FDXR and adrenocortical insufficiency: We suspect that FDXR-associated adrenocortical insufficiency could also be a progressive 2-hit adrenal disorder, where the first genetic hit causes reduced electron transfer to dependent steroidogenic enzymes, while the second hit consists of accumulation of reactive oxygen species and disruption of oxidative phosphorylation associated with FDXR’s role in Fe-S cluster assembly, inevitably causing cell death (9, 14).