Adrenoleukodystrophy is a rare genetic disorder. Histopathological features of this disorder include demyelination and axonal loss in white matter. We describe a six-year-old boy with significantly decreased N-acetyl-aspartate (NAA)/Creatin (Cr), increased Choline (Cho)/Cr and Myo-inositol (MI)/Cr in parieto-occipital white matter by MR spectroscopy. In contrast to the normal appearance of frontal white matter on MR imaging, increased Cho/Cr and MI/Cr ratios were detected on MR spectroscopy. These changes in involved areas could be an indication of neuroaxonal loss, demyelination and gliosis.
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