However, several other features were more in keeping with hand-foot-genital syndrome (MIM: 140000), and prior testing had focused on HOXA13. The distal breakpoint of the inversion lay ∼45 kb upstream of HOXA13. Positional effects for HOXA13 have been proposed to act over much longer distances.44 The gene discussed is HOXA13; the disease is hand-foot-genital syndrome.