The etiologic spectrum of PAI is broad and includes congenital adrenal hyperplasia (CAH), X-linked Adrenal hypoplasia congenita, SF-1 linked Adrenal hypoplasia congenita, adrenoleukodystrophy (ALD), adrenomyeloneuropathy, familial glucocorticoid deficiency (FGD), Triple A syndrome, Xp21 deletion syndrome, infectious adrenalitis and autoimmune adrenalitis (4–7). The gene discussed is SF1; the disease is adrenoleukodystrophy.