Conn’s syndrome

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Conn syndrome is an aldosterone producing adenoma. Conn syndrome is a benign adenoma in one of the adrenal glands produces and secrets an excessive level of aldosterone. Conn’s syndrome is also known as primary hyperaldosteronism.

In aldosterone producing adenoma the excessive secretion of aldosterone hormone promotoes the reabsorption of sodium at the renal tubules, which then lead water to be absorbed in body, which then finally leads to increased total blood volume therefore resulting in hypertension. As the sodium is reabsorbed, potassium is pumped out. This results in hypokalaemia in patient along with hyperaldosteronism.

Age/sex prevalance of Conn’s syndrome

Conn’s syndrome is more prevalent in men than in women. Prevalence of occurrence is 2:1, men: women.
Conn’s syndrome occurs more in the age group of 30-50 years.

Races affected by Conn’s syndrome

Individuals of any race can be affected by Conn’s syndrome.

Causes of Conn’s syndrome

Primary hyperaldosteronism has many causes, including adrenal hyperplasia and adrenal carcinoma.
The syndrome is due to
• Bilateral adrenal hyperplasia
• Glucocorticoid-remediable hyperaldosteronism
• Renin-angiotensin system disorders
• Adrenal adenoma

Conn’s syndrome Sign and Symptoms

Symptoms presented in Conn’s syndrome
• lethargy
• Muscle weakness
• Muscle cramps
• Cardiac arrhythmias
• Hypertension
• Hypokalaemia
• Polyuria
• Polydispsia

Investigations of Conn’s syndrome

Laboratory investigations to be done are as follows
• Plasma aldosterone
• Plasma rennin activity ratio
• Ratio of rennin and aldosterone if greater than 30 is indicative of primary hyperaldosteronism
• Urinary potassium
• ECG

In the imaging studies following are helpful
• CT scan
• MRI
• Catopril test
• Adrenal venous sampling.

Treatment of Conn’s syndrome

In patients who are suffering from single benign tumor are removed surgically.
For patients with hyperplasia of both glands, successful treatment is often achieved with spironolactone or eplerenone, drugs that block the effect of aldosterone.

Prognosis of Conn’s syndrome

The prognosis is good for these patients; however half of them need to continue anti-hypertensive therapy for the rest of their lives.
In the absence of proper treatment, individuals with hyperaldosteronism often suffer from poorly controlled high blood pressure, which may be associated with increased rates of stroke, heart disease, and kidney failure.

Complications of Conn’s syndrome

• Deep tendon reflexes are lost.
• Due to increase in blood pressure heart disease may occur.
• Congestive heart failure
• Coronary artery disease
• Abnormal heart rhythm due to low potassium levels.

Differential diagnosis of Conn’s syndrome

• Familial hyperaldosteronism type 1
• Syndrome of apparent mineralocorticoid excess
• Secondary hyperaldosteonism
• Any condition resulting in hypokalaemia
• Liddle syndrome

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