A 29-year-old patient with adrenoleukodystrophy presenting with Addison’s disease
| العنوان: | A 29-year-old patient with adrenoleukodystrophy presenting with Addison’s disease |
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| المؤلفون: | Toshihide Kawai, Kumiko Tanaka, Hajime Tanaka, Takeshi Katsuki, Nobuyuki Shimozawa, Naoko Amano, Tomohide Adachi |
| المصدر: | Endocrine Journal. 67:655-658 |
| بيانات النشر: | Japan Endocrine Society, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Adult, Male, endocrine system, medicine.medical_specialty, Hydrocortisone, endocrine system diseases, Hormone Replacement Therapy, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Physical examination, Anorexia, ATP Binding Cassette Transporter, Subfamily D, Member 1, Gastroenterology, Primary Adrenal Insufficiency, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Addison Disease, Internal medicine, Adrenal Glands, medicine, Humans, Young adult, Adrenoleukodystrophy, Glucocorticoids, medicine.diagnostic_test, business.industry, Brain, medicine.disease, Hyperintensity, Early Diagnosis, 030220 oncology & carcinogenesis, Addison's disease, medicine.symptom, business, Glucocorticoid, medicine.drug |
| الوصف: | Adrenoleukodystrophy (ALD) is an X-linked disorder caused by a hemizygous mutation of the ABCD1 gene. Patients with ALD show progressive central nervous system demyelination and primary adrenal insufficiency. In Japan, most reported ALD cases were childhood-onset, and only one case of an adult patient with Addison's disease form of ALD has ever been reported. Herein, we present a case of a 29-year-old man with Addison's disease form of ALD. The patient had anorexia, weight loss, and skin pigmentation from 18 years of age. At first visit, his weight had decreased by 12 kg from 57 kg when he was 15 years old. Endocrinological examination showed low serum cortisol (1.2 μg/dL) with high plasma ACTH (4,750 pg/mL), and abdominal computed tomography showed normal adrenal glands. Very-long-chain fatty acid (VLCFA) levels were elevated, and the ABCD1 mutation, p.Gly116Arg, was identified in hemizygous state. He had no significant neurological findings on physical examination and no white matter lesions on brain magnetic resonance imaging (MRI). He was diagnosed with ALD presenting as Addison's disease, and glucocorticoid replacement therapy was initiated. Four years after the diagnosis, he still did not show any neurological findings and any white matter lesions on brain MRI. Evaluating VLCFA levels for ALD diagnosis is important in young adult men with idiopathic primary adrenal insufficiency as well as in children. Early diagnosis enables more rational approaches including the early detection of neurological complications and might improve the prognosis of patients. |
| تدمد: | 1348-4540 0918-8959 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::50719ac54629e403f52275e05d2b9211Test https://doi.org/10.1507/endocrj.ej19-0576Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....50719ac54629e403f52275e05d2b9211 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 13484540 09188959 |
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