Additional endocrine examinations demonstrated the following: no response of plasma ACTH levels by the human corticotropin-releasing hormone (hCRH) test; an exaggerated response of plasma ACTH levels by the growth hormone-releasing peptide 2 (GHRP2) test; little suppression of plasma cortisol levels (less than half the basal level) in a high-dose (8 mg) overnight DST; and no clear pituitary adenoma and no shift of pituitary stalk on MRI with Gd-DTPA enhancement (Fig. 2). This evidence concerns the gene POMC and pituitary gland adenoma.