Lorenzo's Oil and Thrombocytopenia in Patients with Adrenoleukodystrophy

To the Editor: Adrenoleukodystrophy is a sex-linked disorder in which very-long-chain fatty acids accumulate in all body tissues¹. For this reason, a variety of diets have been formulated to lower the levels of these acids. One diet includes Lorenzo's Oil, a product that contains 20 percent erucic acid (22:1) and 80 percent oleic acid (18:1). During the past two years, 40 male and 6 female patients have received Lorenzo's Oil according to a protocol calculated to provide 20 percent of daily caloric intake. In 19 of these patients the platelet count has decreased significantly (Table 1). The degree of…