Primary aldosteronism (Conn’s syndrome)
Introduction
Primary aldosteronism occurs when the adrenal glands produce too much of the steroid hormone aldosterone, which helps control sodium and potassium excretion
-Excessive aldosterone production increases sodium retention and suppresses plasma renin
-It increases renal potassium excretion, which can lead to hypokalemia
-The most common cause of refractory hypertension in young and middle-aged adults: Primary aldosteronism
-Most frequent cause of primary aldosteronism: Bilateral adrenal cortical hyperplasia
Symptoms & signs
Fatigue, edema, tingling, muscle weakness, excessive thirst, frequent urination, visual disturbances, normotension, hypertension, paresthesias with tetany, headache, polyuria and polydipsia
Diagnosis
Labs: low plasma renin; low potassium; Elevated plasma and urine aldosterone levels, sodium bicarbonate levels
Imaging: Adrenal CT
Treatment
Unilateral Adrenal adenoma: usually treated by adrenalectomy
Bilateral adrenal hyperplasia: usually treated with medical therapy
Medications: Spironolactone, Eplerenone, Amiloride