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An inherited metabolic disease that is has its basis in the disruption of carbohydrate metabolic process.
No HPO annotations are available for this condition.
NGLY1-related congenital disorder of deglycosylation (NGLY1-CDDG) is a multisystemic neurodevelopmental disorder in which individuals most commonly exhibit a tetrad of developmental delay / intellectual disability, hyperkinetic movement disorder, hypolacrima, and elevated transaminases during early childhood [, , , , ]. Diagnosis has been achieved at ages ranging from three months to 20 years, mostly through broad molecular testing, such as exome analysis. While most individuals with NGLY1-CDDG survive into early adulthood, with a relatively stable clinical course , death during infancy from unclear causes has been reported.
Formal diagnostic criteria have not been established.
NGLY1-related congenital disorder of deglycosylation (NGLY1-CDDG) should be suspected in individuals with the following clinical features and supportive laboratory findings. Clinical features include:
Developmental delay / intellectual disability, most often in the severe to profound range
No approved treatments are currently available for inborn carbohydrate metabolic disorder. The disease remains an area of unmet medical need.
Evaluations Following Initial Diagnosis To establish the extent of disease and needs in an individual diagnosed with NGLY1-related congenital disorder of deglycosylation (NGLY1-CDDG), the evaluations summarized (if not performed as part of the initial evaluation that led to diagnosis) are recommended. Table 3. Recommended Evaluations Following Initial Diagnosis of NGLY1-CDDG
In the absence of formal surveillance guidelines, the authors recommend the following:
Annual follow up by:
Pediatrician or internist
Physical medicine and rehabilitation medicine
1 clinical trial registered. Pipeline includes 1 NA.
269 publications have been identified in PubMed for inborn carbohydrate metabolic disorder. Kisho has analyzed 182 by research type. Research spans Case Report / Case Series (27%), Basic Science / Preclinical (25%), and Review / Meta-Analysis (21%).
Research Type | Count | % of Total |
|---|---|---|
Patient case studies | 49 | 27% |
Data assembled from 6 of 12 sources · Last updated Nov 4, 2026, 2:41 AM UTC
European rare disease database
Genetic and Rare Diseases Info Center
Source: GeneReviews — "NGLY1-Related Congenital Disorder of Deglycosylation"
Hypo- or alacrima
Supportive laboratory findings include elevated ALT and AST during early childhood that spontaneously normalize. Note: Typical serum screening tests for congenital disorders of glycosylation (i.e., analysis of serum transferrin glycoforms, N and O glycan profiling) will NOT reliably detect NGLY1-CDDG (see , Biochemical).
The diagnosis of NGLY1-CDDG is established...
Source: GeneReviews — "NGLY1-Related Congenital Disorder of Deglycosylation"
The tetrad of developmental delay / cognitive impairment, hyperkinetic movement disorder, hypo/alacrima, and elevated transaminases during early childhood is pathognomonic of NGLY1-CDDG [, , , , ]. However, other multisystemic disorders and conditions that feature variable neurologic phenotypes, including seizures, chorea, athetosis, dystonia, myoclonus, tremors, ataxia, and dysmetria, are in the differential diagnosis.
Table 2.
Disorders to Consider in the Differential Diagnosis of NGLY1-Related Congenital Disorder of Deglycosylation
Disorder | Gene(s) | MOI | Clinical Features
Overlapping | Distinguishing
Congenital disorders of glycosylation (CDGs) (see Congenital Disorders of N-Linked Glycosylation and Multiple Pathway Overview.) | See footnote 1. | ARXL | • Intrauterine growth restriction
Source: GeneReviews — "NGLY1-Related Congenital Disorder of Deglycosylation"
Inborn carbohydrate metabolic disorder is included in newborn screening programs (Tyrosinemia Type I) in all 50 states and 3 territories.
Biomarker and diagnostic research for inborn carbohydrate metabolic disorder has been reported in the published literature.
System/Concern | Evaluation | Comment |
|---|---|---|
Eyes | Ophthalmologic eval for hypolacrima retinal disease | — |
ENT/Mouth | Auditory brain stem evoked potentials | — |
Respiratory | Sleep study | If review of systems reveals snoring or symptoms concerning for sleep apnea |
Gastrointestinal | Nutrition eval to optimize intake | Feeding swallowing eval if indicated; Transaminase levels; Eval for constipation |
Musculoskeletal | Radiologic orthopedic assessment incl DXA scan | To evaluate bone health help manage scoliosis, coxa valga, /or contractures |
Skin | QSWEAT analysis to evaluate for hypohydrosis | Neurologic |
Endocrinologic | Vitamin D level | To assess for vitamin D deficiency Hematologic/ |
Lymphatic | Protein C; factor II, IX, XI; fibrinogen levels | Consultation w/hematologist if abnormal Miscellaneous/ |
Other | Speech language eval | Referral to speech therapist if indicated Rehabilitation team eval |
Treatment of Manifestations in Individuals with NGLY1-CDDG Manifestation/Concern | Treatment | Considerations/Other |
Hypolacrima | Lubricating eye drops /or bland ointments | — |
Hearing loss | Standard treatment | See Hereditary Hearing Loss and Deafness Overview. |
Sleep apnea | Routine management | — |
Oromotor deficits leading to feeding problems | Feeding therapy; supplemental tube feeding if indicated | Referral to gastroenterologist |
Constipation | Standard management | Referral to gastroenterologist if refractory to typical medical management |
Abnormal hematologic /or gastroenterologic labs | Follow up w/hematologist gastroenterologist | — |
Scoliosis osteopenia | Routine management | — |
Hypohydrosis | Adequate access to water cool environment (AC, wet T-shirt, /or spray bottle of water) | Cooling vests may be helpful in hot climates. |
Seizures | Standard treatment | Referral to neurologist for those w/refractory or severe seizures |
Vitamin D deficiency | Supplemental vitamin D | — |
Any condition requiring surgical intervention | Surgery best performed in centers w/surgeons anesthesiologists experienced in care of those w/metabolic disorders special needs | AC = air conditioning The following information represents typical management recommendations for individuals with developmental delay / intellectual disability in the United States; standard recommendations may vary from country to country. Ages 0-3 years. |
Source: GeneReviews — "NGLY1-Related Congenital Disorder of Deglycosylation"
Hot environment should be avoided by those with hypohydrosis.
Source: GeneReviews — "NGLY1-Related Congenital Disorder of Deglycosylation"
No FDA-approved treatments for NGLY1-CDDG exist. Enzyme replacement therapy is currently being evaluated in the pre-clinical arena. Pre-clinical screens for endo-beta-N-acetylglucosaminidase (ENGase) inhibitors are underway . Large-scale compound screens on model organisms and cell lines are being evaluated. Search ClinicalTrials.gov in the US and EU Clinical Trials Register in Europe for information on clinical studies for a wide range of diseases and conditions.
Source: GeneReviews — "NGLY1-Related Congenital Disorder of Deglycosylation"
1 trial found
Neurology
Nutrition
Follow up as recommended by:
Developmental pediatrician
Gastroenterologist/hepatologist
Audiologist
Clinical or biochemical geneticist
Source: GeneReviews — "NGLY1-Related Congenital Disorder of Deglycosylation"
Laboratory research
45 |
25% |
Research summaries | 38 | 21% |
Disease patterns and progression | 16 | 9% |
Testing and diagnosis research | 13 | 7% |
Clinical study results | 12 | 7% |
New treatment approaches | 8 | 4% |
Other research | 1 | 1% |
Suarez DA (2026). [PMID: 41880697](https://pubmed.ncbi.nlm.nih.gov/41880697/). *Mol Genet Metab*. [Review / Meta-Analysis]
Rodrigues A (2026). [PMID: 41564618](https://pubmed.ncbi.nlm.nih.gov/41564618/). *Mol Genet Metab*. [Clinical Trial Publication]
Köprülü Ö (2026). [PMID: 41399023](https://pubmed.ncbi.nlm.nih.gov/41399023/). *J Pediatr Endocrinol Metab*. [Case Report / Case Series]
Betesh-Abay B (2026). [PMID: 41898592](https://pubmed.ncbi.nlm.nih.gov/41898592/). *Int J Mol Sci*. [Review / Meta-Analysis]
Burke E (2026). [PMID: 41539482](https://pubmed.ncbi.nlm.nih.gov/41539482/). *Pediatrics*. [Case Report / Case Series]
Morana E (2026). [PMID: 41611076](https://pubmed.ncbi.nlm.nih.gov/41611076/). *Eur J Med Genet*. [Case Report / Case Series]
Stone WL (2026). [PMID: 28846219](https://pubmed.ncbi.nlm.nih.gov/28846219/). *Unknown Journal*. [Review / Meta-Analysis]
Tokic S (2026). [PMID: 38776074](https://pubmed.ncbi.nlm.nih.gov/38776074/). *J Physiol*. [Basic Science / Preclinical]
Murdoch M (2026). [PMID: 41881488](https://pubmed.ncbi.nlm.nih.gov/41881488/). *BMJ Case Rep*. [Case Report / Case Series]
Grünert SC (2026). [PMID: 41554131](https://pubmed.ncbi.nlm.nih.gov/41554131/). *J Inherit Metab Dis*. [Epidemiology / Natural History]
AI-curated news mentioning inborn carbohydrate metabolic disorder
Updated Nov 1, 2026
In 2013, one of Cara's colleagues ... disorders — just to rule them out. ... Sanfilippo syndrome. Cara remembered learning about the rare inherited disease back in medical school. "When they said the word, it all kind of came rushing back," she says. "And it was just this bale of dread, like, oh, my goodness, this is horrific." Children with Sanfilippo have a faulty gene that leaves them unable to break down heparin sulfate, a molecule critical to normal cell ... In 2013, one of Cara's colleagues suggested testing Eliza for a group of metabolic disorders — just to rule them out. ... Sanfilippo syndrome. Cara remembered learning about the rare inherited disease back in medical school. "When they said the word, it all kind of came rushing back," she says. "And it was just this bale of dread, like, oh, my goodness, this is horrific." Children with Sanfilippo have a faulty gene that leaves them unable to break down heparin sulfate, a molecule critical to normal cell function. A family affected by Sanfilippo syndrome raised millions of dollars for research. The Food and Drug Administration just approved a gene therapy the support helped make possible. The therapy used a modified virus to deliver a working copy of the broken gene to patients' cells. Eliza O'Neill gets a kiss from her dad, Glenn, before becoming the first person to receive an experimental gene therapy for her rare disease in 2016. The Food and Drug Administration just approved a gene therapy the support helped make possible. ... Embed <iframe src="https://www.npr.org/player/embed/nx-s1-6014739/nx-s1-9974959" width="100%" height="290" frameborder="0" scrolling="no" title="NPR embedded audio player"> ... Glenn (from left), Beckham, Cara and Eliza O'Neill pose for a family photo in 2015. Eliza has Sanfilippo syndrome, a rare inherited disease.
Government funding for biomedical ... trial efficiency in parts of Latin America. Higher rates of oncology, cardiovascular diseases, metabolic disorders, infectious diseases, and rare conditions are also expanding the volume and complexity of drug development programs. Pharmaceutical and biotechnology companies are increasing clinical research budgets to advance novel therapeutics, creating ... Government funding for biomedical research in countries such as China and Singapore is supporting regional activity, while streamlined patient recruitment is improving trial efficiency in parts of Latin America. Higher rates of oncology, cardiovascular diseases, metabolic disorders, infectious diseases, and rare conditions are also expanding the volume and complexity of drug development programs. Pharmaceutical and biotechnology companies are increasing clinical research budgets to advance novel therapeutics, creating sustained demand for manufacturing, packaging, storage, distribution, and supply chain management services. 120-Page Report Examines How Biologics, Personalized Medicine and Decentralized Trials Are Raising Demand for Cold-Chain and Just-in-Time Logistics as... According to the report, the market is expected to expand at a compound annual growth rate of 8.4% from 2026 to 2033, supported by rising research and development investments, increasing chronic disease prevalence, and the globalization of clinical trials. Growth in biologics and personalized medicine is creating demand for specialized clinical trial supply chain services. Monoclonal antibodies, cell therapies, and gene therapies require controlled storage, cold chain logistics, and precise transportation processes. Objectives Chapter 2. Executive Summary 2.1. Market Outlook 2.2. Segment Outlook 2.3. Competitive Insights Chapter 3. Clinical Trial Supplies Market Variables, Trends & Scope 3.1. Market Lineage Outlook 3.1.1. Parent Market Outlook 3.1.2. Related/Ancillary Market Outlook 3.2. Market Dynamics 3.2.1. Market Driver Analysis 3.2.2. Market Restraint Analysis 3.3. Technology Landscape 3.4. Pricing Model Analysis 3.5. Tariff Impact Analysis 3.6. Value Chain Analysis 3.6.1. Supply Trends 3.6.2. Demand Trends 3.7. Market Analysis Tools 3.7.1. Porter's Five Force Analysis 3.7.2. PESTEL by SWOT Analysis
Alaunos Therapeutics (NASDAQ: TCRT) jumps over 146% after completing its Velaris Therapeutics acquisition and a concurrent $350 million private placement. Alaunos completed the acquisition of Velaris Therapeutics, adding ActRII-Fc ligand traps and an anti-PDGF-B antibody for pulmonary arterial hypertension and related cardiopulmonary diseases. A concurrent oversubscribed private placement led by Fairmount raised approximately $350 million, expected to fund operations into 2029, including proof-of-concept data for VLR199 in 2028. Alaunos Therapeutics is a biotechnology company focused on developing novel therapeutics. The Company's obesity and metabolic disorders program is advancing ALN1003, an oral small-molecule candidate being evaluated as a potential differentiated, non-hormonal, non-incretin approach for obesity- and metabolic-disease-relevant biology. ... Alaunos Therapeutics announced today the completion of the acquisition of Velaris Therapeutics, Inc., a privately-held biotechnology company advancing a pipeline of potentially transformative therapies for pulmonary arterial hypertension ("PAH") and related cardiopulmonary diseases. A concurrent private placement of Series C non-voting convertible preferred stock (the "Private Placement") was led by Fairmount with participation from Venrock Healthcare Capital Partners, certain accounts advised by T. Rowe Price Investment Management, Inc., Wellington Management, Janus Henderson Investors, Access Biotechnology, BB Biotech, Perceptive Advisors, Sirenia Capital Management LP, ADAR1 Capital Management and other leading investment management firms. The private placement resulted in gross proceeds to Alaunos of approximately $350 million and is expected to fund operations into 2029, enabling the generation of key proof-of-concept data sets for VLR199 and VLR360, as well as through initial regulatory filings for VLR247 and VLR258. Biotech Stock bioAffinity Technologies (Nasdaq: BIAF) Soars on Japanese Patent AllowanceOctober 8, 2026 · Pacira BioSciences (Nasdaq: PCRX) Makes 52 Week High on Acquisition NewsOctober 8, 2026
The San Diego-based biotech's upsized offering highlights growing confidence in siRNA innovation as the firm prepares for Nasdaq debut. Late-stage clinical biotechnology company ADARx Pharmaceuticals has announced the successful pricing of its upsized initial public offering (IPO). Related:Scribe rips the script with upsized $128.7m IPO · ADARx’s technology has been designed to control the expression of specific disease drivers through highly selective RNA-targeted therapies. ADARx said it is advancing a pipeline of highly potent, durable, and selective RNA-targeted therapeutic candidates targeting complement-mediated diseases, genetic disorders, cardiovascular conditions, thrombosis, central nervous system (CNS) diseases, and metabolic disorders including obesity – one of healthcare's most pressing challenges. Beyond its wholly owned programs, ADARx has strategically positioned itself through collaboration and license option agreements, expanding its reach and de-risking its development pathway. AbbVie is also executing a private placement that will provide the firm with around 4.9% of ADARx’s outstanding shares after the IPO closes. The pair inked a licensing deal in May 2025 that included a $335 million upfront payment to develop small interfering RNA (siRNA) therapeutics across multiple disease areas. With nearly half a billion dollars in fresh capital, ADARx is well-positioned to advance its pipeline through critical clinical milestones and potentially toward commercialization. ADARx’s IPO is the third largest this year.
The supplied market analysis estimates ... having a genetic component and a significant proportion involving pediatric onset. Neurological disorders represent an important category within the rare-disease landscape, while oncology, hematology, metabolic disorders, pulmonary diseases, and other therapeutic areas are also attracting substantial research attention. The orphan drugs industry is evolving alongside advances in genomics, molecular biology, cell therapy, and ... The supplied market analysis estimates that approximately 6,000 to 8,000 rare diseases have been identified, with around 80% having a genetic component and a significant proportion involving pediatric onset. Neurological disorders represent an important category within the rare-disease landscape, while oncology, hematology, metabolic disorders, pulmonary diseases, and other therapeutic areas are also attracting substantial research attention. The orphan drugs industry is evolving alongside advances in genomics, molecular biology, cell therapy, and precision medicine. Pharmaceutical and biotechnology companies are expanding pipelines targeting rare cancers, neurological disorders, hematological diseases, genetic conditions, and metabolic disorders. Advances in genomics, cell therapy, gene-editing technologies, and biologics are broadening the scientific basis for developing treatments for conditions that previously had limited therapeutic options. The global orphan drugs market was valued at approximately US 195 0 billion in 2023 and is projected to grow at a CAGR of 6 9 from 2024 to 2034 reaching approximately US 424 0 billion by the end of ... Press release - Transparency Market Research - Orphan Drugs Market to Reach US$424.0 Billion by 2034 Amid Rising Rare Disease Burden and R&D Investments - TMR - published on openPR.com