Several factors like NR5A1 or SF1, dosage-sensitive sex reversal, adrenal hypoplasia critical region, on chromosome X, gene 1 (DAX1), desert hedgehog (DHH), platelet-derived growth factor- A (PDGF-A), orphan nuclear receptor chicken ovalbumin upstream promoter transcription factor II (COUP-TFII), insulin-like growth factor 1 (IGF-1), hepatocyte growth factor (HGF), homeobox gene Aristaless (ARX), etc. regulate this differentiation process (19). This evidence concerns the gene IGF1 and chronic primary adrenal insufficiency.