Adrenomyeloneuropathy with Later Development of Cerebral Form Caused by a Hemizygous Splice-site Variant in ABCD1

Intern Med. 2024 Apr 1;63(7):999-1004. doi: 10.2169/internalmedicine.2240-23. Epub 2023 Aug 9.

Abstract

Adrenomyeloneuropathy (AMN)/adrenoleukodystrophy (ALD) is an X-linked genetic disorder caused by pathogenic variants in ABCD1. We treated a 54-year-old man with slowly progressive spastic paraparesis with later development of the cerebral form. A pathogenic splice-site variant of ABCD1 (c.1489-1G>A, p.Val497Alafs*51) and elevated levels of very long-chain fatty acids were found, leading to the diagnosis of AMN. Detailed ABCD1 mRNA expression analyses revealed decreased levels of ABCD1 mRNA accompanied by deletion of the first 31 bp in exon 6. The altered mRNA transcriptional patterns associated with splice site variants are diverse and may provide important insights into ALD pathogenesis.

Keywords: ABCD1; RNA; adrenoleukodystrophy; adrenomyeloneuropathy; nonsense-mediated mRNA decay.

Publication types

  • Case Reports

MeSH terms

  • ATP Binding Cassette Transporter, Subfamily D, Member 1 / genetics
  • Adrenoleukodystrophy* / diagnosis
  • Adrenoleukodystrophy* / genetics
  • Adrenoleukodystrophy* / metabolism
  • Humans
  • Male
  • Middle Aged
  • Pedigree
  • RNA, Messenger / genetics

Substances

  • RNA, Messenger
  • ABCD1 protein, human
  • ATP Binding Cassette Transporter, Subfamily D, Member 1