AAAS and Down syndrome: Triple-A (Allgrove) syndrome is a rare, adrenocorticotrophic (ACTH)-resistant, autosomal recessive hereditary disease, caused by mutations of the triple-A (AAAS) gene, which encodes for the protein ALADIN (alacrima achalasia, adrenal insufficiency, and neurologic disorder), located on chromosome 12q13.