Conn's syndome

Question 1

What is Conn’s syndrome?

Answer 1

Primary hyperaldosteronism

Question 2

What is the common presentation of Conn’s syndrome?

Answer 2

Hypokalaemia and characteristically mild to moderate (occasionally severe) hypertension`

Question 3

What are the causes of conn’s?

Answer 3

May be caused by discrete adrenal adenomas or bilateral hyperplasia of zona glomerulosa.

Question 4

What are the symptoms of hypokalaemia that can appear in Conn’s syndrome?

Answer 4

• Muscle weakness
• Cramps
• Polyuria

Question 5

In whom should Conn’s syndrome be suspected?

Answer 5

Hypertensive patient who is:

• <40y/o
• Hypokalaemic
• Resistant to drug therapy
• Family hx

Question 6

How is Conn’s syndrome diagnosed?

Answer 6

Measure renin and aldosterone over overnight recumbency and again after 4hrs in upright position

Pts with adrenal adenomas have suppressed renin and increased aldosterone which does not change with posture.
Those with bilateral hyperplasia also have hyporeninaemic hyperaldosteronism but plasma aldosterone increases with posture.

Adrenal ademona demonstrated by CT, MR or ultrasound.

Bilateral hyperplasia can be confirmed by catheterising renal veins and demonstrating similar aldosterone levels on both sides

Question 7

What is the treatment for Conn’s syndrome?

Answer 7

Treat with spironolactone

Adrenal ademonas can be excised.