POMC and familial glucocorticoid deficiency: Subsequent investigations revealed low serum cortisol (morning: <22 nmol/L, reference 138–690 nmol/L; afternoon: <22 nmol/L, reference 69–345 nmol/L) and very high adrenocorticotropic hormone (ACTH) levels (>278 ng/L, reference <46.37 ng/L) suggesting glucocorticoid deficiency.