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| {{SK}} Primary hyperaldosteronism | | {{SK}} Primary hyperaldosteronism |
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| '''Conn's syndrome''' is characterized by the overproduction of the [[mineralocorticoid]] [[hormone]] [[aldosterone]] by the [[adrenal gland]]s. Aldosterone causes [[sodium]] and water retention and [[potassium]] excretion in the [[kidney]]s, leading to [[arterial hypertension]] (high blood pressure). It is a rare but recognised cause of hypertension.
| | ==[[Conn syndrome overview|Overview]]== |
| | | ==[[Conn syndrome historical perspective|Historical Perspective]]== |
| ==Signs, symptoms and findings== | | ==[[Conn syndrome pathophysiology |Pathophysiology]]== |
| Conn's syndrome is also known as primary [[hyperaldosteronism]]. Apart from high blood pressure, the symptoms may include [[myalgia|muscle cramps]] and [[headache]]s (due to the low potassium), [[metabolic alkalosis]] (due to increased secretion of H+ ions by the kidney). The high [[pH]] of the blood makes [[calcium in biology|calcium]] less available to the tissues and causes symptoms of [[hypocalcemia]] (low calcium levels). | | ==[[Conn syndrome causes|Causes]]== |
| | | ==[[Conn syndrome differential diagnosis|Differentiating Conn syndrome from other Diseases]]== |
| It can be mimicked by [[liquorice]] ingestion ([[glycyrrhizin]]) and [[Liddle syndrome]].
| | ==[[Conn syndrome epidemiology and demographics|Epidemiology and Demographics]]== |
| | | ==[[Conn syndrome natural history, complications and prognosis|Natural history, Complications and Prognosis]]== |
| ==Diagnosis== | | ==Diagnosis== |
| Measuring aldosterone alone is not considered adequate to diagnose Conn's syndrome. Rather, both [[renin]] and aldosterone are measured, and the ''ratio'' is diagnostic.<ref>{{cite journal |author=Tiu S, Choi C, Shek C, Ng Y, Chan F, Ng C, Kong A |title=The use of aldosterone-renin ratio as a diagnostic test for primary hyperaldosteronism and its test characteristics under different conditions of blood sampling |journal=J Clin Endocrinol Metab |volume=90 |issue=1 |pages=72-8 |year=2005 |pmid=15483077}}</ref><ref>http://www.ubht.nhs.uk/pathology/ChemicalPathology/TestProtocols/16Renin.html</ref>
| | [[Conn syndrome history and symptoms|History and Symptoms]] | [[Conn syndrome physical examination|Physical Examination]] | [[Conn syndrome laboratory findings|Laboratory Findings]] | [[Conn syndrome other imaging findings|Other Imaging Findings]] | [[Conn syndrome other diagnostic studies|Other Diagnostic Studies]] |
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| Usually, renin levels are suppressed, leading to a very low renin-aldosterone ratio (<0.0005). This test is confounded by antihypertensive drugs, which have to be stopped up to 6 weeks.
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| If there is biochemic proof of hyperaldosteronism, [[computed axial tomography|CT scanning]] can confirm the presence of an adrenal adenoma.
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| [[Image:Endocrinesystem.png|frame|center|Major endocrine glands. (Male left, female on the right.) 1. Pineal gland 2. Pituitary gland 3. Thyroid gland 4. Thymus 5. Adrenal gland 6. Pancreas 7. Ovary 8. Testis]] | |
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| ==Causes==
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| The syndrome is due to:
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| * [[aldosterone]]-secreting [[adrenal adenoma]] (benign tumor, 50-60%)
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| * [[hyperplasia]] of the adrenal gland (40-50%)
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| * rare forms
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| ==Therapy==
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| Surgical removal of the offending adrenal ([[adrenalectomy]]) takes away the source of the excess hormones.<ref>{{cite book |title=NMS Surgery |last=Jarrell |first=Bruce E. |coauthors=Anthony Carabasi |year=2007 |publisher=Lippincott Williams & Wilkins |isbn=0781759013 }}</ref> Meanwhile, the blood pressure can be controlled with [[spironolactone]] (a [[diuretic]] that counteracts the actions of aldosterone) and other antihypertensives.
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| ==Eponym==
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| It is named after Dr Jerome W. Conn (1907-1994), the American endocrinologist who first described the condition in 1955. <ref>Conn JW, Louis LH. ''Primary aldosteronism: a new clinical entity.'' Trans Assoc Am Physicians 1955;68:215-31; discussion, 231-3. PMID 13299331.</ref>
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| ==References==
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| {{Reflist|2}}
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| | ==Treatment== |
| | [[Conn syndrome medical therapy|Medical Therapy]] | [[Conn syndrome surgery|Surgery]] | [[Conn syndrome cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] |
| | ==Case Studies== |
| | :[[Conn syndrome case study one|Case #1]] |
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| {{Endocrine pathology}} | | {{Endocrine pathology}} |
