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Start free with EleplanAlacrimia-choreoathetosis-liver dysfunction syndrome
ORPHA:404454Disease
Also called NGLY1 deficiency · NGLY1-CDDG
What it is
A rare, genetic, inborn error of metabolism disorder characterized by global developmental delay, hypotonia, choreoathetosis, hypo-/alacrimia, and liver dysfunction which manifests with elevated liver transaminases and hepatocyte cytoplasmic storage material or vacuolization on liver biopsy. Additional features reported include acquired microcephaly, hypo-/areflexia, seizures, peripheral neuropathy, intellectual and language/speech disability, additional ocular anomalies and EEG and brain imaging abnomalities.
Key facts
- Prevalence
- <1 / 1 000 000
- Age of onset
- Infancy, Neonatal
- 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%
27- Abnormal myelination
- Absent speech
- Alacrima
- Cerebellar atrophy
- Choreoathetosis
- Chronic constipation
- Decreased CSF 5-hydroxyindolacetic acid concentration
- Decreased CSF albumin
- Decreased CSF biopterin level
- Decreased CSF homovanillic acid concentration
- Decreased CSF protein
- Decreased lacrimation
- Decreased LDL cholesterol concentration
- Developmental regression
- EEG abnormality
- Elevated circulating hepatic transaminase concentration
- Failure to thrive
- Generalized myoclonic seizure
- Global developmental delay
- Hypotriglyceridemia
- Inability to walk
- Increased susceptibility to fractures
- Intellectual disability
- Intellectual disability, profound
- Obstructive sleep apnea
- Poor speech
- Small for gestational age
Sometimes5–29%
53- Achilles tendon contracture
- Acromesomelia
- Action tremor
- Astasia
- Athetosis
- Atonic seizure
- Axonal loss
- Chorea
and 45 more in this range
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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