An 8-month-old boy exhibits severe motor, sensory, and cognitive impairments. Brain biopsy shows a disease of white matter characterized by the accumulation of "globoid cells." Biochemical studies reveal an absence of galactocerebroside b-galactosidase activity. What is the appropriate diagnosis?

Krabbe disease is a rapidly progressive, invariably fatal, autosomal recessive neurologic disorder caused by a deficiency of galactocerebroside b-galactosidases. The condition appears in young infants and is defined by the presence of perivascular aggregates of mononuclear and multinucleated cells (globoid cells) in the white matter. The globoid cells are macrophages that contain undigested galactosylceramide. Alexander disease (choice A) is a rare neurologic disorder, also of infants, characterized by mutations in the gene encoding glial fibrillary acidic protein, which leads to aggregates of fibrous structures, known as Rosenthal fibers. Hurler disease (choice B) features the accumulation of mucopolysaccharides.Diagnosis: Krabbe disease