Also known as Townes-Brocks syndrome with limb anomalies, is a rare genetic disorder that affects various parts of the body. It is typically characterized by a combination of malformations involving the ears, kidneys, thumbs, and other parts of the body. This syndrome is named after the physicians who first described it, Dr. David Townes and Dr. Richard Brocks.


  • Is by mutations in the SALL1 gene, which is important for normal embryonic development. This gene provides instructions for making a protein that is involved in the formation of various structures in the body during early development.


  • Ear Anomalies: Individuals with TBS often have malformations of the ears, which can range from small or absent earlobes to more complex ear abnormalities. These anomalies can lead to hearing impairment.
  • Thumb Abnormalities: Many individuals with TBS have thumb anomalies, such as underdeveloped or duplicated thumbs. These thumb abnormalities can vary widely in severity.
  • Kidney Abnormalities: Kidney malformations are common in TBS. These can include structural issues with the kidneys, which might lead to problems with kidney function.
  • Imperforate Anus: An imperforate anus is a condition in which the opening to the anus is absent or blocked. This is another feature seen in some cases of TBS.
  • Heart Defects: Some individuals with TBS might have congenital heart defects, although these are less common and vary in severity.
  • Limb Anomalies: Apart from thumb abnormalities, TBS can also be associated with other limb anomalies, such as abnormalities of the bones in the arms or legs.
  • Intellectual and Developmental Disabilities: While not always present, some individuals with TBS might have intellectual and developmental disabilities. However, intelligence can vary widely among affected individuals.


  • Clinical Evaluation: A clinical geneticist, pediatrician, or other medical specialist with experience in genetic syndromes will conduct a thorough physical examination of the individual. They will assess for the presence of characteristic features of TBS, such as ear anomalies, thumb abnormalities, kidney malformations, and other associated symptoms.
  • Medical History: Gathering a detailed medical history is crucial. The healthcare provider will inquire about the individual's birth history, developmental milestones, any complications or surgeries, and a family history of similar conditions. This information can provide valuable insights into the diagnosis.
  • Genetic Testing: Genetic testing is a fundamental component of diagnosing TBS. The SALL1 gene mutation is associated with TBS, so genetic testing involves analyzing this gene for mutations. Different types of genetic tests that may be used include:
  • SALL1 Gene Sequencing: This involves directly sequencing the SALL1 gene to identify any mutations or abnormalities.
  • Genetic Panel Testing: A broader genetic test that examines multiple genes associated with syndromes involving ear, kidney, and limb abnormalities.
  • Whole Exome Sequencing (WES): This is a more comprehensive test that sequences the protein-coding regions of all genes in the genome. It can identify mutations not previously suspected based on clinical presentation.
  • Imaging Studies: Imaging studies, such as ultrasounds or radiographs, might be conducted to evaluate the extent of kidney malformations or other internal organ abnormalities.
  • Hearing Assessment: Since ear anomalies and hearing impairment are common in TBS, a thorough hearing assessment, including audiograms, may be performed.


  1. Berberis Vulgaris: This remedy is often associated with kidney and urinary tract disorders. It may be considered when there is pain and discomfort in the kidney region, along with symptoms like burning and discomfort during urination.
  2. Apis Mellifica: Apis is derived from the honeybee and is often used for conditions involving swelling, inflammation, and burning sensations. In kidney disease, it may be considered for conditions like nephritis with edema.
  3. Cantharis: This remedy is commonly used for urinary tract infections and conditions involving intense burning and cutting pains during urination. It may be helpful in cases of kidney inflammation and urinary problems.
  4. Lycopodium: Lycopodium is often used for kidney problems when there is a sensation of fullness or bloating in the abdomen, gas and digestive disturbances, and diminished kidney function.
  5. Arsenicum Album: Arsenicum is used for a range of symptoms, including weakness, anxiety, and restlessness. In kidney disease, it might be considered when there are symptoms of weakness, dehydration, and burning sensations in the urinary tract.
  6. Terebinthina: This remedy may be considered for kidney inflammation with symptoms like pain in the back and radiating down the urinary tract, blood in the urine, and discomfort.
  7. Solidago Virgaurea: Also known as Goldenrod, this remedy is sometimes used for kidney and urinary tract conditions, particularly when there is irritation and inflammation.