What happens in this disease?
Changes in the ATM gene cause the disease. This gene makes a protein that helps repair damaged DNA. When the protein does not work, cells in the cerebellum are damaged. The immune system is weakened and the cells become very sensitive to radiation.
Which symptoms can occur?
Symptoms usually begin before the age of 5.
- Difficulty walking and with balance, called ataxia
- Slurred speech
- Difficulty moving the eyes to the side
- Widened small blood vessels in the whites of the eyes and on the skin, called telangiectasia
- Frequent, recurring lung infections
- An increased risk of blood cancers such as leukemia and lymphoma
- Extreme sensitivity to radiation, including X-rays
How is it diagnosed?
The doctor examines the child and looks at the symptoms. Alpha-fetoprotein (AFP) in the blood is usually high. Immune tests are done, and the diagnosis is confirmed with a genetic test that looks at the ATM gene.
Treatment and care
In September 2026, an approved treatment specific to the disease became available in the USA for movement and balance problems. This treatment does not cure the disease itself. Physiotherapy and speech therapy provide support. Immune deficiency and nutrition problems are managed separately. Unnecessary X-rays are avoided, and radiation therapy is avoided. The doctor who follows the disease decides which treatment is suitable.
For the family: inheritance and genetic counselling
The disease is passed on through recessive inheritance. The mother and father are usually healthy carriers. For a couple who are both carriers, the chance of having an affected child is 1 in 4 in each pregnancy. Recessive diseases can be more common in families where relatives marry each other. Carriers do not develop the disease, but the risk of some cancers may be increased. Women who are carriers have a higher risk of breast cancer. Genetic counselling helps the family talk through these risks.