Teaching NeuroImages: MRI findings in X-linked adrenoleukodystrophy
| Autor: | Jong M. Rho, Kenneth A. Myers, Xing-Chang Wei |
|---|---|
| Rok vydání: | 2023 |
| Předmět: |
Male
medicine.medical_specialty Pathology Magnetic Resonance Spectroscopy Cortisol awakening response genetic structures Clinical Sciences Choline Resident and Fellow Section Ophthalmology Dysmetria Adrenal insufficiency Humans Medicine Lactic Acid Adrenoleukodystrophy Child Strabismus CSF albumin Aspartic Acid Neurology & Neurosurgery medicine.diagnostic_test business.industry Neurosciences Brain Magnetic resonance imaging medicine.disease Magnetic Resonance Imaging Decreased Visual Acuity Cognitive Sciences Neurology (clinical) business |
| Zdroj: | Neurology, vol 85, iss 17 |
| ISSN: | 1526-632X 0028-3878 |
| Popis: | A 6-year-old boy presented with 4 months progressive verbal comprehension difficulties, declining school performance, strabismus, and visual impairment. General examination noted moderate hypotension and hyperpigmented skin. Pertinent neurologic examination abnormalities included difficulty with comprehension, decreased visual acuity (20/50 bilaterally), disconjugate gaze, bilateral dysmetria, and unsteady gait. CSF protein was elevated (1.82 g/L). Brain MRI showed posterior cerebrum and brainstem abnormalities consistent with adrenoleukodystrophy1 (figure). Morning cortisol was decreased (21 nM) and adrenocorticotrophic hormone stimulation test confirmed adrenal insufficiency. Diagnosis was confirmed by very long chain fatty acid analysis (elevated C26:0/C22:0 and C24:0/C22:0 ratios) and identification of pathogenic ABCD1 mutation. |
| Databáze: | OpenAIRE |
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