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IEMbase 0748: ACSL4-related long-chain fatty acid-CoA ligase 4 deficiency

Scope

Field Value
IEMbase ID 748
Nosology 14.1.01.02
Nosology code IEM0655
Gene ACSL4
External IDs OMIM:300387; ORPHA:86818
Generated mapping UNMAPPED; weak candidate VLCAD_Deficiency.yaml
Candidate DisMech targets None exact
Review date 2026-07-07

IEMbase phenotype signal

IEMbase labels this X-linked record as ACSL4-related long-chain fatty acid-CoA ligase 4 deficiency, with alternate name X-linked mental retardation 63. The cached signal is sparse but specific: decreased enzyme activity in fibroblasts and white blood cells in adulthood, and characteristic intellectual disability in adolescent and adult age bands.

DisMech phenotype coverage

No exact ACSL4 / X-linked intellectual disability 63 entry is present locally. Wilsons_Disease.yaml mentions ACSL4 only as pathway context for ferroptosis; it is not ACSL4-related disease coverage.

The generated VLCAD_Deficiency.yaml candidate is a false positive. VLCAD deficiency is an ACADVL long-chain fatty acid beta-oxidation disorder with a different gene, inheritance context, biochemical mechanism, and clinical presentation.

Concordance and completeness

Judgement: true local gap.

The IEMbase record is concise and mainly establishes disease identity, X-linked inheritance, reduced ACSL4 activity, and intellectual disability. That is enough to distinguish it from fatty acid oxidation disorders such as VLCAD.

Curation actions

  • Add a distinct ACSL4 / X-linked intellectual disability 63 target if this disease is brought into DisMech.
  • Reject VLCAD_Deficiency.yaml as exact or partial identity coverage.
  • Preserve the enzyme-activity evidence separately from phenotype assertions.