POMC and hypogonadotropic hypogonadism: Hypothalamic dysfunction may underlie many components of the syndrome, including hyperphagia, sleep abnormalities, temperature dysregulation, and multiple pituitary hormone insufficiencies, including growth hormone (GH), adrenocorticotropic hormone (ACTH), TSH deficiencies, hypogonadotropic hypogonadism, but also, less commonly, precocious puberty (170, 172, 173).