The clinical course of X-ALD in men: patients are born asymptomatic, whereas Addison’s disease is usually the first manifestation of the disease, affecting up to 80% of men. Adrenomyeloneuropathy appears later in life (3rd decade) with an incidence increasing with increasing age and affecting almost 100% of men. Cerebral form of ALD may be apparent in early childhood, however it can emerge at any age and is thought to be the result of an interplay between genetic and environmental factors | Kemp et al. 2016

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