POMC and acute adrenal insufficiency: He was referred to our Department, where the diagnosis of acute adrenal failure was made on the basis of the clinical phenotype, mild hyponatremia (132 mmol/l), high plasma ACTH level (961 pg/ml n.v. 10–130), low plasma cortisol levels (31,5 ng/ml n.v. 50–200), and normal aldosterone and renine levels.