These alterations made the team consider the hypothesis of hypercortisolism and exams were performed: overnight 1 mg dexamethasone suppression test was positive - cortisol 35.7 μg/dL (reference range 36-137 μg/day); midnight serum cortisol was elevated - 44.8 μg/dL (reference range 1.7-8.9 μg/dL) as were two 24-hour urinary free cortisol measurements - 609.1 μg/day and 1,636.6 μg/day (normal range: 36-137 μg/day); adrenocorticotropic hormone (ACTH) was 61.0 ng/L (reference range < 63.3 ng/L). This evidence concerns the gene POMC and adrenal gland hyperfunction.