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Journal of the Korean Child Neurology Society 2005;13(1):99-103.
Published online May 30, 2005.
A Case of Neonatal Adrenoleukodystrophy Presented with Neonatal Seizure.
Jungi Choi, Su Jeong You, Tae Sung Ko, Ellen Ai Rhan Kim, Ki Soo Kim, Soo Young Pi, Han Wook Yoo
Department of Pediatrics, College of Medicine, Asan Medical Center, Ulsan University, Seoul, Korea. tsko@amc.seoul.co.kr
Abstract
Neonatal adrenoleukodystrophy(NALD) is an inherited autosomal recessive disease characterized by very early onset of neurologic deterioration, extreme hypotonia, poor sucking reflex, failure to thrive, poor or absent grasp and Moro reflexes, diminished deep tendon reflexes, neonatal seizure refractory to antiepileptic drugs, progressive hepatomegaly, and mild or absent craniofacial dysmorphism. In the peroxisomal biogenesis disorders, whose basic defect are the incapabilities to import one or more proteins into the organelle, include Zellweger syndrome(ZS), NALD, and infantile Refsum disease(IRD). These are now thought to represent a continuous spectrum of disease severity, ZS the most severe, IRD the least severe, and NALD intermediate. Furthermore, their biochemistry and microscopic pathology are nearly identical. The biochemical abnormalities of NALD are the elevated levels of very long chain fatty acid(VLCFA), phytanic acid, pristanic acid, pipecolic acid in plasma, cultured skin fibroblasts, and reduced plasmalogen contents in erythrocytes. There are no effective treatments until now. We experienced an one day old neonate with hypotonia and seizure, who was diagnosed as NALD by elevated plasma VLCFA. So we report the case with a brief review of literature.
Key Words: Neonatal adrenoleukodystrophy(NALD), Neonatal seizure, Hypotonia


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