• A 22-year-old man was seen with Addison's disease, psychosis, and neurologic abnormalities. A tentative diagnosis of adrenoleukomyeloneuropathy was made. Because of his age, negative family history, and the potentially serious prognosis of this disorder, the diagnosis was verified with an adrenal biopsy. We believe this procedure is the method of choice in confirming the sporadic, atypical case of adrenoleukomyeloneuropathy.