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Living with Renal tubulopathy-encephalopathy-liver failure syndrome

A condition with kidney, brain, and liver problems that is similar to but milder than GRACILE syndrome.

Understanding Renal tubulopathy-encephalopathy-liver failure syndrome

Renal tubulopathy-encephalopathy-liver failure syndrome describes a range of conditions similar to, but milder than, GRACILE syndrome.

It can involve kidney tube problems, brain dysfunction (encephalopathy), and liver problems, and can be associated with psychiatric disorders. GARD lists onset in the newborn or infant period.

Signs & symptoms

GARD doesn't list specific symptoms for this condition yet. The summary describes these features:

  • Kidney tubule problems (renal tubulopathy)
  • Brain dysfunction (encephalopathy)
  • Liver problems
  • Psychiatric disorders in some people

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 digestive system specialists and genetic specialists.

  3. Consider genetic testing

    Changes in BCS1L are linked to this condition. Genetic testing and counseling can help confirm a diagnosis and explain what it means for your family.

  4. Connect with expert centers

    United Mitochondrial Disease Foundation and MitoAction may keep lists of experts for this condition.

Care & treatment

Care team
Digestive system specialists (gastroenterologists); Genetic specialists (geneticists)
Expert care
Expert lists: United Mitochondrial Disease Foundation, MitoAction
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 United Mitochondrial Disease Foundation and other patient organizations
  • 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
Would genetic testing for the BCS1L gene help our family?
How should kidney, brain, and liver health be monitored?
How does this condition differ from GRACILE syndrome?

Quick facts

Symptoms usually startNewborn and as an Infant
InheritanceAutosomal Recessive, Mitochondrial
GenesBCS1L

This condition is caused by changes in the BCS1L gene. GARD lists autosomal recessive and mitochondrial inheritance.

GeneticGastrointestinalInherited MetabolicMitochondrial

Also known as: renal tubulopathy with encephalopathy and liver failure syndrome

Patient organizations

Source: NIH GARD · Renal tubulopathy-encephalopathy-liver failure syndromeGARD ID 17231 · 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 Renal tubulopathy-encephalopathy-liver failure syndrome.

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  • Eligibility is confirmed by the study team

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