• Jing Wang, Qian Zhu, and Hongqian Liu.
• Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, China.
• Medicine (Baltimore). 2018 May 1; 97 (21): e10837e10837.

RationaleX-linked adrenoleukodystrophy (X-ALD) is the most common peroxisomal disorder, which is inherited as an X-linked recessive trait. ATP binding cassette subfamily D member 1 (ABCD1) localized to Xq28 is the only gene associated with ALD.Patient ConcernsWe report a case of Chinese boy with childhood cerebral ALD, who began experiencing symptoms at the age of 5 years and 2 months. Very long chain fatty acids analysis revealed high levels of C24/C22 ratio and C26/C22 ratio in the plasma. Magnetic resonance imaging (MRI) showed abnormal bilateral white matter lesions in brainstem, temporal, occipital, and parietal lobes.DiagnosesDirect sequencing of the ABCD1 gene identified a novel c.1502del mutation on exon 6, which causes a substitution of the 501st amino acid from methionine to serine and finally the 557th codon is changed to stop codon.InterventionsSpecial education and rehabilitation therapy.OutcomesThe disease progressed rapidly and resulted in death at the age of 8 years.LessonsEarly detection of mutations in the ABCD1 gene may facilitate diagnosis, genetic counseling and potentially aid prenatal diagnosis of the disease.

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