What pathology is characterized by a lack of negative feedback leading to high ACTH levels due to insufficient cortisol production?

The condition characterized by a lack of negative feedback leading to elevated ACTH levels due to insufficient cortisol production is congenital adrenal hyperplasia. In this disorder, often caused by a deficiency in one of the enzymes involved in steroidogenesis (commonly 21-hydroxylase), the adrenal glands are unable to produce sufficient cortisol. As cortisol levels drop, the pituitary gland responds by increasing the secretion of ACTH, attempting to stimulate cortisol production. However, due to the enzymatic block, cortisol remains low, and ACTH continues to rise.

The high ACTH levels are a direct result of the body's response to the insufficient cortisol levels, illustrating the concept of negative feedback regulation in the endocrine system. In normal physiology, adequate levels of cortisol would inhibit ACTH secretion, but in congenital adrenal hyperplasia, this feedback loop is disrupted.

In contrast, adrenal insufficiency can lead to high ACTH levels as well; however, it does not encompass the same enzymatic defects and pathophysiology specific to congenital adrenal hyperplasia. Congenital adrenal hyperplasia with AR inheritance refers specifically to the genetic aspect rather than clarifying the physiological mechanisms at play. Adrenal crisis involves acute decompensation of adrenal insufficiency, which does not highlight the