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A severe form of congenital disorders of N-linked glycosylation characterized by severe developmental and psychomotor delay, muscular hypotonia, intractable early-onset seizures, and microcephaly. Additional features include altered blood coagulation with a high probability of hemorrhages or thromboses, nephrotic syndrome, ascites, hepatomegaly, cardiomyopathy, ocular manifestations (strabismus, nystagmus), and immunodeficiency. The disease is caused by loss-of-function mutations in the gene ALG1 (16p13.3).
Features include always present findings: Enlarged liver (hepatomegaly), Nonimmune hydrops fetalis, Multifocal epileptiform discharges, and Hypertelorism and others. 22 total HPO annotations.
Organ System | Phenotype Count | Example Features |
|---|---|---|
Muscles | 5 | Flexion contracture, Low muscle tone (hypotonia), Generalized hypotonia |
ALG1 encodes ALG1 chitobiosyldiphosphodolichol beta-mannosyltransferase (464 aa). Mannosyltransferase that operates in the biosynthetic pathway of dolichol-linked oligosaccharides, the glycan precursors employed in protein asparagine (N)-glycosylation. Highest expression in Cells Cultured fibroblasts (30.7 TPM) and Testis (25.3 TPM).
ALG1-congenital disorder of glycosylation is caused by mutations in the ALG1 gene on chromosome 16.
ALG1 is classified as a druggable target (Enzyme category) with score 0.0.
Genetic testing for ALG1 is available. Testing is considered confirmatory for diagnosis.
Phenotype severity distribution: 12 always present features.
Estimated prevalence: <1 in 1,000,000 (VERY_RARE).
No clinical trials have been registered for ALG1-congenital disorder of glycosylation.
8 publications have been identified in PubMed for ALG1-congenital disorder of glycosylation. Research spans Case Report / Case Series (38%), Basic Science / Preclinical (38%), and Gene Therapy / Novel Therapeutics (25%).
Zhao JG (2026). [PMID: 42168360](https://pubmed.ncbi.nlm.nih.gov/42168360/). *Cell Death Differ*. [Basic Science / Preclinical]
Trivedi S (2026). [PMID: 42220679](https://pubmed.ncbi.nlm.nih.gov/42220679/). *Cureus*. [Case Report / Case Series]
Quinlan A (2025). [PMID: 39324476](https://pubmed.ncbi.nlm.nih.gov/39324476/). *Am J Med Genet A*. [Case Report / Case Series]
Muffels IJJ (2025). [PMID: 40672295](https://pubmed.ncbi.nlm.nih.gov/40672295/). *bioRxiv*. [Gene Therapy / Novel Therapeutics]
Muffels IJJ (2025). [PMID: 40743674](https://pubmed.ncbi.nlm.nih.gov/40743674/). *Mol Genet Metab*. [Gene Therapy / Novel Therapeutics]
Data assembled from 7 of 12 sources · Last updated Sep 20, 2026, 1:21 PM UTC
Online Mendelian Inheritance in Man
European rare disease database
Genetic and Rare Diseases Info Center
Common questions about ALG1-congenital disorder of glycosylation
Brain and nerves
4 |
Seizure, Multifocal epileptiform discharges, Brain shrinkage (cerebral atrophy) |
Digestive system | 2 | Enlarged liver (hepatomegaly), Enlarged spleen (splenomegaly) |
Pregnancy and birth | 1 | Nonimmune hydrops fetalis |
Hormones | 1 | Hypogonadism |
Blood and immune system | 1 | Enlarged spleen (splenomegaly) |
Head and neck | 1 | Microcephaly |
Bones and joints | 1 | Joint contracture |
Heart and blood vessels | 1 | Heart muscle disease (cardiomyopathy) |
Growth and development | 1 | Intrauterine growth retardation |
Age of onset: before birth, at birth.
Bosnyak I (2024). [PMID: 38736633](https://pubmed.ncbi.nlm.nih.gov/38736633/). *JIMD Rep*. [Case Report / Case Series]
Budhraja R (2024). [PMID: 38470198](https://pubmed.ncbi.nlm.nih.gov/38470198/). *Proteomics*. [Basic Science / Preclinical]
AI-curated news mentioning ALG1-congenital disorder of glycosylation
Updated Jul 21, 2026
FDA approved Casgevy CRISPR gene therapy for children as young as 2 with sickle cell disease on July 1, 2026. Here's what families need to know about this milestone. Approximately 5,500 additional American children are now eligible for this established one-time therapy, according to Vertex Pharmaceuticals, Casgevy's developer. Casgevy also covers transfusion-dependent beta-thalassemia in this new age indication. Sickle cell disease is a lifelong inherited blood disorder that warps red blood cells into stiff, crescent shapes that can block blood flow, starving organs and tissues of oxygen. The world's first CRISPR-based gene therapy has been approved for children as young as two years old, opening the possibility of a single, potentially curative treatment to thousands of American children with sickle cell disease before years of organ damage can narrow what medicine can do for them. Families with children aged 2 and older who have sickle cell disease should speak with their pediatric hematologist about whether Casgevy is appropriate to consider at this stage of their child's disease. Ask specifically which authorized treatment centers perform Casgevy in your region. Treatment is available only at specialized sites, and geographic access remains limited. Contact your child's insurance plan or Medicaid office to ask about coverage. Medicaid coverage for gene therapies varies by state, and some states have developed outcomes-based payment models for high-cost therapies. "With today's decision, pediatric patients as young as 2 years of age can now access a critical additional treatment option to treat these debilitating, life-threatening diseases," said Karim Mikhail, acting director of the Office of Therapeutic Products at the FDA's Center for Biologics Evaluation and Research, according to the FDA press announcement. Casgevy is a non-viral, ex vivo CRISPR/Cas9 gene-edited cell therapy.
A new treatment for children aged 2 or older with sickle cell disease has been approved by the U.S. Food & Drug Administration. In a press release on Wednesday, the FDA announced it had approved Casgevy, the first gene therapy for children with sickle cell disease. (NewsNation) — A new treatment for children aged 2 or older with sickle cell disease has been approved by the Food & Drug Administration (FDA). In a Wednesday news release, the FDA announced it had approved Casgevy, the first gene therapy for children with the disease. “Casgevy is a gene therapy consisting of the patient’s own (autologous) hematopoietic (blood) stem cells, administered as a one-time single dose for intravenous infusion,” the release noted. “Pediatric patients as young as 2 years of age can now access a critical additional treatment option to treat these debilitating, life-threatening diseases,” Karim Mikhail, the acting director of the Center for Biologics Evaluation and Research, wrote. “These disorders carry a heavy burden for children and their families, affecting growth, development, and long-term health in profound ways,” Megha Kaushal, acting deputy director of the Office of Therapeutic Products in CBER, said in the release.