Question: A 33-year-old woman with a loss of 6 kg in the last 4 months, asthenia and anorexia. Amenorrhea for 2 months. The hormonal results indicate a basal cortisol serum concentration of 108 nmol / l (baseline normal value 115-550) and 123 nmol / l after stimulation with ACTH. The baseline plasma concentration of ACTH is 48 pmol / l (normal value: 2-12). What is the most likely diagnosis? 
 Options:  <1> Primary adrenal insufficiency. <2> Secondary adrenal insufficiency. <3> Tertiary adrenal insufficiency due to hypothalamic lesion. <4> ACTH-producing pituitary tumor (corticotropinoma). <5> More tests should be done since the diagnosis is inconclusive.
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