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Encyclopedia > Adrenoleukodystrophy
Adrenoleukodystrophy
Classification & external resources
ICD-10 E71.3
ICD-9 330.0, 277.86
OMIM 300100 202370
DiseasesDB 292
MeSH D000326

Adrenoleukodystrophy (ALD) (also known as Schilder's Disease and Sudanophilic Leukodystrophy) is a rare inherited disorder that leads to progressive brain damage, failure of the adrenal gland and eventually death. ALD is one of a group of inherited disorders called Leukodystrophies progressively damaging the myelin, a complex fatty neural tissue that insulates many nerves of the central and peripheral nervous systems. Without myelin, nerves are unable to conduct an impulse, leading to increasing disability as myelin destruction increases and intensifies. An essential protein, called a transporter protein, is missing in sufferers. This protein is needed to carry an enzyme which is used to break down long chain fatty acids found in the normal diet. A build up of these long chain fatty acids in the body due to this can causes damage to the brain and the adrenal gland. The victims of ALD are nearly always male, with about one in five women carrying the disease developing a milder form in adult life. There are several different types of the disease which can be inherited in two different ways. It is more commonly inherited as an X-linked condition. Image File history File links Broom_icon. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // E00-E35 - Endocrine diseases (E00-E07) Disorders of thyroid gland (E00) Congenital iodine-deficiency syndrome (E01) Iodine-deficiency-related thyroid disorders and allied conditions (E02) Subclinical iodine-deficiency hypothyroidism (E03) Other hypothyroidism (E030) Congenital hypothyroidism with diffuse goitre (E031) Congenital hypothyroidism without goitre (E032) Hypothyroidism due to medicaments and other... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Mendelian Inheritance in Man project is a database that catalogues all the known diseases with a genetic component, and - when possible - links them to the relevant genes in the human genome. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ... Leukodystrophy refers to progressive degeneration of the white matter of the brain due to imperfect growth or development of the myelin sheath, the fatty covering that acts as an insulator around nerve fiber. ... Myelin is an electrically insulating phospholipid layer that surrounds the axons of many neurons. ... A diagram showing the CNS: 1. ... The Peripheral nervous system resides or extends outside the CNS central nervous system (the brain and spinal cord) to serve the limbs and organs. ... Nerves (yellow) Nerves redirects here. ... For other uses, see Impulse (disambiguation). ... Look up disability in Wiktionary, the free dictionary. ... Sex-linked genes are those carried on the mammalian X chromosome but not the Y chromosome. ...


Although this disorder affects the growth and/or development of myelin, Leukodystrophies are different from demyelinating disorders such as multiple sclerosis where myelin is formed normally but is lost by immunologic dysfunction or for other reasons.

Contents

Symptoms

The clinical presentation is largely dependent on the age of onset of the disease. The most severe type is the childhood cerebral form, which normally occurs in males between the ages of 4 and 10 and is characterized by failure to develop, seizures, ataxia, adrenal insufficiency, as well as degeneration of visual and auditory function. This form can also occur in adolescents and very rarely in adults. This article is about epileptic seizures. ... For other uses, see Ataxia (disambiguation). ... In medicine, adrenal insufficiency (or hypocortisolism) is the inability of the adrenal gland to produce adequate amounts of cortisol in response to stress. ... A separate article is about the punk band called The Adolescents. ...


In another form of ALD, which primarily strikes young men, the spinal cord dysfunction is more prominent and therefore is called adrenomyeloneuropathy, or "AMN." The patients usually present with weakness and numbness of the limbs and urination or defecation problems. Most victims of this form are also males, although some female carriers exhibit symptoms similar to AMN. The Spinal cord nested in the vertebral column. ... Manneken Pis of Brussels. ... Anatomy of the anus and rectum For the death metal band Defecation, see Defecation (band). ...


Adult and neonatal (which tend to affect both males and females and be inherited in an autosomal recessive manner) forms of the disease also exist but they are extremely rare. Some patients may present with sole findings of adrenal insufficiency (Addison's disease). ALD also causes uncontrollable rage in some cases. In genetics, the term recessive gene refers to an allele that causes a phenotype (visible or detectable characteristic) that is only seen in a homozygous genotype (an organism that has two copies of the same allele). ... In medicine, adrenal insufficiency (or hypocortisolism) is the inability of the adrenal gland to produce adequate amounts of cortisol in response to stress. ...


Diagnosis

The diagnosis is established by clinical findings and the detection of serum long chain fatty acid levels. MRI examination reveals white matter abnormalities, and neuroimaging findings of this disease are quite reminiscent of the findings of multiple sclerosis. Genetic testing for the analysis of the defective gene is available in some centers. Blood plasma is the liquid component of blood, in which the blood cells are suspended. ... In chemistry, especially biochemistry, a fatty acid is a carboxylic acid often with a long unbranched aliphatic tail (chain), which is either saturated or unsaturated. ... The mri are a fictional alien species in the Faded Sun Trilogy of C.J. Cherryh. ... For other uses, see Gene (disambiguation). ...


Pathophysiology

The most common form of ALD is X-linked (the defective gene is on the X chromosome, location Xq28), and is characterized by excessive accumulation of very long chain fatty acids (VLCFA) — fatty acids chains with 24–30 carbon atoms (particularly hexacosanoate, C26) in length. This was originally described by Moser et al in 1981.[1] So, when the ALD gene was discovered in 1993, it was a surprise that the corresponding protein was in fact a member of a family of transporter proteins, not an enzyme. It is still a mystery as to how the transporter affects the function of the fatty acid enzyme and, for that matter, how high levels of very long chain fatty acids cause the loss of myelin on nerve fibers. Sex-linked genes are those carried on the mammalian X chromosome but not the Y chromosome. ... In chemistry, especially biochemistry, a fatty acid is a carboxylic acid (or organic acid), often with a long aliphatic tail (long chains), either saturated or unsaturated. ... For other uses, see Carbon (disambiguation). ...


The gene (ABCD1 or "ATP-binding cassette, subfamily D, member 1") codes for a protein that transfers fatty acids into peroxisomes, the cellular organelles where the fatty acids undergo β-oxidation.[2] A dysfunctional gene leads to the accumulation of very long chain fatty acids (VLCFA). ABCD1 is a gene associated with adrenoleukodystrophy. ... Basic structure of a peroxisome Peroxisomes are ubiquitous organelles in eukaryotes that participate in the metabolism of fatty acids and other metabolites. ... Schematic of typical animal cell, showing subcellular components. ... Schematic demonstrating mitochondrial fatty acid beta-oxidation and effects of LCHAD deficiency Beta oxidation is the process by which fatty acids, in the form of Acetyl-CoA molecules, are broken down in the mitochondria to generate Acetyl-CoA, the entry molecule for the Krebs Cycle. ...


The precise mechanisms through which high VLCFA concentrations cause the disease are still unknown as of 2005, but accumulation is severe in the organs affected.


The prevalence of X-linked adrenoleukodystrophy is approximately 1 in 20,000 individuals. This condition occurs with a similar frequency in all populations.


Treatment

While there is currently no cure for the disease, some dietary treatments, for example, Lorenzo's oil in combination with a diet low in VLCFA, have been used with limited success, especially before disease symptoms appear. A recent study by Moser et al (2005) shows positive long-term results with this approach;[3] see also the Myelin Project. Lorenzos Oil is a 1992 drama film directed by George Miller. ... The Myelin Project is a medical project intended to re-generate the nerves myelin sheath, — a process called remyelination — destroyed in a host of diseases such as multiple sclerosis and the leukodystrophies. ...


Bone marrow transplantation has been proven to help ALD who are either presymptomatic or exhibiting mild symptoms early in the course of the disease. Bone marrow transplantation is a medical procedure that involves stem cell transplantation. ...


Lovastatin is an anticholesterol drug that seems to help, but researchers aren't sure how or why. Lovastatin is a member of the drug class of statins, used for lowering cholesterol (hypolipidemic agent) in those with hypercholesterolemia and so preventing cardiovascular disease. ...


Treatment, however, is to AID the symptoms and is NOT a cure.


Famous patients

Lorenzo Odone is probably the most famous patient with ALD. Frustrated by the limited research available, his parents Augusto and Michaela Odone[4] sparked the invention of "Lorenzo's oil". The quest for a treatment for Lorenzo was depicted in the film Lorenzo's Oil, and is the subject of the Phil Collins song "Lorenzo" (on his 1996 album Dance Into The Light). Augusto Odone (born c. ... Lorenzos Oil is a 1992 drama film directed by George Miller. ... For other uses, see Phil Collins (disambiguation). ... Album cover for Phil Collinss Dance Into the Light. ...


References

  1. ^ Moser HW, Moser AB, Frayer KK, Chen W, Schulman JD, O'Neill BP, Kishimoto Y. Adrenoleukodystrophy: increased plasma content of saturated very long chain fatty acids. Neurology 1981;31:1241-9. PMID 7202134.
  2. ^ Mosser J, Douar AM, Sarde CO, Kioschis P, Feil R, Moser H, Poustka AM, Mandel JL, Aubourg P. Putative X-linked adrenoleukodystrophy gene shares unexpected homology with ABC transporters. Nature 1993;361:726-30. PMID 8441467.
  3. ^ Moser HW, Raymond GV, Lu S-E, Muenz LR, Moser AB, Xu J, Jones RO, Loes DJ, Melhem ER, Dubey P, Bezman L, Brereton NH, Odone A. Follow-up of 89 asymptomatic patients with adrenoleukodystrophy treated with Lorenzo's Oil. Arch Neurol 2005;62;1073-80. PMID 16009761.
  4. ^ About Lorenzo, his Parents, and Oumouri. The Myelin Project. Retrieved on 2006-06-03.

Nature is a prominent scientific journal, first published on 4 November 1869. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 154th day of the year (155th in leap years) in the Gregorian calendar. ...

External links


  Results from FactBites:
 
Adrenoleukodystrophy - Wikipedia, the free encyclopedia (826 words)
Adrenoleukodystrophy (ALD) is a degenerative disorder of the fatty white sheath covering nerve fibers, known as myelin.
A type of leukodystrophy, the victims of ALD are typically male, as the disease is usually inherited in a sex-linked manner on the X chromosome.
The prevalence of X-linked adrenoleukodystrophy is approximately 1 in 20,000 individuals.
Adrenoleukodystrophy (3285 words)
Adrenoleukodystrophy is a rare inherited metabolic disorder characterized by the loss of the fatty covering (myelin sheath) on nerve fibers within the brain (cerebral demyelination) and the progressive degeneration of the adrenal gland (adrenal atrophy).
Neonatal Adrenoleukodystrophy is inherited as an autosomal recessive genetic trait.
The symptoms of Adrenoleukodystrophy are thought to result from deficient enzyme (e.g., lignoceroyl-CoA ligase) activity, leading to an abnormal accumulation of very long chain fatty acids in certain cells and tissues, particularly in the brain and the outer region of the adrenal glands (adrenal cortex).
  More results at FactBites »


 

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