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X-linked adrenoleukodystrophy.
[adrenomyeloneuropathy]
X-
linked
adrenoleukodystrophy
(
X-
ALD
)
is
caused
by
a
defect
in
the
gene
ABCD
1
,
which
maps
to
Xq
28
and
codes
for
a
peroxisomal
membrane
protein
that
is
a
member
of
the
ATP-binding
cassette
transporter
superfamily
.
X-
ALD
is
panethnic
and
affects
approximately
1
:
20
,
000
males
.
Phenotypes
include
the
rapidly
progressive
childhood
,
adolescent
,
and
adult
cerebral
forms
;
adrenomyeloneuropathy
,
which
presents
as
slowly
progressive
paraparesis
in
adults
;
and
Addison
disease
without
neurologic
manifestations
.
These
phenotypes
are
frequently
misdiagnosed
,
respectively
,
as
attention
-deficit
hyperactivity
disorder
(
ADHD
)
,
multiple
sclerosis
,
or
idiopathic
Addison
disease
.
Approximately
50
%
of
female
carriers
develop
a
spastic
paraparesis
secondary
to
myelopathic
changes
similar
to
adrenomyeloneuropathy
.
Assays
of
very
long
chain
fatty
acids
in
plasma
,
cultured
chorion
villus
cells
and
amniocytes
,
and
mutation
analysis
permit
presymptomatic
and
prenatal
diagnosis
,
as
well
as
carrier
identification
.
The
timely
use
of
these
assays
is
essential
for
genetic
counseling
and
therapy
.
Early
diagnosis
and
treatment
can
prevent
overt
Addison
disease
,
and
significantly
reduce
the
frequency
of
the
severe
childhood
cerebral
phenotype
.
A
promising
new
method
for
mass
newborn
screening
has
been
developed
,
the
implementation
of
which
will
have
a
profound
effect
on
the
diagnosis
and
therapy
of
X-
ALD
.
Diseases
Validation
Diseases presenting
"early diagnosis"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
adrenomyeloneuropathy
alexander disease
allergic bronchopulmonary aspergillosis
aromatase deficiency
carcinoma of the gallbladder
cholangiocarcinoma
classical phenylketonuria
coats disease
cohen syndrome
congenital adrenal hyperplasia
congenital diaphragmatic hernia
congenital toxoplasmosis
cowden syndrome
cushing syndrome
cutaneous mastocytosis
cystinuria
dentin dysplasia
dentinogenesis imperfecta
dracunculiasis
erdheim-chester disease
erythropoietic protoporphyria
esophageal carcinoma
esophageal squamous cell carcinoma
fabry disease
familial hypocalciuric hypercalcemia
familial mediterranean fever
gm1 gangliosidosis
hirschsprung disease
holt-oram syndrome
homocystinuria without methylmalonic aciduria
hydrocephalus with stenosis of the aqueduct of sylvius
inclusion body myositis
kabuki syndrome
kallmann syndrome
kindler syndrome
krabbe disease
locked-in syndrome
monosomy 21
neuralgic amyotrophy
oculocutaneous albinism
oligodontia
omenn syndrome
oral submucous fibrosis
papillon-lefèvre syndrome
phenylketonuria
primary effusion lymphoma
primary hyperoxaluria type 1
proteus syndrome
pyomyositis
pyruvate dehydrogenase deficiency
scrub typhus
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
thoracic outlet syndrome
triple a syndrome
typhoid
von hippel-lindau disease
wiskott-aldrich syndrome
wolf-hirschhorn syndrome
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