Further, multiple sulfatase deficiency (MSD), a similar lysosomal storage – related leukodystrophy with significant CNS involvement arising from autosomal recessive mutation in the sulfatase-modifying factor 1 (SUMF1) encoding gene, causes profound reduction in downstream sulfatase activities, including the sulfatases associated with other LSDs like MLD and various mucopolysaccharidosis (MPS) (Fraldi et al., 2007). This evidence concerns the gene SUMF1 and mucosulfatidosis.