Principal causes include congenital adrenal hyperplasia (CAH), X-linked congenital adrenal hypoplasia (AHC), familial glucocorticoid deficiency (FGD) caused by adrenal cortical unresponsiveness to ACTH, adrenoleukodystrophy (ALD) and triple A syndrome (Allgrove syndrome) (1, 2). The gene discussed is POMC; the disease is adrenoleukodystrophy.