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[A man with progressive spastic paraparesis].
[adrenomyeloneuropathy]
Adrenomyeloneuropathy
is
an
X-
linked
disease
caused
by
defects
in
the
ABCD
1
gene
,
which
encodes
the
ALD
protein
(
a
peroxisome
membrane
transport
protein
)
.
Deficiency
of
the
ALD
protein
impairs
the
breakdown
of
very
long
chain
fatty
acids
(
VLCFA
)
that
subsequently
accumulate
.
The
disease
can
present
with
spastic
paraplegia
,
adrenocortical
failure
,
or
a
combination
of
both
.
Spastic
paraplegia
can
be
inherited
as
well
as
acquired
and
is
seen
relatively
often
in
neurological
practice
.
Precise
diagnosis
is
important
as
it
provides
information
on
prognosis
and
treatment
,
and
allows
at
-risk
family
members
to
be
identified
.
The
case
history
of
a
man
with
adrenomyeloneuropathy
is
presented
,
and
relevant
literature
concerning
pathogenesis
,
clinical
presentation
and
treatment
of
the
disease
was
retrieved
from
Medline
and
reviewed
.
Adrenomyeloneuropathy
is
often
accompanied
by
mild
peripheral
neuropathy
or
adrenal
failure
and
usually
presents
in
young
men
with
spastic
paraplegia
.
Female
carriers
may
also
manifest
clinical
symptoms
.
Screening
for
VLCFA
is
widely
available
and
performed
in
blood
samples
.
Specific
diagnosis
requires
measurement
of
the
VLCFAs
;
C
2
6
,
C
2
4
and
C
2
2
,
confirmation
of
absent
ALD
protein
or
the
finding
of
a
specific
gene
mutation
.
In
addition
to
hormone
replacement
for
adrenal
failure
,
treatment
is
limited
to
standard
spasmolytic
agents
and
physical
therapy
.
More
specific
treatments
are
currently
being
tested
.
Diseases
Validation
Diseases presenting
"blood samples"
symptom
22q11.2 deletion syndrome
acute rheumatic fever
adrenomyeloneuropathy
alpha-thalassemia
aniridia
aromatase deficiency
benign recurrent intrahepatic cholestasis
canavan disease
classical phenylketonuria
cohen syndrome
congenital adrenal hyperplasia
congenital toxoplasmosis
cushing syndrome
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
fabry disease
familial mediterranean fever
heparin-induced thrombocytopenia
hirschsprung disease
hodgkin lymphoma, classical
homocystinuria without methylmalonic aciduria
kallmann syndrome
oculocutaneous albinism
oligodontia
oral submucous fibrosis
papillon-lefèvre syndrome
phenylketonuria
primary effusion lymphoma
scrub typhus
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
typhoid
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
wolf-hirschhorn syndrome
x-linked adrenoleukodystrophy
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