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Living with Hypotonia-failure to thrive-microcephaly syndrome

An extremely rare nervous system and metabolic condition with low muscle tone, delayed development, slow weight gain, and a small head.

Understanding Hypotonia-failure to thrive-microcephaly syndrome

Hypotonia-failure to thrive-microcephaly syndrome, or leukotriene C4 synthase deficiency, is an extremely rare neurometabolic developmental disorder.

It causes low muscle tone (hypotonia), delayed development, slow weight gain, and a small head (microcephaly). It is seen in newborns and infants.

Signs & symptoms

GARD doesn't list specific symptoms for this condition. Its summary describes:

  • Low muscle tone (hypotonia)
  • Delayed development
  • Slow weight gain
  • Small head (microcephaly)

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 genetic specialists.

  3. Consider genetic testing

    Changes in LTC4S 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
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
What therapies could help development and feeding?
Which specialists should be on our care team?
Would genetic testing for LTC4S help our family?

Quick facts

Symptoms usually startNewborn and as an Infant
InheritanceAutosomal Recessive
GenesLTC4S

Changes in the LTC4S gene cause this condition. It is autosomal recessive, so a child inherits a changed copy of the gene from each parent.

GeneticInherited Metabolic

Also known as: deficiency of leukotriene c4 synthase; hypotonia with failure to thrive and microcephaly syndrome; leukotriene c4 synthase deficiency; ltc4 synthase deficiency

Patient organizations

Rare-disease groups that can help

Source: NIH GARD · Hypotonia-failure to thrive-microcephaly syndromeGARD ID 16725 · GARD page updated September 2026 · Plain-language summary by Know Rare; editorial review pending. General information, not medical advice.

You are more than your diagnosis

Perspectives from people navigating life with Hypotonia-failure to thrive-microcephaly syndrome.

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  • Eligibility is confirmed by the study team

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