Generalized inherited glucocorticoid resistance is a rare disorder caused by glucocorticoid receptor mutations and characterized clinically by hypercortisolism. Pituitary and peripheral resistance are balanced so that neither adrenal insufficiency nor Cushingoid features develop. Clinical characteristics reflect overproduction of adrenal androgens and mineralocorticoids, which are caused by excess stimulation of the adrenal gland by ACTH. These clinical characteristics respond to dexamethasone therapy. Localized and/or acquired glucocorticoid resistance may occur in some circumstances.