Conn's Syndrome

• Primary hyperaldosteronism results from autonomous aldosterone secretion, which, in turn, leads to suppression of renin secretion.
  
• Primary aldosteronism usually occurs in individuals between the ages of 30 and 50 years and accounts for 1% of cases of hypertension.
  
• Primary hyperaldosteronism is usually associated with hypokalemia; however, more patients with Conn's syndrome are being diagnosed with normal potassium levels.
  
• Most cases result from a solitary functioning adrenal adenoma (approximately 70%) and idiopathic bilateral hyperplasia (30%).
  
• Adrenocortical carcinoma and glucocorticoid suppressible hyperaldosteronism are rare, each accounting for less than 1% of cases.
  
• Patients typically present with hypertension, which is longstanding, moderate to severe, and may be difficult to control despite multiple-drug therapy. Other symptoms include muscle weakness, polydipsia, polyuria, nocturia, headaches, and fatigue. Weakness and fatigue are related to the presence of hypokalemia.
  

• Hypokalemia is a common finding and hyperaldosteronism must be suspected in any hypertensive patient who presents with coexisting hypokalemia while on diuretic therapy, despite potassium replacements.
• Patients with primary hyperaldosteronism have an elevated plasma aldosterone concentration (PAC) level with a suppressed plasma renin activity (PRA); a PAC:PRA ratio of 25 to 30:1 is strongly suggestive of the diagnosis.

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