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A rare genetic immunological disease reported in a single consanguineous Pakistani family with several affected members presenting with severe bacterial and viral infections, recurrent hepatopathy (portal inflammation, fibrosis), and recurrent, stereotypical febrile episodes, sometimes lasting several days, with encephalopathy and difficult-to-control seizures. Variable cardiac malformations were also reported. Although there were autoimmune lymphoproliferative syndrome (ALPS)-like biological features, clinical ALPS was not present. A homozygous missense mutation in the FADD gene (11q13.3) was found in the family and the disease is thought to follow an autosomal recessive pattern of inheritance.
Features include always present findings: Encephalopathy, Seizure, Elevated circulating alanine aminotransferase concentration, and Howell-Jolly bodies and others; and common findings: Brain shrinkage (cerebral atrophy) and Liver scarring (fibrosis) (hepatic fibrosis). 15 total HPO annotations.
Organ System | Phenotype Count | Example Features |
|---|---|---|
Brain and nerves | 3 | Encephalopathy, Brain shrinkage (cerebral atrophy), Seizure |
FADD encodes Fas associated via death domain (208 aa). Apoptotic adapter molecule that recruits caspases CASP8 or CASP10 to the activated FAS/CD95 or TNFRSF1A/TNFR-1 receptors. Highest expression in Cells Cultured fibroblasts (31.3 TPM) and Cells EBV-transformed lymphocytes (24.6 TPM).
FADD-related immunodeficiency is associated with mutations in the FADD gene on chromosome 11.
FADD is classified as a druggable target with score 8.7.
Genetic testing for FADD is available. Testing is considered confirmatory for diagnosis.
Phenotype severity distribution: 6 always present features, 2 common features.
Estimated prevalence: <1 in 1,000,000 (VERY_RARE).
No clinical trials have been registered for FADD-related immunodeficiency.
2 publications have been identified in PubMed for FADD-related immunodeficiency. Research spans Case Report / Case Series (50%) and Basic Science / Preclinical (50%).
Lu J (2025). [PMID: 40658608](https://pubmed.ncbi.nlm.nih.gov/40658608/). *Cancer Res*. [Basic Science / Preclinical]
Giovannini G (2024). [PMID: 38752438](https://pubmed.ncbi.nlm.nih.gov/38752438/). *Epilepsia*. [Case Report / Case Series]
Data assembled from 6 of 12 sources · Last updated Sep 19, 2026, 9:39 PM UTC
Online Mendelian Inheritance in Man
European rare disease database
Genetic and Rare Diseases Info Center
Common questions about FADD-related immunodeficiency
Digestive system | 3 | Hepatic bridging fibrosis, Decreased liver function, Liver scarring (fibrosis) (hepatic fibrosis) |
Lab test results | 3 | Elevated circulating alanine aminotransferase concentration, Increased circulating interleukin 10 concentration, Autoimmune antibody positivity |
Blood and immune system | 2 | Recurrent infections, Autoimmune antibody positivity |
Muscles | 1 | Brain shrinkage (cerebral atrophy) |
Heart and blood vessels | 1 | Ventricular septal defect |
Lungs and breathing | 1 | Pulmonary artery atresia |
Age of onset: at birth.