SAMD9 and chronic primary adrenal insufficiency: In 2016, mutations in SAMD9 were identified in patients with adrenal hypoplasia with extra-adrenal features such as intrauterine growth restriction, recurrent infections, gonadal and bone marrow failure, a condition designated as MIRAGE (Myelodysplasia, Infection, Restriction of growth, Adrenal hypoplasia, Genital phenotypes, and Enteropathy) syndrome [10].