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Charcot-Marie-Tooth disease type 4G (CMT4G) is a subtype of Charcot-Marie-Tooth disease type 4 characterized by early childhood onset of progressive distal muscle weakness and atrophy, delayed motor development, prominent distal sensory impairment, areflexia, moderately reduced nerve conduction velocities, and foot and hand deformities in Balkan (Russe) Gypsies.
Features include always present findings: Distal lower limb amyotrophy; and very common findings: Decreased motor nerve conduction velocity, Areflexia, Distal lower limb muscle weakness, and Distal sensory impairment and others. 38 total HPO annotations.
Organ System | Phenotype Count | Example Features |
|---|---|---|
Arms and legs | 8 | Distal upper limb muscle weakness, Claw hand deformity, Distal lower limb muscle weakness |
Brain and nerves | 7 | Hyporeflexia, Difficulty walking (gait disturbance), Dysphonia |
Muscles | 5 | Distal upper limb muscle weakness, Distal muscle weakness, Distal lower limb muscle weakness |
Bones and joints | 1 | Sideways curvature of the spine (scoliosis) |
Eyes | 1 | Ptosis |
HK1 encodes hexokinase 1 (917 aa). Catalyzes the phosphorylation of various hexoses, such as D-glucose, D-glucosamine, D-fructose, D-mannose and 2-deoxy-D-glucose, to hexose 6-phosphate (D-glucose 6-phosphate, D-glucosamine 6-phosphate, D-fructose 6-phosphate, D-mannose 6-phosphate and 2-deoxy-D-glucose 6-phosphate, respectively). Highest expression in Brain Cerebellar Hemisphere (153.8 TPM) and Brain Cerebellum (139.0 TPM).
Charcot-Marie-Tooth disease type 4G is associated with mutations in the HK1 gene on chromosome 10.
The HK1 protein participates in HK1 H577_C672del, glucokinase and hexokinases, and Defective HK1 causes hexokinase deficiency (HK deficiency) pathways.
HK1 is classified as a druggable target (Enzyme and Kinase categories) with score 7.5.
Genetic testing for HK1 is available. Testing is considered confirmatory for diagnosis.
Phenotype severity distribution: 1 always present feature, 12 very common features, 10 common features.
Estimated prevalence: Unknown (Unknown prevalence).
No clinical trials have been registered for Charcot-Marie-Tooth disease type 4G.
2 publications have been identified in PubMed for Charcot-Marie-Tooth disease type 4G. Research spans Basic Science / Preclinical (100%).
Zhu Q (2025). [PMID: 41411330](https://pubmed.ncbi.nlm.nih.gov/41411330/). *PloS one*. [Basic Science / Preclinical]
Ceprian M (2024). [PMID: 38673950](https://pubmed.ncbi.nlm.nih.gov/38673950/). *International journal of molecular sciences*. [Basic Science / Preclinical]
Data assembled from 6 of 12 sources · Last updated Sep 18, 2026, 10:13 PM UTC
Online Mendelian Inheritance in Man
European rare disease database
Genetic and Rare Diseases Info Center
Common questions about Charcot-Marie-Tooth disease type 4G