Therefore, mutated StAR impedes steroidogenesis and accumulates cholesterol, causing lipoid CAH, which is the most severe form of steroidogenesis and is characterized by the near absence of all steroids, high basal ACTH, and plasma renin activity, and grossly enlarged adrenals stacked with cholesterol and cholesterol esters (31). The gene discussed is POMC; the disease is congenital adrenal hyperplasia.