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An argument can therefore be made that the real ALD is actually the adrenomyeloneuropathic form, with the more aggressive cerebral ALD of young boys driven by a superimposed autoimmune inflammation that is secondary to the myelin lipid derangement

MMA exceeding 1000 nmol/L warrants immediate and thorough clinical attention, as it strongly indicates a severe deficiency or metabolic disorder related to vitamin B12 function [3]

In addition, it has also been tied to premature graying

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Availability of data and materials All data are included in the manuscript