telecanthus
Corners of eye widely separated
0000506
Percent of people who have these symptoms is not available through HPO
Aganglionic megacolon
Enlarged colon lacking nerve cells
0002251
Ataxia 0001251
Autosomal dominant inheritance 0000006
Autosomal recessive inheritance 0000007
Blue irides
Blue eyes
0000635
Cryptorchidism
Undescended testes
Undescended testis
[ more ]
0000028
Global developmental delay 0001263
Heterochromia iridis
Different colored eyes
0001100
Hypogonadism
Decreased activity of gonads
0000135
Hypopigmented skin patches
Patchy loss of skin color
0001053
Leukodystrophy 0002415
Muscular hypotonia
Low or weak muscle tone
0001252
Nystagmus
Involuntary, rapid, rhythmic eye movements
0000639
Polyneuropathy
Peripheral nerve disease
0001271
Premature graying of hair
Early graying
Premature graying
Premature greying
Premature hair graying
[ more ]
0002216
Sensorineural hearing impairment 0000407
Spastic paraparesis 0002313
White eyebrow
Pale eyebrow
0002226
White eyelashes
Blonde eyelashes
Pale eyelashes
[ more ]
0002227
White forelock
White part of hair above forehead
0002211
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Last updated: 7/1/2020

If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments.

If you can’t find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care.

You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists.

Healthcare Resources


Related diseases are conditions that have similar signs and symptoms. A health care provider may consider these conditions in the table below when making a diagnosis. Please note that the table may not include all the possible conditions related to this disease.

Conditions with similar signs and symptoms from Orphanet
The differential diagnosis includes other forms of Waardenburg syndrome, piebaldism and ermine phenotype, as well as other causes of hearing loss or Hirschsprung disease.
Visit the Orphanet disease page for more information.

Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.

Organizations Supporting this Disease

Social Networking Websites


These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

In-Depth Information

  • Online Mendelian Inheritance in Man (OMIM) is a catalog of human genes and genetic disorders. Each entry has a summary of related medical articles. It is meant for health care professionals and researchers. OMIM is maintained by Johns Hopkins University School of Medicine. 
    Waardenburg syndrome type 4A
    Waardenburg syndrome type 4B
    Waardenburg syndrome type 4C
  • Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.
  • PubMed is a searchable database of medical literature and lists journal articles that discuss Waardenburg syndrome type 4. Click on the link to view a sample search on this topic.

Questions sent to GARD may be posted here if the information could be helpful to others. We remove all identifying information when posting a question to protect your privacy. If you do not want your question posted, please let us know.


  1. Waardenburg syndrome. Genetics Home Reference (GHR). April 2006; http://ghr.nlm.nih.gov/condition/waardenburg-syndrome.
  2. Waardenburg syndrome, type 4A; WS4A. Online Mendelian Inheritance of Man. 2010; http://www.ncbi.nlm.nih.gov/omim/277580. Accessed 4/18/2011.