Cited by 276Metabolism and Genetic DisordersLysosomal Storage Disorders ResearchAdrenal Hormones and Disorders

Adrenoleukodystrophy—Neuroendocrine pathogenesis and redefinition of natural history

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Kemp, Stephan, Huffnagel, Irene C., Linthorst, Gabor E., Wanders, Ronald J., Engelen, Marc·2016·Nature Reviews Endocrinology

Abstract

X-Linked adrenoleukodystrophy (ALD) is a peroxisomal metabolic disorder with a highly complex clinical presentation. ALD is caused by mutations in the ABCD1 gene, which leads to the accumulation of very long-chain fatty acids in plasma and tissues. Virtually all men with ALD develop adrenal insufficiency and myelopathy. Approximately 60% of men develop progressive cerebral white matter lesions (known as cerebral ALD). However, one cannot identify these individuals until the early changes are seen using brain imaging. Women with ALD also develop myelopathy, but generally at a later age than men and adrenal insufficiency or cerebral ALD are very rare. Owing to the multisystem symptomatology of the disease, patients can be assessed by the paediatrician, general practitioner, endocrinologist or a neurologist. This Review describes current knowledge on the clinical presentation, diagnosis and treatment of ALD, and highlights gaps in our knowledge of the natural history of the disease owing to an absence of large-scale prospective cohort studies. Such studies are necessary for the identification of new prognostic biomarkers to improve care for patients with ALD, which is particularly relevant now that newborn screening for ALD is being introduced.

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Crossref · 10.1038/nrendo.2016.90

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Authors
Kemp, S., Huffnagel, I. C., Linthorst, G. E., Wanders, R. J., & Engelen, M.
Affiliations
Amsterdam UMC Location University of Amsterdam (NL)
Corresponding author
Kemp, Stephan
Venue
Nature Reviews Endocrinology
Published
2016-06-17
Volume
12
Issue
10
Pages
606-615
ISSN
  • 1759-5029 (ISSN-L)
  • 1759-5037
OpenAlex
W2438153122
Cited by
275
References
149
Citations by year
2026: 23 · 2025: 28 · 2024: 35 · 2023: 17 · 2022: 30 · 2021: 39 · 2020: 39 · 2019: 23 · 2018: 21 · 2017: 16 · 2016: 3
FWCI
2.24
Type
journal article
Language
en
Open access
Locations
  • Nature Reviews Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
  • Pure Amsterdam UMC (publishedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Metabolism and Genetic Disorders
  • Health Sciences › Medicine › Physiology › Lysosomal Storage Disorders Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords
adrenoleukodystrophy, ABCD1 gene, very long chain fatty acids, adrenal insufficiency, myelopathy, cerebral adrenoleukodystrophy, white matter lesions, natural history (disease), diagnosis, treatment, newborn screening, prognostic factors, sex differences
MeSH terms
ATP Binding Cassette Transporter, Subfamily D, Member 1, Adrenal Insufficiency, Adrenoleukodystrophy, Brain, Fatty Acids, Female, Glucocorticoids, Humans, Male, Peripheral Nervous System Diseases, Spinal Cord Diseases, Disease Progression, ATP-Binding Cassette Transporters, Hormone Replacement Therapy, Leukoencephalopathies

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