HSN-FLVCR1

FLVCR1 | 2019

What Is HSN-FLVCR1?

HSN-FLVCR1 is a type of CMT caused by autosomal recessive mutations in the FLVCR1 gene. This gene provides instructions for making a transporter protein that supports the survival of sensory nerve cells. Mutations in the FLVCR1 gene disrupt this function, leading to impaired nerve signal transmission.

HSN-FLVCR1 is autosomal recessive, meaning that both copies of the gene must have a mutation to cause this subtype.

Clinical Features

The age of symptom onset in HSN-FLVCR1 is variable, ranging from childhood to adulthood. The disease involves loss of sensation that begins in the hands and feet (glove-and-stocking distribution) and progresses over time towards the center of the body. Nerve conduction studies usually show somewhat slowed conduction velocities and reduced amplitudes, consistent with an axonal form of CMT.

HSN-FLVCR1 symptoms may include:

  • Progressive loss of sensation in the feet and hands
  • Loss of pain and temperature sensation
  • Reduced or absent reflexes
  • Foot deformities, including high arches, and hammertoes (clawed toes)
  • Distal weakness that develops as the disease progresses
  • Foot drop
  • Additional symptoms not listed here

Disease Course

HSN-FLVCR1 shows wide variability in severity and progression. Some individuals are mildly affected, while others develop a more severe disease. Disease progression is generally slow, and life expectancy is not reduced.

Clinical Basics

Subtype
HSN-FLVCR1

Classification
HSN

Subtype Alias
AXPC1

Neuropathy Type
Axonal

Inheritance Pattern
autosomal recessive

Genetic Context

HGNC-Approved Gene Symbol
FLVCR1

Gene Full Name
Flvcr Choline and Heme Transporter 1

HGNC Gene Alias(es)
FLVCR

Chromosome
1q32.3

Zygosity of Responsible Variant
Homozygous or Compound Heterozygous

Variant Mechanism

Loss of Function (LoF)

Details

Mechanistic basis:
Biallelic

Confidence:
High

Prediction:
The literature predicts a biallelic loss-of-function mechanism for HSN-FLVCR1: recessive homozygous or compound-heterozygous variants impair FLVCR1 choline and heme transporter activity, so both copies must be lost to compromise sensory neuron survival. Restored wild-type FLVCR1 is predicted to rescue, consistent with loss rather than a dominant-negative or gain-of-function effect.

Rationale:
Biallelic FLVCR1 variants lose heme and choline transporter function, so restored wild-type is predicted to rescue: a simple recessive loss rather than a dominant-negative or gain-of-function effect.

ClinVar Pathogenic Variants

View HSN-FLVCR1 ClinVar Variants

FLVCR1 OMIM Entry

FLVCR1 OMIM

More Info

HSN-FLVCR1 Research Opportunity

CMT Natural History Study

Original Discovery Publication

Publication Title

Heme and Sensory Neuropathy: Insights from Novel Mutations in the Heme Exporter Feline Leukemia Virus Subgroup C Receptor 1

Authors

Bertino, F., Firestone, K., Bellacchio, E., Jackson, K. E., Asamoah, A., Hersh, J., Fiorito, V., Destefanis, F., Gonser, R., Tucker, M. E., Altruda, F., Tolosano, E., & Chiabrando, D.

Publication Date
December 1, 2019

Updated: July 18, 2026 | By: K. Raymond

The Dorsal Root

More From The Dorsal Root


Jean-Martin Charcot lecturing at the Salpêtrière while comparing anatomical illustrations of a cavovarus Charcot-Marie-Tooth (CMT) foot and a Charcot neuroarthropathy foot, highlighting two different conditions that share the Charcot name.


A Name That Does Too Much Work

Jean-Martin Charcot's name appears throughout medicine, but nowhere does it create more confusion than in the foot. Learn why the CMT foot and Charcot neuroarthropathy, also known as Charcot foot, share a name yet differ in how they develop, appear, and are managed.


Close-up of a doctor’s hand holding a prescription pad while a patient’s wrist is wrapped with metal chains.


When Medicine Lost Its Compass

Evidence failed not because it was wrong, but because it was weaponized. I lived the downstream effects of that failure for more than a decade. This is what happens when medicine forgets that data always ends in a human being.


Illustrated graphic showing large ‘404’ numerals with people interacting with data screens and servers, alongside text reading ‘CMT Genetic Testing Error 404: Gene Not Found’ and ‘Examining Why Less Than Half of All Who Have Charcot-Marie-Tooth Disease Are Not Able to Obtain Genetic Confirmation of Their Disease.


Error 404: Gene Not Found

CMT genetic testing often fails to identify the cause of the disease, even when comprehensive panels are used. Here, we discuss why this happens, what genetic tests can and cannot do, and why a negative result still matters.