Merck Manual

Please confirm that you are not located inside the Russian Federation

honeypot link

Wolf-Hirschhorn Syndrome

(4p Minus Syndrome)


Nina N. Powell-Hamilton

, MD, Sidney Kimmel Medical College at Thomas Jefferson University

Last full review/revision Jul 2020| Content last modified Jul 2020
Click here for the Professional Version

In Wolf-Hirschhorn syndrome, part of chromosome 4 is missing.

Children who survive into their 20s typically have severe disabilities.

Symptoms of Wolf-Hirschhorn Syndrome

Symptoms of Wolf-Hirschhorn syndrome often include profound intellectual disability Intellectual Disability Intellectual disability is significantly below average intellectual functioning present from birth or early infancy, causing limitations in the ability to conduct normal activities of daily... read more . Children may also have epilepsy Seizures in Children Seizures are a periodic disturbance of the brain’s electrical activity, resulting in some degree of temporary brain dysfunction. When older infants or young children have seizures, they often... read more , a broad or beaked nose, scalp defects, drooping upper eyelids (ptosis) and gaps or fissures (colobomas) of the iris, cleft palate Cleft Lip and Cleft Palate The most common birth defects of the skull and face are cleft lip and cleft palate, affecting about 2 of every 1,000 babies. Cleft lip is a separation of the upper lip, usually just below the... read more Cleft Lip and Cleft Palate , and delayed bone development. Boys may have undescended testes Undescended Testes and Retractile Testes Undescended testes (cryptorchidism) are testes that remain in the abdomen or the groin instead of descending into the scrotum. Retractile testes (hypermobile testes) have descended into the... read more Undescended Testes and Retractile Testes (cryptorchidism) and a misplaced opening of the urethra (hypospadias Hypospadias Defects of the genitals can involve the penis, scrotum, or testes (testicles) in boys and the vagina and labia in girls. Sometimes the genitals are ambiguous, that is, not clearly female or... read more Hypospadias ). Some children have an immune deficiency, which means their body is less able to fight off infections. Many affected children die during infancy.

Diagnosis of Wolf-Hirschhorn Syndrome

  • Chromosomal testing

The diagnosis of Wolf-Hirschhorn syndrome may be suspected by chromosomal testing before birth or by the child's physical characteristics after birth. The diagnosis can be confirmed by chromosomal testing.

Treatment of Wolf-Hirschhorn Syndrome

  • Supportive care

Treatment of Wolf-Hirschhorn syndrome is supportive.

NOTE: This is the Consumer Version. DOCTORS: Click here for the Professional Version
Click here for the Professional Version
Others also read
Test your knowledge
Preventive Health Care Visits in Infants
Frequent doctor visits are recommended for all infants younger than 1 year of age. These visits, also called well-child visits, make it possible to check development, look for health problems, provide age-appropriate vaccinations, and educate parents. Which of the following is a condition that might affect some infants born very prematurely, with less than 32 weeks of development in the uterus?
Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID

Also of Interest

Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID