d-bifunctional protein deficiency
Findings
No curated finding names d-bifunctional protein deficiency yet. Everything below is reference data from Mondo, HPO and GenCC, not evidence about what affects it.
Definition
A genetic disorder that affects the ability of the body to effectively break down fat from our diet. It is typically characterized by hypotonia (low muscle tone) and seizures in the newborn period. Other symptoms include unusual facial features and an enlarged liver (hepatomegaly). Most babies with this condition nevergain anydevelopmental skills and do not survive past the age of 2. DBP deficiency is caused by mutations in the HSD17B4 gene and is inherited in an autosomal recessive manner. Some researchers have suggested classifying DBP deficiency into three subtypes, depending on how severely the mutation in the HSD17B4 gene affects the function of the gene and the protein that it codes for. Almost all individuals with types I, II, and III have similar signs and symptoms. A fourth subtype has additionally been proposed for individuals that have less severe symptoms. While there is no cure for DBP deficiency, treatment is focused on improving nutrition and growth, controlling symptoms, and limiting the progression of liver disease.
Definition from the Mondo Disease Ontology (MONDO:0009855), read 2026-09-29. CC BY 4.0.
- Inheritance
- Autosomal recessive inheritance
- Onset and course
- Neonatal onset
HPO, annotations 2026-09-02
Features
47 features
What the disease is reported to present with, and how often among people who have it — never how often a feature means the disease. HPO, annotations 2026-09-02.
- Bilateral tonic-clonic seizureHPOHP:0002069
- 2 of 2 reported patients
- Calcific stipplingHPOHP:0002832
- 12 of 12 reported patients
- Elevated circulating hepatic transaminase concentrationHPOHP:0002910
- 2 of 2 reported patients
- Global developmental delayHPOHP:0001263
- 126 of 126 reported patients
- HypotoniaHPOHP:0001252
- 2 of 2 reported patients
- Increased circulating very long-chain fatty acid concentration
Genes
1 gene
Germline variants in the gene encoding each protein, as classified by GenCC submitters, each in their own words. Limited, disputed and refuted submissions are listed too.
- HSD17B4HGNC:5213
- Definitive · Ambry Genetics · Autosomal recessive · 2020
- Definitive · ClinGen · Autosomal recessive · 2020
- Definitive · Myriad Women's Health · Autosomal recessive · 2019
- Definitive · G2P · Autosomal recessive · 2015
- Definitive · Natera · Autosomal recessive · 2023
- Strong · Labcorp Genetics (formerly Invitae) · Autosomal recessive · 2022
- Strong · PanelApp Australia · Autosomal recessive · 2025
Where it sits
Other names
6 names
Resolves to: d-bifunctional protein deficiency
- Also called
- D-bifunctional enzyme deficiencyHSD17B4 deficiencymultifunctional enzyme deficiencyperoxisomal multifunctional enzyme (MFE2) deficiencyperoxisomal multifunctional enzyme deficiencypseudo-Zellweger syndrome