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Adrenoleukodystrophy.
[adrenomyeloneuropathy]
X-
linked
adrenoleukodystrophy
(
ALD
)
is
caused
by
mutations
in
the
ABCD
1
gene
that
encodes
a
protein
of
the
peroxisomal
membrane
named
ALDP
.
Mutations
in
ALDP
result
in
elevated
levels
of
very
long
chain
fatty
acids
(
VLCFA
)
and
reduced
VLCFA
oxidation
in
peroxisomes
.
Three
main
phenotypes
are
seen
in
affected
males
.
The
childhood
cerebral
form
manifests
usually
between
ages
4
and
8
years
.
It
initially
resembles
attention
deficit
disorder
or
hyperactivity
.
Progressive
central
demyelination
with
impairment
of
cognition
,
behavior
,
vision
,
hearing
,
and
motor
function
follow
the
initial
symptoms
and
often
lead
to
total
disability
within
2
years
.
The
second
phenotype
,
adrenomyeloneuropathy
,
manifests
most
commonly
in
the
late
twenties
as
progressive
paraparesis
,
sphincter
disturbances
,
sexual
dysfunction
,
and
often
,
impaired
adrenocortical
function
;
all
symptoms
are
progressive
over
decades
.
The
third
phenotype
,
'
Addison
disease
only
'
,
presents
with
primary
adrenocortical
insufficiency
between
age
2
years
and
adulthood
and
most
commonly
by
age
7
.
5
years
,
without
evidence
of
neurologic
abnormality
.
Approximately
50
%
of
females
who
are
carriers
develop
neurologic
manifestations
that
resemble
adrenomyeloneuropathy
but
have
a
later
onset
(
age
≥
35
years
)
and
a
milder
disease
.
In
this
review
,
we
will
give
an
overview
of
the
present
understanding
of
ALD
,
and
the
implications
of
new
diagnostics
and
treatment
.
Diseases
Validation
Diseases presenting
"adrenomyeloneuropathy"
symptom
adrenomyeloneuropathy
x-linked adrenoleukodystrophy
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