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Living with Short stature due to primary acid-labile subunit deficiency

A rare genetic condition with moderate slow growth, low growth-factor levels and high insulin.

Understanding Short stature due to primary acid-labile subunit deficiency

Short stature due to primary acid-labile subunit (ALS) deficiency is a rare genetic growth condition with low levels of the growth factors IGF-1 and IGFBP-3.

Children have a moderate slowdown in growth after birth and low IGF-1 and IGFBP-3 levels. Insulin levels are high. Growth hormone levels and response are normal. Other features can include delayed bone maturation, delayed puberty, weight around the middle and a small lower jaw. Signs start in the newborn and infant period.

Signs & symptoms

Symptoms vary from person to person. GARD lists these among the most common:

  • Slow growth
  • Delayed bone maturation
  • Delayed puberty
  • Insulin resistance
  • Weight carried around the middle
  • Small lower jaw (micrognathia)

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 and hormone specialists.

  3. Consider genetic testing

    Changes in IGFALS 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); Hormone specialists (endocrinologists)
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 of the IGFALS gene confirm this diagnosis?
How should insulin and blood sugar be monitored?
Which hormone specialist should we see?

Quick facts

Symptoms usually startNewborn and as an Infant
InheritanceAutosomal Recessive
GenesIGFALS

GARD lists changes in the IGFALS gene. A child inherits a changed copy of the gene from each parent (autosomal recessive).

GeneticEndocrine

Also known as: acid-labile subunit deficiency; acid-labile subunit, deficiency of

Patient organizations

Rare-disease groups that can help

Source: NIH GARD · Short stature due to primary acid-labile subunit deficiencyGARD ID 16964 · 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 Short stature due to primary acid-labile subunit deficiency.

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