HES4 and arthrogryposis multiplex congenita: More recently, in American Angus cattle an outbreak of a recessive inherited form of AMC was reported to be associated with a 23 kb sized genomic deletion encompassing the entire ISG15 ubiquitin-like modifier (ISG15) gene, the 5’ regulatory region of the hairy and enhancer split 4 (HES4) gene, and the first two exons of the agrin (AGRN) gene (OMIA 001465-9913) (Additional file 1) [5].