has material basis in germline mutation in SMN1 spinal muscular atrophy, type IV https://github.com/monarch-initiative/mondo/issues/4521 https://www.malacards.org/card/spinal_muscular_atrophy_type_iv spinal muscular atrophy, adult form icd11.foundation:443229384 SMA type 4 spinal muscular atrophy of adults ICD9:335.19 SMA4 spinal muscular atrophy 4 SMA 4 NANDO:1200007 OMIM:271150 UMLS:C1838230 SMA-IV spinal muscular atrophy-4 spinal muscular atrophy, proximal, adult, autosomal recessive spinal muscular atrophy, type IV Orphanet:83420 MESH:C563948 DOID:0050529 MEDGEN:325364 spinal muscular atrophy type 4 GARD:0000564 adult-onset spinal muscular atrophy Proximal spinal muscular atrophy type 4 (SMA4) is the adult-onset form of proximal spinal muscular atrophy characterized by muscle weakness and hypotonia resulting from the degeneration and loss of the lower motor neurons in the spinal cord and the brain stem nuclei. SMA type IV SCTID:85505000 MONDO:0010056 proximal spinal muscular atrophy