Adrenomyeloneuropathy in patients with 'Addison's disease': genetic case analysis.

J R Soc Med

Wrexham Academic Unit, Wales College of Medicine, Cardiff University, Wales, UK.

Published: May 2006

AI Article Synopsis

  • This study reviews the clinical symptoms and diagnostic challenges of adrenomyeloneuropathy and adrenoleukodystrophy, which are variations of the same genetic disorder.
  • Investigators observed three generations of a family, noting neurological symptoms and measuring levels of very long chain fatty acids, which were elevated in affected individuals.
  • A novel mutation in the adrenoleukodystrophy gene was found, emphasizing the importance of early diagnosis for genetic counseling and future treatment options.

Article Abstract

Objective: To review the clinical presentations and diagnostic issues in adrenomyeloneuropathy and adrenoleukodystrophy, which are different presentations of the same single gene disorder.

Design: Observational study.

Participants: Three generations of an affected kindred.

Intervention: None.

Main Outcome Measures: Neurological features suggestive of adrenoleukodystrophy or adrenomyeloneuropathy. Measurement of very long chain fatty acids. Molecular analysis of the adrenoleukodystrophy gene.

Results: Three adults presented with adrenomyeloneuropathy and two children with adrenoleukodystrophy. Circulating concentrations of long chain fatty acids were raised consistent with clinical features. A mutation in exon 6 of the adrenoleukodystrophy gene (P543L) was identified. This had not previously been identified but has subsequently been reported by other groups.

Conclusions: Adrenomyeloneuropathy should be considered in the differential diagnosis in male patients presenting with adrenal failure. Early diagnosis allows genetic counselling in such families and may become more important as treatment strategies evolve.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1457755PMC
http://dx.doi.org/10.1177/014107680609900516DOI Listing

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