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A child has a genetic defect in which he is unable to make any adrenal cortex hormones except aldosterone.

Since cortisol usually shuts off the hypothalamic CRH secretion by negative feedback, his low cortisol levels will cause his hypothalamus to keep secreting CRH. The CRH will stimulate his anterior pituitary to release more ACTH. The excess ACTH will cause hyperpigmentation, or darkened skin.

But because his adrenal cortex cannot make cortisol, even though the adrenal cortex is being stimulated by ACTH, cortisol levels will remain low.

Decrease

Increase