ARSB and mucopolysaccharidosis type 6: MPS VI, also known as Maroteaux-Lamy syndrome, is caused by deficiencies in N-acetylgalactosamine-4-sulfatase resulting from pathogenic variants in the arylsulfatase B (ARSB) gene and results in the accumulation of 4-sulfated chondroitin and dermatan sulfates [29].