X-linked adrenoleukodystrophy (X-ALD): clinical presentation and guidelines for diagnosis, follow-up and management.

X-linked adrenoleukodystrophy (X-ALD): clinical presentation and guidelines for diagnosis, follow-up and management.
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DOI:
10.1186/1750-1172-7-51
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发表时间:
2012-08-13
影响因子:
3.7
通讯作者:
Poll-The BT
Poll-The BT
中科院分区:
医学2区
文献类型:
--
作者:
Engelen M;Kemp S;de Visser M;van Geel BM;Wanders RJ;Aubourg P;Poll-The BT

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X连锁肾上腺脑白质营养不良(X-ALD)是最常见的过氧化物酶体疾病。这种疾病是由abcd1基因突变引起的,该基因编码过氧化物体膜蛋白aldp,该蛋白参与超长链脂肪酸(VLCFA;≥C22)的跨膜运输。ALDP缺陷会导致血浆和组织中VLCFA水平升高。男性X-ALD的临床范围从孤立的肾上腺皮质功能不全和缓慢进行的脊髓病到毁灭性的脑脱髓鞘。大多数杂合子女性在60 岁时会出现症状。在个别患者中,病程仍然不可预测。本文重点介绍了X-ALD患者的诊断和治疗,并为临床医生遇到这种高度复杂的疾病提供了指导。
X-linked adrenoleukodystrophy (X-ALD) is the most common peroxisomal disorder. The disease is caused by mutations in the ABCD1 gene that encodes the peroxisomal membrane protein ALDP which is involved in the transmembrane transport of very long-chain fatty acids (VLCFA; ≥C22). A defect in ALDP results in elevated levels of VLCFA in plasma and tissues. The clinical spectrum in males with X-ALD ranges from isolated adrenocortical insufficiency and slowly progressive myelopathy to devastating cerebral demyelination. The majority of heterozygous females will develop symptoms by the age of 60 years. In individual patients the disease course remains unpredictable. This review focuses on the diagnosis and management of patients with X-ALD and provides a guideline for clinicians that encounter patients with this highly complex disorder.
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