CONN’s Syndrome

Question 1

What is the definition of conns?

Answer 1

Primary hyperaldosteronism due to an aldosterone producing adenoma

Excess aldosterone, independent of RAAS

Main cause - secondary cause of hypertension

Question 2

Causes of conns

Answer 2

2/3 - adrenal adenoma (conns)
1/3 - bilateral adrenal hyperplasia

Question 3

Pathology of conns

Answer 3

High aldosterone = high Na+ and low K+ = hypertension and hypokalaemia

Question 4

Signs and symptoms of conns

Answer 4

Hypertension, hypokalaemia, muscle weakness, parasthesia, polydipsia + polyuria - nocturia (unfixable with ACE - i)

Question 5

Diagnose conns

Answer 5

1st line - aldosterone: renin ratio high
Diagnostic = high serum aldosterone not suppressed with IV saline or fludrocortisone
Plasma K+ = decreased
U&E

Question 6

Treatment of Conns

Answer 6

1st line: spironolactone (aldosterone antagonist) - use 4 weeks pre op & for bilateral hyperplasia

Gold standard: surgery (laparoscopic adrenalectomy) - if adenoma