The relatively rapid response to exogenous HCG stimulation outside of pregnancy confirms that the aberrant LHCGR remains capable of rapid activation, as demonstrated also by the rapid appearance of hypertension and hypokalemia at each pregnancy; this is similar to the transient Cushing’s syndrome during pregnancy when LHCGR is expressed in primary bilateral macronodular adrenal hyperplasia (PBMAH) patients (12). The gene discussed is LHCGR; the disease is Cushing syndrome due to macronodular adrenal hyperplasia.