HNRNPD-Related Syndrome

Table of contents
- What is HNRNPD-related syndrome?
- Key Role
- Symptoms
- What causes HNRNPD-related syndrome?
- Why does my child have a change in the HNRNPD gene?
- What are the chances that other family members or future children will have HNRNPD-related syndrome?
- How many people have HNRNPD-related syndrome?
- Do people who have HNRNPD-related syndrome look different?
- How is HNRNPD-related syndrome treated?
- Behavior and development concerns linked to HNRNPD-related syndrome
- Medical and physical concerns linked to HNRNPD-related syndrome
- Where can I find support and resources?
- Sources and References
What is HNRNPD-related syndrome?
HNRNPD-related syndrome happens when there are changes in the HNRNPD gene. These changes can keep the gene from working as it should.

Key Role
The HNRNPD protein binds to a molecule in the cell called RNA. RNA is made from a DNA sequence and is needed for the cell to make proteins. The HNRNPD gene may play an important role in the development of the brain.
Symptoms
Because the HNRNPD gene might be important in development, some people may have:
- Developmental delay
- Intellectual disability
- Speech delay
- Emotional or behavioral issues
- Attention-deficit/hyperactivity disorder (ADHD)
- Seizures
What causes HNRNPD-related syndrome?
HNRNPD-related syndrome is a genetic condition, which means that it is caused by variants in genes. Our genes contain the instructions, or code, that tell our cells how to grow, develop, and work. Every child gets two copies of the HNRNPD gene: one copy from their mother’s egg, and one copy from their father’s sperm. In most cases, parents pass on exact copies of the gene to their child. But the process of creating the egg or sperm is not perfect. A change in the genetic code can lead to physical issues, developmental issues, or both.
Sometimes a spontaneous variant happens in the sperm, egg or after fertilization. When a brand new genetic variant happens in the genetic code is called a ‘de novo’ genetic variant. The child is usually the first in the family to have the genetic variant.
De novo variants can take place in any gene. We all have some de novo variants, most of which don’t affect our health. But because HNRNPD plays a key role in development, de novo variants in this gene can have a meaningful effect.
Research shows that HNRNPD-related syndrome is often the result of a de novo variant in HNRNPD. Many parents who have had their genes tested do not have the HNRNPD genetic variant found in their child who has the syndrome. In some cases, HNRNPD-related syndrome happens because the genetic variant was passed down from a parent.
Autosomal dominant conditions
HNRNPD-related syndrome is an autosomal dominant genetic condition. This means that when a person has the one damaging variant in HNRNPD they will likely have symptoms of HNRNPD-related syndrome. For someone with an autosomal dominant genetic syndrome, every time they have a child there is a 50 percent chance they pass on the same genetic variant and a 50 percent chance they do not pass on the same genetic variant.
Autosomal Dominant Genetic Syndrome
Why does my child have a change in the HNRNPD gene?
No parent causes their child’s HNRNPD-related syndrome. We know this because no parent has any control over the gene changes that they do or do not pass on to their children. Please keep in mind that nothing a parent does before or during the pregnancy causes this to happen. The gene change takes place on its own and cannot be predicted or stopped.
What are the chances that other family members or future children will have HNRNPD-related syndrome?
Each family is different. A geneticist or genetic counselor can give you advice on the chance that this will happen again in your family.
The risk of having another child who has HNRNPD-related syndrome depends on the genes of both biological parents.
- If neither biological parent has the same genetic variant found in their child, the chance of having another child who has the syndrome is on average 1 percent. This 1 percent chance is higher than the chance of the general population. The increase in risk is due to the very unlikely chance that more of the mother’s egg cells or the father’s sperm cells carry the same genetic variant.
- If one biological parent has the same genetic variant found in their child, the chance of having another child who has the syndrome is 50 percent.
For a symptom-free brother or sister of someone who has HNRNPD-related syndrome, the sibling’s risk of having a child who has HNRNPD-related syndrome depends on the sibling’s genes and their parents’ genes.
- If neither parent has the same genetic variant causing HNRNPD-related syndrome, the symptom-free sibling has a nearly 0 percent chance of having a child who would inherit HNRNPD-related syndrome.
- If one biological parent has the same genetic variant causing HNRNPD-related syndrome, the symptom-free sibling has a 50 percent chance of also having the same genetic variant. If the symptom-free sibling has the same genetic variant, their chance of having a child who has the genetic variant is 50 percent.
For a person who has HNRNPD-related syndrome, the risk of having a child who has the syndrome is about 50 percent.

How many people have HNRNPD-related syndrome?
As of 2025, about 13 people in the world with an HNRNPD genetic variant have been identified in medical research.

Do people who have HNRNPD-related syndrome look different?
People with an HNRNPD genetic variant may look different. Appearance can vary and can include, but are not limited to, these features:
- Ear defects or larger than average ears
- Rounder than average face

How is HNRNPD-related syndrome treated?
Scientists and doctors have only just begun to study HNRNPD-related syndrome. At this point, there are no medicines designed to treat the syndrome. A genetic diagnosis can help people decide on the best way to track the condition and manage therapies. Doctors can refer people to specialists for:
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- Physical exams and brain studies
- Genetics consults
- Development and behavior studies
- Other issues, as needed
A developmental pediatrician, neurologist, or psychologist can follow progress over time and can help:
-
- Suggest the right therapies. This can include physical, occupational, speech, or behavioral therapy.
- Guide individualized education plans (IEPs).
Specialists advise that therapies for HNRNPD-related syndrome should begin as early as possible, ideally before a child begins school.
If seizures happen, consult a neurologist. There are many types of seizures, and not all types are easy to spot. To learn more, you can refer to resources such as the Epilepsy Foundation’s website: www.epilepsy.com/learn/types-seizures.

This section includes a summary of information from major published articles. It highlights how many people have different symptoms. To learn more about the articles, see the Sources and References section of this guide.
Behavior and development concerns linked to HNRNPD-related syndrome
Speech and learning
Most people with HNRNPD-related syndrome had developmental delay or intellectual disability, gross and fine motor delay, and speech and/or language impairment.
- 10 out of 13 people had developmental delay or intellectual disability (77 percent)
- 8 out of 13 people had speech and/or language impairment (62 percent)
Behavior
People with HNRNPD-related syndrome had behavioral issues, such as autism, attention-deficit/hyperactivity disorder (ADHD), and aggressive, impulsive, or violent behavior.
- 6 out of 13 people had autism (46 percent)
- 2 out of 12 people had ADHD (17 percent)
- 4 out of 12 people had aggressive, impulsive, or violent behavior (33 percent)

Brain
Some people with HNRNPD-related syndrome had neurological medical issues, including seizures, lower than average muscle tone (hypotonia), a movement defect, and brain changes seen on magnetic resonance imaging (MRI).
- 2 out of 13 people had seizures (15 percent)
- 3 out of 12 people had hypotonia (25 percent)
- 5 out of 13 people had a movement defect (39 percent)
- 3 out of 12 people had brain changes seen on MRI (25 percent)

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Medical and physical concerns linked to HNRNPD-related syndrome
Other medical features
People with HNRNPD-related syndrome sometimes had feeding issues and/or gastrointestinal issues; genitourinary issues; vision issues; and ear defects.
- 4 out of 12 people had feeding difficulties and/or gastrointestinal issues (33 percent)
- 4 out of 13 people had genitourinary issues (31 percent)
- 4 out of 12 people had vision issues (33 percent)
- 3 out of 12 people had ear defects (25 percent)

Where can I find support and resources?
HNRNP Family Foundation
The HNRNP Family Foundation is dedicated to improving the lives of patients and families around the world that live with rare HNRNP-Related Neurodevelopmental Disorders (HNRNP-RNDDs). They work closely with dedicated scientists and the medical community to drive patient-centered research. They are committed to finding treatments and creating a neurodiverse affirming community through education and support.
Simons Searchlight
Simons Searchlight is an online international research program, building an ever growing natural history database, biorepository, and resource network of over 175 rare genetic neurodevelopmental disorders. By joining their community and sharing your experiences, you contribute to a growing database used by scientists worldwide to advance the understanding of your genetic condition. Through online surveys and optional blood sample collection, they gather valuable information to improve lives and drive scientific progress. Families like yours are the key to making meaningful progress. To register for Simons Searchlight, go to the Simons Searchlight website at www.simonssearchlight.org and click “Join Us.”
- Learn more about Simons Searchlight – www.simonssearchlight.org/frequently-asked-questions
- Simons Searchlight webpage with more information on HNRNPD – www.simonssearchlight.org/research/what-we-study/hnrnpd

Sources and References
- Gillentine, M. A., Wang, T., Hoekzema, K., Rosenfeld, J., Liu, P., Guo, H., Kim, C. N., De Vries, B. B. A., Vissers, L., … & Eichler, E. E. (2021). Rare deleterious mutations of HNRNP genes result in shared neurodevelopmental disorders. Genome Medicine, 13(1), 63. doi:10.1186/s13073-021-00870-6