Perrault Syndrome 4, also known as prlts4, is related to perrault syndrome and hydrops, lactic acidosis, and sideroblastic anemia. An important gene associated with Perrault Syndrome 4 is LARS2 (Leucyl-TRNA Synthetase 2, Mitochondrial). Affiliated tissues include brain and uterus, and related phenotypes are progressive sensorineural hearing impairment and increased circulating gonadotropin level