Metachromatic leukodystrophy (MLD) is a lysosomal storage diseases, which are progressive, inherited, and neurodegenerative disorders (MLD included).

4 types of MLD occur with varying ages of onset and courses (i.e., 1. Late infantile, 2. Early juvenile, 3. Late juvenile, 4. Adult).

All forms of MLD involve a progressive deterioration of motor & neurocognitive function.
The typing is somewhat arbitrary, as the types overlap, and some cases do not fall neatly within a single type. MLD actually & scribes a continuum of clinical severity. The presence of white matter abnormalities on brain images is characteristic.

Pathophysiology
In patients, the inability to degrade sulfated glycolipids, especially the galactosyl-3-sulfate ceramides charac­terizes MLD. A deficiency in the lysosomal enzyme sulfatide sulfatase (arylsulfatase A) is present in MLD


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