Primary hyperaldosteronism differential diagnosis: Difference between revisions
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==Differentiating Conn's Syndrome From Other Diseases== | ==Differentiating Conn's Syndrome From Other Diseases== | ||
Conn's syndrome should be differentiated from other diseases causing hypertension and hypokalemia for example: | Conn's syndrome should be differentiated from other diseases causing hypertension and hypokalemia for example:<ref name="pmid23832473">{{cite journal |vauthors=Del Giudice A, Prencipe M, Aucella F |title=[Primary hyperaldosteronism: a diagnostic algorithm] |language=Italian |journal=G Ital Nefrol |volume=30 |issue=3 |pages= |year=2013 |pmid=23832473 |doi= |url= |issn=}}</ref><ref name="pmid19237821">{{cite journal |vauthors=Kasifoglu T, Akalin A, Cansu DU, Korkmaz C |title=Hypokalemic paralysis due to primary hyperaldosteronism simulating Gitelman's syndrome |journal=Saudi J Kidney Dis Transpl |volume=20 |issue=2 |pages=285–7 |year=2009 |pmid=19237821 |doi= |url= |issn=}}</ref><ref name="pmid19442332">{{cite journal |vauthors=Mulatero P, Bertello C, Verhovez A, Rossato D, Giraudo G, Mengozzi G, Limerutti G, Avenatti E, Tizzani D, Veglio F |title=Differential diagnosis of primary aldosteronism subtypes |journal=Curr. Hypertens. Rep. |volume=11 |issue=3 |pages=217–23 |year=2009 |pmid=19442332 |doi= |url= |issn=}}</ref> | ||
*Renal artery stenosis | *Renal artery stenosis | ||
*Cushing's syndrome | *Cushing's syndrome | ||
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Overview
Differentiating Conn's Syndrome From Other Diseases
Conn's syndrome should be differentiated from other diseases causing hypertension and hypokalemia for example:[1][2][3]
- Renal artery stenosis
- Cushing's syndrome
- Congenital adrenal hyperplasia (CAH)
- 17 alpha hydroxylase deficiency
- 11 beta hydroxylase deficiency
- Liddle's syndrome
- Diuretic use
- Licorice ingestion
- Renin-secreting tumors
- ↑ Del Giudice A, Prencipe M, Aucella F (2013). "[Primary hyperaldosteronism: a diagnostic algorithm]". G Ital Nefrol (in Italian). 30 (3). PMID 23832473.
- ↑ Kasifoglu T, Akalin A, Cansu DU, Korkmaz C (2009). "Hypokalemic paralysis due to primary hyperaldosteronism simulating Gitelman's syndrome". Saudi J Kidney Dis Transpl. 20 (2): 285–7. PMID 19237821.
- ↑ Mulatero P, Bertello C, Verhovez A, Rossato D, Giraudo G, Mengozzi G, Limerutti G, Avenatti E, Tizzani D, Veglio F (2009). "Differential diagnosis of primary aldosteronism subtypes". Curr. Hypertens. Rep. 11 (3): 217–23. PMID 19442332.
| Hypertension and Hypokalemia | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Plasma renin activity | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Normal or High (Plasma Renin/Aldosterone ratio <10 | Suppressed (Plasma Renin/Aldosterone ratio >20 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| *Renin-secreting tumors *Diuretic use *Renovascular hypertension *Coarctation of aorta *Malignant phase hypertension | Urinary aldosterone | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Elevated | Normal | Low | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Conn's syndrome (Primary aldosteronism) | Profound K+ depletion | • 17 alpha hydroxylase deficiency • 11 beta hydroxylase deficiency • Liddle's syndrome • Licorice ingestion • Deoxycortisone producing tumor | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Add Mineralocrticoid antagonist for 8 weeks | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| BP response | No BP response | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| • Deoxycorticosterone excess( Tumor, 17 alpha hydroxylase and 11 beta hydroxylase deficiency) • Licorice ingestion •Glucocorticoid resistance | Liddle's syndrome) | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||