Hypercortisolism work-up revealed her 8 Am cortisol was 103 μg/dL (2841 nmol/L) (normal: 4.3-22.4 μg/dL; 118-618 nmol/L) and 24-hour urinary free cortisol (UFC) was 15 184 μg/24 hours (41 907 nmol/24 hours) (normal: 3.5-45 μg/24 hours; 96.6-1244.2 nmol/24 hours) and significantly raised serum ACTH of greater than 1250 pg/mL (>275 pmol/L) (normal: < 46.0 pg/mL; < 10.0 pmol/L), suggesting ACTH-dependent hypercortisolism. This evidence concerns the gene POMC and adrenal gland hyperfunction.