Vanishing white matter disease (VWMD) is an autosomal recessive disorder characterized by progressive degeneration of the white matter. While variable clinical presentation is well documented, there are no reports of adrenal insufficiency. We describe a young Saudi girl with VWMD whose atypical phenotype suggested adrenoleukodystrophy. This complicated the diagnostic workup until homozygosity scan revealed a novel mutation in EIF2B2.This report widens the clinical spectrum of VWMD and raises the possibility of an allele-specific association with adrenal insufficiency.
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