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Wednesday, January 07, 2009

Conn’s Syndrome is Adrenal Adenoma

Question 87
Conn’s Syndrome is 
a.       Adrenal hyperplasia
b.      Adrenal carcinoma
c.       Adrenal adenoma
d.      None of the above
Answer
c. Adrenal Adenoma.
Reference:
Harrison 16th Edition Page 2138
QTDF
Harrison
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Discussion
In the original case of excessive and inappropriate aldosterone production, the disease was the result of an aldosterone-producing adrenal adenoma (Conn's syndrome). Most cases involve a unilateral adenoma, which is usually small and may occur on either side.
Explanation
Self Explanatory. Though Hyperaldosteronism can be due to many causes, an aldosterone producing adrenal adenoma is called as Conn’s Disease
Comments
Rarely, primary aldosteronism is due to an adrenal carcinoma. Aldosteronism is twice as common in women as in men, usually occurs between the ages of 30 and 50, and is present in approximately 1% of unselected hypertensive patients. However, the prevalence may be as high as 10%, depending on the criteria and study population. Most of this difference is not secondary to the prevalence of patients with an aldosteronoma but rather because of the inclusion of those with bilateral hyperplasia.
In many patients with clinical and biochemical features of primary aldosteronism, a solitary adenoma is not found at surgery. Instead, these patients have bilateral cortical nodular hyperplasia. In the literature, this disease is also termed idiopathic hyperaldosteronism, and/or nodular hyperplasia. The cause is unknown
Tips
High blood pressure (hypertension) is the main, and often the only, symptom.
Other symptoms may occur because high aldosterone levels in the blood act on the kidney to increase the loss of the mineral potassium in the urine. This in turn may lead to a fall in blood potassium, resulting in tiredness, muscle weakness and passing of large volumes of urine (polyuria), especially at night (nocturia). However, these symptoms are also found in many other conditions (for example, diabetes mellitus or hypercalcaemia) and do not, by themselves, establish a diagnosis of Conn's syndrome. Also, many patients with proven Conn's syndrome do not have a low blood potassium level.

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