POMC and pyruvate dehydrogenase deficiency: Equally, the ACTH stimulation test lacks sensitivity, estimates range from 80 to 88% for PDH cases to 57 to 63% for ADH cases (Peterson et al. 1982, Feldman 1983, Reusch & Feldman 1991, Kaplan et al. 1995, Monroe et al. 2012).