POMC and hyperinsulinemic hypoglycemia, familial, 4: In addition, there are other several systemic manifestations such as urinary abnormalities (hydroureter and hydronephrosis among others), neurological signs (ataxia, cognitive impairment), endocrine disorders (deficient growth hormone and corticotropin secretion, hypogonadism in man and delayed menarche in female), and psychiatric symptoms (ranging from mood swings, panic attacks and sleep abnormalities to severe depression) [7].