PRKACA and congenital adrenal hyperplasia: Mutations in protein kinase cAMP-activated catalytic subunit alpha (PRKACA) are especially prevalent in unilateral adenomas, while protein kinase cAMP-activated catalytic subunit alpha copy number gains are associated with bilateral adrenal hyperplasia.[19] Mutations in catenin beta 1 have also been implicated in cortisol-producing adenomas.[19,20]