A 59-year-old woman with rheumatoid arthritis abruptly discontinued prednisone 5 days ago. She presents with fatigue, nausea, diffuse myalgias, and dizziness. Vital signs show BP 92/58 mmHg, HR 102 bpm, RR 18/min, temperature 37.2°C. Labs reveal morning cortisol 3 mcg/dL (low), ACTH 8 pg/mL (low), sodium 131 mEq/L, potassium 4.0 mEq/L. Glucose is 92 mg/dL. Which underlying mechanism best explains her presentation?

1. A)Suppression of the hypothalamic pituitary adrenal axis by chronic glucocorticoid therapyGABARITO
2. B)Adrenal hemorrhage due to meningococcemia
3. C)Autoimmune destruction of the adrenal cortex
4. D)ACTH secreting pituitary adenoma
5. E)Aldosterone secreting adrenal adenoma