STAR and Adrenal insufficiency: In our previous study (17), patient F34 (46,XY) had complete male external genitalia and with the compound heterozygous variants (c.367G>A/c.465+2T>A,p.Glu123Lys/unknown), in which the enzymatic activity assay revealed that STAR-Glu123Lys was reserved by 26.15%, and the high residual activity could rescue the steroidogenesis capacity of fetal Leydig cells because he had developed male external genitalia although he had first presented at the age of 6 months with adrenal insufficiency after receiving the first dose of vaccine.