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Start free with EleplanAcute infantile liver failure-cerebellar ataxia-peripheral sensory motor neuropathy syndrome
ORPHA:466794Disease
Also called Autosomal recessive spinocerebellar ataxia type 21 · SCAR21
What it is
A rare autosomal recessive axonal hereditary motor and sensory neuropathy characterized by infantile onset of recurrent episodes of acute liver failure (resulting in chronic liver fibrosis and hepatosplenomegaly), delayed motor development, cerebellar dysfunction presenting as gait disturbances and intention tremor, neurogenic stuttering, and motor and sensory neuropathy with muscle weakness especially in the lower legs, and numbness. Mild intellectual disability was reported in some patients. MRI of the brain shows non-progressive atrophy of the cerebellar vermis and thinning of the optic nerve.
Key facts
- Prevalence
- <1 / 1 000 000
- Age of onset
- Infancy
- Inheritance
- Autosomal recessive
- Classified as
- Disease
Prevalence figures describe populations, not individuals, and are often estimates from a single study. Where the figure is an incidence or a birth prevalence, it says so.
Signs and symptoms
Common30–79%
20- Acute hepatic failure
- Cerebellar vermis atrophy
- Distal lower limb muscle weakness
- Dysmetric saccades
- Fever
- Frequent falls
- Gait ataxia
- Generalized limb muscle atrophy
- Global developmental delay
- Hepatic fibrosis
- Hepatosplenomegaly
- Hyporeflexia
- Intellectual disability, mild
- Intention tremor
- Paresthesia
- Peripheral neuropathy
- Progressive cerebellar ataxia
- Saccadic smooth pursuit
- Somatic sensory dysfunction
- Stuttering
These ranges are how often a sign appears across everyone diagnosed, not a prediction for one person — most people have some of these and not others. Orphanet also records findings that are specifically absent in this disease; those are in the data but not listed here.
Gene
ICD-10 codes
ICD-10 has no distinct code for most rare diseases, so many are filed under the nearest available one. A shared code identifies the group, not this disease — the ORPHAcode above is what identifies it.
Related health topics
Reached through the ICD-10 categories this disease is filed under, so these describe the broader group rather than this disease specifically.
Cross-references
Orphadata Science: Free access data from Orphanet. © INSERM 1999. Data version 2026-06-23. Available under CC BY 4.0. This is a reference, not medical advice.
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