In a secondary analysis of the Angiotensin II for the Treatment of High-Output Shock (ATHOS-3) trial enrolling patients with refractory vasodilatory shock, significant ACE deficiency was hypothesized based on elevated angiotensin I: angiotensin II ratios of peptides [2]. The gene discussed is ACE; the disease is hyperinsulinemic hypoglycemia, familial, 4.