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Genetics Home Reference: your guide to understanding genetic conditions
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Farber lipogranulomatosis

Reviewed December 2013

What is Farber lipogranulomatosis?

Farber lipogranulomatosis is a rare inherited condition involving the breakdown and use of fats in the body (lipid metabolism). In affected individuals, lipids accumulate abnormally in cells and tissues throughout the body, particularly around the joints.

Three classic signs occur in Farber lipogranulomatosis: a hoarse voice or a weak cry, small lumps of fat under the skin and in other tissues (lipogranulomas), and swollen and painful joints. Affected individuals may also have difficulty breathing, an enlarged liver and spleen (hepatosplenomegaly), and developmental delay.

Researchers have described seven types of Farber lipogranulomatosis based on their characteristic features.

Type 1 is the most common, or classical, form of this condition and is associated with the classic signs of voice, skin, and joint problems that begin a few months after birth. Developmental delay and lung disease also commonly occur. Infants born with type 1 Farber lipogranulomatosis usually survive only into early childhood.

Types 2 and 3 generally have less severe signs and symptoms than the other types. Affected individuals have the three classic signs and usually do not have developmental delay. Children with these types of Farber lipogranulomatosis typically live into mid- to late childhood.

Types 4 and 5 are associated with severe neurological problems. Type 4 usually causes life-threatening health problems beginning in infancy due to massive lipid deposits in the liver, spleen, lungs, and immune system tissues. Children with this type typically do not survive past their first year of life. Type 5 is characterized by progressive decline in brain and spinal cord (central nervous system) function, which causes paralysis of the arms and legs (quadriplegia), seizures, loss of speech, involuntary muscle jerks (myoclonus), and developmental delay. Children with type 5 Farber lipogranulomatosis survive into early childhood.

Types 6 and 7 are very rare, and affected individuals have other associated disorders in addition to Farber lipogranulomatosis.

How common is Farber lipogranulomatosis?

Farber lipogranulomatosis is a rare disorder. About 80 cases have been reported worldwide.

What genes are related to Farber lipogranulomatosis?

Mutations in the ASAH1 gene cause Farber lipogranulomatosis. The ASAH1 gene provides instructions for making an enzyme called acid ceramidase. This enzyme is found in cell compartments called lysosomes, which digest and recycle materials. Acid ceramidase breaks down fats called ceramides into a fat called sphingosine and a fatty acid. These two breakdown products are recycled to create new ceramides for the body to use. Ceramides have several roles within cells. For example, they are a component of a fatty substance called myelin that insulates and protects nerve cells.

Mutations in the ASAH1 gene lead to severe reduction in acid ceramidase, typically to below 10 percent of normal. As a result, the enzyme cannot break down ceramides properly and they build up in the lysosomes of various cells, including in the lung, liver, colon, muscles used for movement (skeletal muscles), cartilage, and bone. The buildup of ceramides along with the reduction of its fatty breakdown products in cells likely causes the signs and symptoms of Farber lipogranulomatosis. It is unclear whether the level of acid ceramidase activity is related to the severity of the disorder.

Related Gene(s)

Changes in this gene are associated with Farber lipogranulomatosis.

  • ASAH1

How do people inherit Farber lipogranulomatosis?

This condition is inherited in an autosomal recessive pattern, which means both copies of the gene in each cell have mutations. The parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition.

Where can I find information about diagnosis or management of Farber lipogranulomatosis?

These resources address the diagnosis or management of Farber lipogranulomatosis and may include treatment providers.

  • Genetic Testing Registry: Farber's lipogranulomatosis (http://www.ncbi.nlm.nih.gov/gtr/conditions/C0268255)

You might also find information on the diagnosis or management of Farber lipogranulomatosis in Educational resources (http://ghr.nlm.nih.gov/condition/farber-lipogranulomatosis/show/Educational+resources) and Patient support (http://ghr.nlm.nih.gov/condition/farber-lipogranulomatosis/show/Patient+support).

General information about the diagnosis (http://ghr.nlm.nih.gov/handbook/consult/diagnosis) and management (http://ghr.nlm.nih.gov/handbook/consult/treatment) of genetic conditions is available in the Handbook. Read more about genetic testing (http://ghr.nlm.nih.gov/handbook/testing), particularly the difference between clinical tests and research tests (http://ghr.nlm.nih.gov/handbook/testing/researchtesting).

To locate a healthcare provider, see How can I find a genetics professional in my area? (http://ghr.nlm.nih.gov/handbook/consult/findingprofessional) in the Handbook.

Where can I find additional information about Farber lipogranulomatosis?

You may find the following resources about Farber lipogranulomatosis helpful. These materials are written for the general public.

You may also be interested in these resources, which are designed for healthcare professionals and researchers.

What other names do people use for Farber lipogranulomatosis?

  • AC deficiency
  • acid ceramidase deficiency
  • acylsphingosine deacylase deficiency
  • ceramidase deficiency
  • Farber disease
  • Farber's disease
  • Farber's lipogranulomatosis
  • Farber-Uzman syndrome

For more information about naming genetic conditions, see the Genetics Home Reference Condition Naming Guidelines (http://ghr.nlm.nih.gov/ConditionNameGuide) and How are genetic conditions and genes named? (http://ghr.nlm.nih.gov/handbook/mutationsanddisorders/naming) in the Handbook.

What if I still have specific questions about Farber lipogranulomatosis?

Ask the Genetic and Rare Diseases Information Center (http://rarediseases.info.nih.gov/gard).

What glossary definitions help with understanding Farber lipogranulomatosis?

autosomal ; autosomal recessive ; breakdown ; cartilage ; cell ; central nervous system ; ceramides ; colon ; deficiency ; developmental delay ; enzyme ; gene ; hepatosplenomegaly ; immune system ; inherited ; involuntary ; joint ; lipid ; lipogranulomatosis ; metabolism ; myoclonus ; nervous system ; neurological ; quadriplegia ; recessive ; syndrome

You may find definitions for these and many other terms in the Genetics Home Reference Glossary (http://ghr.nlm.nih.gov/glossary).

References

  • Alves MQ, Le Trionnaire E, Ribeiro I, Carpentier S, Harzer K, Levade T, Ribeiro MG. Molecular basis of acid ceramidase deficiency in a neonatal form of Farber disease: identification of the first large deletion in ASAH1 gene. Mol Genet Metab. 2013 Jul;109(3):276-81. doi: 10.1016/j.ymgme.2013.04.019. Epub 2013 May 4. (http://www.ncbi.nlm.nih.gov/pubmed/23707712?dopt=Abstract)
  • Bär J, Linke T, Ferlinz K, Neumann U, Schuchman EH, Sandhoff K. Molecular analysis of acid ceramidase deficiency in patients with Farber disease. Hum Mutat. 2001 Mar;17(3):199-209. (http://www.ncbi.nlm.nih.gov/pubmed/11241842?dopt=Abstract)
  • Devi AR, Gopikrishna M, Ratheesh R, Savithri G, Swarnalata G, Bashyam M. Farber lipogranulomatosis: clinical and molecular genetic analysis reveals a novel mutation in an Indian family. J Hum Genet. 2006;51(9):811-4. Epub 2006 Sep 2. (http://www.ncbi.nlm.nih.gov/pubmed/16951918?dopt=Abstract)
  • Ehlert K, Frosch M, Fehse N, Zander A, Roth J, Vormoor J. Farber disease: clinical presentation, pathogenesis and a new approach to treatment. Pediatr Rheumatol Online J. 2007 Jun 29;5:15. (http://www.ncbi.nlm.nih.gov/pubmed/17603888?dopt=Abstract)
  • Farina F, Cappello F, Todaro M, Bucchieri F, Peri G, Zummo G, Stassi G. Involvement of caspase-3 and GD3 ganglioside in ceramide-induced apoptosis in Farber disease. J Histochem Cytochem. 2000 Jan;48(1):57-62. (http://www.ncbi.nlm.nih.gov/pubmed/10653586?dopt=Abstract)

 

The resources on this site should not be used as a substitute for professional medical care or advice. Users seeking information about a personal genetic disease, syndrome, or condition should consult with a qualified healthcare professional. See How can I find a genetics professional in my area? (http://ghr.nlm.nih.gov/handbook/consult/findingprofessional) in the Handbook.

 
Reviewed: December 2013
Published: February 23, 2015