CTSK and Peripheral demyelination: Interestingly, pycnodysostosis patients suffering from lifelong absence of cathepsin K activity have been occasionally reported to exhibit, in addition to the abnormalities in bone development, alterations in the CNS such as hyperplasia of the pituitary, demyelination of the cerebrum, and imbalances between brain growth, vascular supply, and cerebrospinal fluid pressure, with complications including sensorineural deafness and frontal porencephalic cysts [66].