Cureus · 1 author, 1 centre
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This case report describes two male patients with adrenoleukodystrophy (ALD) who developed severe pressure ulcers in the pelvic region and feet, a complication not previously reported in ALD. Both patients had immobility and incontinence, suggesting these ALD-related features confer a high risk for pressure ulcer development.
This case report describes two male patients with adrenoleukodystrophy (ALD) who developed severe pressure ulcers, a complication not previously described in the literature for ALD. The first patient, a 27-year-old with adolescent cerebral-type ALD, had pressure ulcers with bone exposure on the sacral and bilateral greater trochanter region. The second patient, a 64-year-old with the adrenomyeloneuropathy (AMN) phenotype, had pressure ulcers on the sacral region and both feet. Both patients had VLCFA accumulation and a likely pathogenic variant in the ABCD1 gene. Contributing factors identified include immobility due to progressive ALD, poor nutrition, urinary and fecal incontinence, impaired pain perception from cerebral and spinal involvement, and patient-specific psychosocial factors. The authors suggest that ALD patients with immobility and incontinence are at elevated risk for severe pressure ulcers and recommend proactive identification and early multidisciplinary intervention. Limitations include the small sample size inherent to a case report and the inability to verify peripheral sensory neuropathy for patient 1.
