Two brothers with X linked adrenoleukodystrophy

In patients with Addison's disease, diagnosis of Adrenoleukodystrophy (ALD) is suggested by the abrupt development of neuropsychiatric symptoms, associated with Magnetic resonance imaging (MRI) confirmation of extensive, usually symmetric, white matter demyelinating lesion. In these two cases, diagnosis of ALD was strongly supported by symptoms, disease progression, MRI findings. The emergence of neuropsychiatric symptoms in a patient with a prior history of Addison's disease should prompt evaluation for this disorder. Early diagnosis of the disease is required for delaying the progression of the disease. Genetic counseling, carrier detection and antenatal diagnosis can reduce the incidence of this disease, which prognosis is grave in most of the cases.