GH1 and obesity due to melanocortin 4 receptor deficiency: Based on this perspective, the MR signalling at the CPEC level could therefore be a key pathway in IIH pathophysiology and could explain several reported endocrine-metabolic causes of IIH (see Figure 3), including PAL and SAL, obesity, metabolic syndrome, Cushing syndrome, chronic steroid administration, hypervitaminosis A, recombinant growth hormone (r-GH) therapy, and estro-progestin supplementation [50, 89–91].