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Living with Glutamate formiminotransferase deficiency

A rare inherited condition that can affect development; some people have only mild problems and others have none.

Understanding Glutamate formiminotransferase deficiency

Glutamate formiminotransferase deficiency is a rare inherited disorder that can affect development.

Researchers once described a mild form and a severe form. Some people diagnosed as infants don't appear to have any related health problems, and researchers are still learning about the condition. Signs have ranged from mild developmental delay with high levels of a molecule called FIGLU in the urine, to more severe intellectual disability and megaloblastic anemia, in which red blood cells are low in number and larger than normal. It is usually noticed in childhood.

Signs & symptoms

Symptoms vary from person to person. GARD lists these as less common:

  • Delayed speech and language
  • Intellectual disability
  • Megaloblastic anemia (low, enlarged red blood cells)
  • Autism
  • A hole between the upper heart chambers

Not everyone has every symptom. GARD's list comes from the Human Phenotype Ontology.

Diagnosis

  1. Talk with your doctor

    Share the symptoms you've noticed, when they started and your family health history. Notes and photos can help.

  2. See a specialist

    Specialists who may be involved include blood and bone marrow specialists and genetic specialists.

  3. Consider genetic testing

    Changes in FTCD are linked to this condition. Genetic testing and counseling can help confirm a diagnosis and explain what it means for your family.

Care & treatment

Care team
Blood and bone marrow specialists (hematologists); Genetic specialists (geneticists)
Expert care
Ask about multidisciplinary care centers for rare conditions
Treatment
GARD doesn't list specific treatments for this condition. Your care team will tailor care to your symptoms.
Research
Clinical trials and observational studies may be options. See the research section below.

General information, not medical advice. Your care team makes the decisions.

Everyday life

Living with a rare condition is easier with support.

  • Connect with rare disease patient organizations for support
  • Keep notes on symptoms, changes and questions for appointments
  • Ask about patient registries that help research
  • Look into financial aid and travel resources for care visits
Bring these questions to your next doctor visit
Can genetic testing confirm a change in the FTCD gene?
How can I tell whether my child is mildly affected or unaffected?
Should blood counts be checked for anemia?

Quick facts

Symptoms usually startChild
InheritanceAutosomal Recessive
GenesFTCD

Changes in the FTCD gene cause this condition. A child inherits a changed copy of the gene from each parent (autosomal recessive).

GeneticBloodInherited Metabolic

Also known as: arakawa syndrome 1; deficiency of glutamate formiminotransferase; deficiency of glutamate formyltransferase; figluria; formiminoglutamic aciduria; formiminotransferase cyclodeaminase deficiency

Patient organizations

Rare-disease groups that can help

Source: NIH GARD · Glutamate formiminotransferase deficiencyGARD ID 9279 · GARD page updated September 2026 · Plain-language summary by Know Rare; editorial review pending. General information, not medical advice.

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