X-linked adrenoleukodystrophy (X-ALD) is a progressive genetic disorder due to a mutation in X-linked gene ABCD1 and is the most common peroxisomal disorder. ACBD1 gene codes for an ATP-binding cassette (ABC) transporter located in the peroxisomal membrane which is necessary for transport of very-long-chain-fatty-acids (VLCFAs) into the peroxisome [1]. Mutations in ABCD1 gene therefore lead to cellular accumulation of VLCFAs. The three main phenotypes of X-ALD in males include cerebral ALD presenting with leukodystrophy, adrenomyeloneuropathy (AMN) and isolated primary adrenal insufficiency [1].

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