In 9 out of 17 VUS (VUS01, VUS02, VUS03, VUS04, VUS08, VUS09, VUS14, VUS15 and VUS17), representing 7 different ABCD1 variants (VUS03–VUS08 and VUS01–VUS09 carry the same variant), we concluded that the ABCD1 variant is likely pathogenic and that an ALD diagnosis is likely. The gene discussed is ABCD1; the disease is X-linked adrenoleukodystrophy.