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Cholesterol Metabolism

Cerebrotendinous Xanthomatosis

Cerebrotendinous xanthomatosis (CTX) is a rare, progressive and underdiagnosed disorder of cholesterol metabolism affecting many parts of the body.

In people with CTX, the body is unable to break down cholesterol properly causing toxins (e.g., cholestanol and bile alcohols) to build up throughout the body over time. The disorder is inherited in an autosomal recessive genetic manner, meaning that a child is affected when each parent passes on one copy of the mutated gene.

Signs and Symptoms

Signs and symptoms of CTX include neonatal cholestasis (jaundice or bile flow interruption), chronic diarrhea, the development of bilateral cataracts before the age of 18, development of tendon xanthomas (fatty deposits in the tendons) during teenage years or later, and neurologic deterioration. The types, combinations and severity of symptoms can be different from person to person, and making diagnosis challenging and often delayed.

Neonatal Cholestasis

Chronic Diarrhea

Bilateral Cataracts

Tendon Xanthomas

Neurologic Deterioration

Medical Necessity Determination for Chenodal® (Chenodiol Tablets) 250 mg

Chenodal has received a medical necessity determination by the FDA for the treatment of CTX.


  1. Cerebrotendinous Xanthomatosis: MedlinePlus Genetics.
  2. CTX Disease – Patient Overview | About CTX.

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