POMC and congenital adrenal hyperplasia: Hypercorticism with low plasma adrenocorticotrophin (ACTH) and cell proliferation in patients with macronodular adrenal hyperplasia is ascribed to intrinsic adrenal changes, that include the frequent expression of aberrant G-protein-coupled receptors in the membranes of steroidogenic cells that are stimulated by a variety of circulating ligands (1), (2), and a possible paracrine effect of corticotropin produced by the same hyperplastic adrenal tissue (3).