Trust your instinct.
It could be NPC

Luiz Felipe,
2 years old, living with infantile-onset NPC, and dad, Tiago.

Niemann-Pick type C, or NPC, is a rare, inherited condition that can have an irreversible effect on a child’s development and shorten life expectancy.1,2

About NPC

NPC is a condition in which the body is not able to move and clear cholesterol from the cells. It impacts about 1000 people in the United States at any one time, though many cases may go unrecognized. Over time, it can affect the brain, nervous system, and other parts of the body. When neurological symptoms begin before the child turns 6 years old, the condition is referred to as infantile-onset NPC.2-4

About NPC

Signs of infantile-onset NPC in children

NPC can show up differently depending on a child’s age.2

Neurological symptoms that begin before the child turns 2 years old

EARLY SIGNS IN THE BODY:
  • Yellowing of the skin and eyes in newborns that lasts longer than usual
  • Enlarged spleen and/or liver
  • Buildup in the lungs and/or breathing problems
NEUROLOGICAL SYMPTOMS FOLLOW:
  • Low muscle tone
  • Inability to move the eyes up and down
  • Delayed or loss of previously acquired milestones
  • Speech delay
  • Difficulty swallowing
  • Muscle stiffness

Neurological symptoms that begin between ages 2 and 6

History of earlier signs:
  • Yellowing of the skin and eyes in newborns that lasts longer than usual
  • Enlarged spleen and/or liver
  • Buildup in the lungs and/or breathing problems
Neurological symptoms follow:
  • Inability to move the eyes up and down
  • Difficulty moving the eyes up and down quickly
  • Sudden muscle weakness brought on by emotion or laughter
  • Delayed or loss of previously acquired milestones
  • Speech delay
  • Loss of coordination and balance
  • Frequent falls and clumsiness
  • Muscles tightening or pulling involuntarily, causing twisting or abnormal posture
  • Trouble speaking clearly
  • Difficulty swallowing
  • Hearing impairment related to NPC
  • Seizures

Could this be NPC?

Use this symptom checklist to help understand whether what you’re seeing could be signs of NPC.

This checklist is meant to help you understand possible symptoms and should not replace guidance from a healthcare provider. It should be used for children experiencing neurological symptoms before 6 years of age.

Have you noticed any of these early signs?

Some children with NPC experience these signs after birth. Select any that your child has now or has experienced in the past.1

0 out of 3 symptoms selected

Is there a known family history of NPC in a biological relative?

Confirm if anyone in your family has been diagnosed with NPC.

RESULTS

It may be time to start a conversation.

Based on the signs and symptoms you selected, consider talking with your child's healthcare provider about genetic testing.

NEXT STEPS
Be prepared for the conversation

Use this guide to help prepare 
for a conversation with your child's healthcare provider about 
genetic testing.

Find experienced care

A healthcare provider experienced in treating NPC can help guide next steps, answer questions, and support your child’s care.

This checklist is meant to help you understand possible symptoms and should not replace guidance from a healthcare provider. It should be used for children experiencing neurological symptoms before 6 years of age.

NEXT STEPS
Be prepared for the conversation

Use this guide to help prepare for a conversation with your child's healthcare provider about genetic testing.

Find experienced care

A healthcare provider experienced in treating NPC can help guide next steps, answer questions, and support your child’s care.

RESULTS

If you still have concerns, don’t stop asking questions.

The information you shared doesn’t necessarily point to NPC based on this checklist alone. But you still know your child best. If you’re concerned about your child’s symptoms or how they’re changing over time, continue the conversation with your child’s healthcare provider or an NPC specialist.

NEXT STEPS
Find experienced care

A healthcare provider experienced in treating NPC can help guide next steps, answer questions, and support your child’s care.

Be prepared for the conversation

Use this guide to help prepare for a conversation with your child's healthcare provider about genetic testing.

This checklist is meant to help you understand possible symptoms and should not replace guidance from a healthcare provider. It should be used for children experiencing neurological symptoms before 6 years of age.

NEXT STEPS
Find experienced care

A healthcare provider experienced in treating NPC can help guide next steps, answer questions, and support your child’s care.

Be prepared for the conversation

Use this guide to help prepare for a conversation with your child's healthcare provider about genetic testing.

RESULTS

It may be time to start a conversation.

Based on the signs and symptoms you selected, consider talking with your child’s healthcare provider about genetic testing.

NEXT STEPS
Be prepared for the conversation

Use this guide to help prepare a conversation with your child’s healthcare provider about genetic testing.

QR_conversation_starter

Access conversation starter

Find experienced care

A healthcare provider experienced in treating NPC can help guide next steps, answer questions, and support your child’s care.

QR_find_a_checklist

Find a specialist

This checklist is meant to help you understand possible symptoms and should not replace guidance from a healthcare provider. It should be used for children experiencing neurological symptoms before 6 years of age.

RESULTS

If you still have concerns, don’t stop asking questions.

The information you shared doesn’t necessarily point to NPC based on this checklist alone. But you still know your child best. If you’re concerned about your child’s symptoms or how they’re changing over time, continue the conversation with your child’s healthcare provider or an NPC specialist.

NEXT STEPS
Find experienced care

A healthcare provider experienced in treating NPC can help guide next steps, answer questions, and support your child’s care.

QR_specialist

Find a specialist

Be prepared for the conversation

Use this guide to help prepare for conversations with your child’s healthcare provider about genetic testing.

QR_conversation

Access conversation starter

This checklist is meant to help you understand possible symptoms and should not replace guidance from a healthcare provider. It should be used for children experiencing neurological symptoms before 6 years of age.

DON’T RISK
MISSING NPC

In children between ages 2 and 6, neurological symptoms of NPC are often mistaken for other conditions such as2,5:

  • Neurodevelopmental/neurodegenerative/neuromuscular disorders
  • Inherited metabolic/lysosomal disorders
  • Liver disorders
  • Infectious diseases
  • Hematologic/oncologic disorders
  • Psychiatric disorders

You don't need to see all of these signs to ask your doctor about genetic testing for NPC. Early diagnosis can help families plan care, access support sooner, and delay neurological progression.2,6

Fill out and bring this discussion guide to your child's doctor to see if genetic testing is the next step.

Find care from an NPC-experienced center

Use our specialist finder tool to search for healthcare providers and care centers experienced in diagnosing and managing NPC near you.

References: 1. Pineda M, Mengel E, Jahnová H, et al. A suspicion index to aid screening of early-onset Niemann-Pick disease type C (NP-C). BMC Pediatr. 2016;16:107. doi:10.1186/s12887-016-0641-7 2. Hiwot T, Porter FD, Bremova-Ertl T, et al. 2025 Consensus Clinical Management Guidelines for Niemann-Pick Disease Type C. J Inherit Metab Dis. 2026;49(3):e70185. doi:10.1002/jimd.70185 3. Burton BK, Ellis AG, Orr B, et al. Estimating the prevalence of Niemann-Pick disease type C (NPC) in the United States. Mol Genet Metab. 2021;134(1-2):182-187. doi:10.1016/j.ymgme.2021.06.011 4. Berry-Kravis E. Niemann-Pick Disease, Type C: diagnosis, management and disease-targeted therapies in development. Semin Pediatr Neurol. 2021;37:100879. doi:10.1016/j.spen.2021.100879 5. Bremova-Ertl T, Patterson M. Niemann-Pick disease type C. In: Adam MP, Bick S, Mirzaa GM, et al, eds. GeneReviews® [Internet]. Updated November 20, 2025. Accessed August 10, 2026. https://www.ncbi.nlm.nih.gov/books/NBK1296/ 6. Geberhiwot T, Moro A, Dardis A, et al. Consensus Clinical Management Guidelines for Niemann-Pick Disease Type C. Orphanet J Rare Dis. 2018;13(1):50. doi:10.1186/s13023-018-0785-7

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