X-Linked Cerebral Adrenoleukodystrophy

Categories: Blood diseases, Endocrine diseases, Neuronal diseases, Rare diseases

Aliases & Classifications for X-Linked Cerebral Adrenoleukodystrophy

MalaCards integrated aliases for X-Linked Cerebral Adrenoleukodystrophy:

Name: X-Linked Cerebral Adrenoleukodystrophy 52 37
Adrenoleukodystrophy Childhood Cerebral Form 52
Adrenoleukodystrophy X-Linked Cerebral Form 52
Ald Childhood Cerebral Form 52
Childhood Cerebral Ald 52
X-Cald 52


Summaries for X-Linked Cerebral Adrenoleukodystrophy

NIH Rare Diseases : 52 The following summary is from Orphanet , a European reference portal for information on rare diseases and orphan drugs. Orpha Number: 139396 Definition A subtype of X-linked adrenoleukodystrophy (X-ALD), a peroxisomal disease characterized by severe inflammatory demyelination in the brain, and often associated with adrenal insufficiency. Epidemiology X-CALD manifests in 70% of male and 2% of female cases of X-ALD, whose estimated birth incidence (male and female) is 1/20,000. Clinical description X-CALD may occur in healthy boys (2.5-10 years old, 50% of cases), in symptomatic male adrenomyeloneuropathy (AMN, see this term) cases (35%), in adult males as the initial manifestation of X-ALD (~12%) and most rarely in adult women (2%). Adrenocortical insuf?ciency (AI, 65% of cases) is often latent, lacking melanoderma, presenting as fatigue, nausea or even acute primary adrenal insufficiency (see this term). AI sometimes precedes neurologic symptoms that are limited to mild cognitive dysfunction mimicking attention deficit disorder (ADD) in children. An active phase follows: emotional lability, cognitive decline and either visuospatial impairment or frontal syndrome are rapidly accompanied by de?cits such as hemiplegia or quadriparesis, cerebellar ataxia , impaired central auditory discrimination, visual ?eld defects, cortical blindness and often seizures . Patients may lose the ability to understand language and to walk within weeks. Some patients (10%) remain in a chronic or arrested X-CALD and often develop marked visual-spatial and cognitive deficits. Disturbances resembling schizophrenia or psychosis may occur, particularly in adolescents and adults. Etiology X-CALD is due to mutations of ABCD1 (Xq28,) encoding ALDP, a peroxisomal transmembrane protein involved in the transport of very long chain fatty acid CoA-esters (VLCFA) into the peroxisome; perturbing VLCFA homeostasis in glial cells contributes to myelin destabilization. This leads to severe neuroinflammation with impairment of the neuro-vascular unit followed by rapid functional decline. Diagnostic methods Genetic testing must be preceded in men by testing for high plasma concentrations of VLCFA. Initially, brain MRI reveals characteristic abnormal white matter signals, often in the splenium or genu of the corpus callosum . Then, the extent of demyelinating lesions progresses, as revealed by peripheral injection of gadolinium. Differential diagnosis Initial symptoms in boys may ressemble ADD. AI symptoms may resemble congenital or acquired forms of Addison disease (see this term). Antenatal diagnosis Gestational chorionic villus sampling (10-13 weeks), amniocentesis (15-18 weeks) and pre-implantation genetic testing are feasible Genetic counseling Transmission is X-linked, with less than 8% de novo <.i> mutations. Genetic testing of parents and male extended family is mandatory to permit early detection by brain MRI and to propose therapeutic intervention. Systematic testing of women at risk to be carriers is also warranted to propose genetic counseling. Management and treatment Brain MRI is the sole means to detect demyelination prior to symptomatic onset and must be performed every 6 months from 3-12 years, and then annually up to 50 years for all X-ALD males. Allogeneic hematopoietic stem cell transplant (HSCT) remains the only therapeutic intervention that can halt cerebral demyelination, but only when performed at a very early stage. Appropriate donors (HLA-identical non-affected siblings, HLA-matched unrelated donors or cord blood) must be identified rapidly. Autologous HSCT, genetically corrected ex vivo, had a similar efficacy to allogeneic HSCT in the first 4 treated patients. AI and hypogonadism are not cured by HSCT. Plasma testosterone, cortisol, mineralocorticoids, ACTH levels and ACTH stimulation reponses must be tested regularly. Replacement therapy may be required. Prognosis Left untreated, all but 10% of patients are bedridden, blind, lacking speech and require fulltime care, dying within 2-5 years. Arrested X-CALD may enter a phase of rapid neurological deterioration at any time. Visit the Orphanet disease page for more resources.

MalaCards based summary : X-Linked Cerebral Adrenoleukodystrophy, also known as adrenoleukodystrophy childhood cerebral form, is related to adrenoleukodystrophy and adrenomyeloneuropathy. Affiliated tissues include testes and brain.

Related Diseases for X-Linked Cerebral Adrenoleukodystrophy

Diseases related to X-Linked Cerebral Adrenoleukodystrophy via text searches within MalaCards or GeneCards Suite gene sharing:

# Related Disease Score Top Affiliating Genes
1 adrenoleukodystrophy 12.0
2 adrenomyeloneuropathy 10.4
3 neuroleptic malignant syndrome 10.1
4 graft-versus-host disease 10.0

Symptoms & Phenotypes for X-Linked Cerebral Adrenoleukodystrophy

Drugs & Therapeutics for X-Linked Cerebral Adrenoleukodystrophy

Search Clinical Trials , NIH Clinical Center for X-Linked Cerebral Adrenoleukodystrophy

Cell-based therapeutics:

LifeMap Discovery
Data from LifeMap, the Embryonic Development and Stem Cells Database
Stem-cell-based therapeutic approaches for X-Linked Cerebral Adrenoleukodystrophy:
ABCD-1-transduced hematopoietic stem cells for the treatment of childhood cerebral X-linked adrenoleukodystrophy (CCALD)
Embryonic/Adult Cultured Cells Related to X-Linked Cerebral Adrenoleukodystrophy:
ABCD-1-transduced peripheral blood-derived hematopoietic stem cells PMIDs: 19892975

Genetic Tests for X-Linked Cerebral Adrenoleukodystrophy

Anatomical Context for X-Linked Cerebral Adrenoleukodystrophy

MalaCards organs/tissues related to X-Linked Cerebral Adrenoleukodystrophy:

Testes, Brain

Publications for X-Linked Cerebral Adrenoleukodystrophy

Articles related to X-Linked Cerebral Adrenoleukodystrophy:

# Title Authors PMID Year
Quality of life among boys with adrenoleukodystrophy following hematopoietic stem cell transplant. 61
28934891 2018
Anaesthesia for a child with adrenoleukodystrophy: A case report and review of the literature. 61
24700903 2014
Magnetic resonance spectroscopy changes following haemopoietic stem cell transplantation in children with cerebral adrenoleukodystrophy. 61
17254002 2007
Role of leukotrienes as indicators of the inflammatory demyelinating reaction in x-linked cerebral adrenoleukodystrophy. 61
14586618 2003
Neuroleptic malignant syndrome during zuclopenthixol therapy in X-linked cerebral adrenoleukodystrophy. 61
11757591 2001
Diffusion tensor brain MR imaging in X-linked cerebral adrenoleukodystrophy. 61
11222805 2001
Intrathecal IgA synthesis in X-linked cerebral adrenoleukodystrophy. 61
9378899 1997

Variations for X-Linked Cerebral Adrenoleukodystrophy

Expression for X-Linked Cerebral Adrenoleukodystrophy

Search GEO for disease gene expression data for X-Linked Cerebral Adrenoleukodystrophy.

Pathways for X-Linked Cerebral Adrenoleukodystrophy

GO Terms for X-Linked Cerebral Adrenoleukodystrophy

Sources for X-Linked Cerebral Adrenoleukodystrophy

9 Cosmic
10 dbSNP
11 DGIdb
17 EFO
18 ExPASy
19 FMA
28 GO
29 GTR
31 HPO
32 ICD10
33 ICD10 via Orphanet
37 LifeMap
41 MedGen
43 MeSH
44 MESH via Orphanet
45 MGI
48 NCI
49 NCIt
54 Novoseek
57 OMIM via Orphanet
61 PubMed
70 Tocris
72 UMLS via Orphanet
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