Merck Manual

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Wolf-Hirschhorn Syndrome

(4p Minus Syndrome)

By

Nina N. Powell-Hamilton

, MD, Sidney Kimmel Medical College at Thomas Jefferson University

Reviewed/Revised Dec 2021 | Modified Sep 2022
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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 A cleft is an opening that can form in the lip (cleft lip), roof of the mouth (cleft palate), or both if the tissue does not join together completely during pregnancy. Cleft lip and cleft palate... 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 Birth 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... 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. (See also Next-generation sequencing technologies Next-generation sequencing technologies Genetic diagnostic technologies are scientific methods that are used to understand and evaluate an organism's genes. (See also Genes and Chromosomes.) Genes are segments of deoxyribonucleic... read more .)

Treatment of Wolf-Hirschhorn Syndrome

  • Supportive care

Treatment of Wolf-Hirschhorn syndrome is supportive.

NOTE: This is the Consumer Version. DOCTORS: VIEW PROFESSIONAL VERSION
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