Primary hyperaldosteronism: Difference between revisions

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Latest revision as of 16:03, 18 October 2017

For patient information click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]

Synonyms and keywords: Conn's syndrome, Primary hayperaldosteronism.

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Conn syndrome from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural history, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Cost-Effectiveness of Therapy

Case Studies

Case #1

de:Conn-Syndrom nl:Syndroom van Conn sv:Conns sjukdom

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+<div style="-webkit-user-select: none;">
+{| class="infobox" style="position: fixed; top: 65%; right: 10px; margin: 0 0 0 0; border: 0; float: right;"
+|-
+| {{#ev:youtube|https://https://www.youtube.com/watch?v=JBfkGNr01V8|350}}
+|-
+|}
 __NOTOC__
-{{Infobox_Disease |
+{| class="infobox" style="float:right;"
-  Name           = Conn's syndrome |
+|-
-  Image          = Aldosterone_svg.png  |
+| [[File:Siren.gif|link=Primary hyperladosteronism resident survival guide|41x41px]]|| <br> || <br>
-  Caption        = [[Aldosterone]] |
+| [[Primary hyperaldosteronism resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']]
-  DiseasesDB     = 3073 |
+|}
-  ICD10          = {{ICD10|E|26|0|e|20}} |
+'''For patient information click [[Primary hyperaldosteronism Patient Information|here]]'''
-  ICD9           = {{ICD9|255.1}} |
+{{Primary hyperaldosteronism}}
-  ICDO           = |
+{{CMG}}; {{AE}} {{HK}}
-  OMIM           = |
-  MedlinePlus    = 000330 |
-  MeshID         = D006929 |
-}}
-{{GS}}
-{{Conn syndrome}}
-{{SK}} Primary hyperaldosteronism
+{{SK}} Conn's syndrome, Primary hayperaldosteronism.
-'''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.
+==[[Primary hyperaldosteronism overview|Overview]]==
+==[[Primary hyperaldosteronism historical perspective|Historical Perspective]]==
+==[[Primary hyperaldosteronism pathophysiology |Pathophysiology]]==
+==[[Primary hyperaldosteronism causes|Causes]]==
+==[[Primary hyperaldosteronism differential diagnosis|Differentiating Conn syndrome from other Diseases]]==
+==[[Primary hyperaldosteronism epidemiology and demographics|Epidemiology and Demographics]]==
+==[[Primary hyperaldosteronism Risk Factors|Risk Factors]]==
-==Signs, symptoms and findings==
+==[[Primary hyperaldosteronism Screening|Screening]]==
-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).
-It can be mimicked by [[liquorice]] ingestion ([[glycyrrhizin]]) and [[Liddle syndrome]].
+==[[Primary hyperaldosteronism natural history, complications and prognosis|Natural history, Complications and Prognosis]]==
 ==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>
+[[Primary hyperaldosteronism history and symptoms|History and Symptoms]] | [[Primary hyperaldosteronism physical examination|Physical Examination]] | [[Primary hyperaldosteronism laboratory findings|Laboratory Findings]] | [[Primary hyperaldosteronism other imaging findings|Other Imaging Findings]] | [[Primary hyperaldosteronism other diagnostic studies|Other Diagnostic Studies]]
-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.
-If there is biochemic proof of hyperaldosteronism, [[computed axial tomography|CT scanning]] can confirm the presence of an adrenal adenoma.
-[[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]]
-==Causes==
-The syndrome is due to:
-* [[aldosterone]]-secreting [[adrenal adenoma]] (benign tumor, 50-60%)
-* [[hyperplasia]] of the adrenal gland (40-50%)
-* rare forms
-==Therapy==
-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.
-==Eponym==
-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>
-==References==
-{{Reflist|2}}
+==Treatment==
+[[Primary hyperaldosteronism medical therapy|Medical Therapy]] | [[Primary hyperaldosteronism surgery|Surgery]] | [[v cost-effectiveness of therapy|Cost-Effectiveness of Therapy]]
+==Case Studies==
+:[[Primary hyperaldosteronism case study one|Case #1]]
 {{Endocrine pathology}}

v t e Endocrine pathology: endocrine diseases (E00-35, 240-259)
Thyroid	Hypothyroidism (Iodine deficiency, Cretinism, Congenital hypothyroidism, Goitre, Myxedema) - Hyperthyroidism (Graves disease, Toxic multinodular goitre, Teratoma with thyroid tissue or Struma ovarii) - Thyroiditis (De Quervain's thyroiditis, Hashimoto's thyroiditis, Riedel's thyroiditis) - Euthyroid sick syndrome
Pancreas	Diabetes mellitus (type 1, type 2, coma, angiopathy, ketoacidosis, nephropathy, neuropathy, retinopathy) - Hypoglycemia - Hyperinsulinism - Zollinger-Ellison syndrome - insulin receptor (Rabson-Mendenhall syndrome)
Parathyroid	Hypoparathyroidism (Pseudohypoparathyroidism) - Hyperparathyroidism (Primary, Secondary, Tertiary)
Pituitary	Hyperpituitarism (Acromegaly, Hyperprolactinaemia, SIADH) - Hypopituitarism (Simmonds' disease / Sheehan's syndrome, Kallmann syndrome, Growth hormone deficiency, Diabetes insipidus) - Adiposogenital dystrophy - Empty sella syndrome - Hypophysitis
Adrenal	Cushing's syndrome (Nelson's syndrome, Pseudo-Cushing's syndrome) - CAH (Lipoid, 3β, 11β, 17α, 21α) - Hyperaldosteronism (Conn syndrome, Bartter syndrome) - Adrenal insufficiency (Addison's disease) - Hypoaldosteronism
Gonads	Ovarian dysfunction (Polycystic ovary syndrome, Premature ovarian failure) - Testicular dysfunction (5-alpha-reductase deficiency) - Testosterone biosynthesis (17-beta-hydroxysteroid dehydrogenase deficiency) - General (Hypogonadism, Delayed puberty, Precocious puberty)
Other	Androgen insensitivity syndrome - Autoimmune polyendocrine syndrome - Carcinoid syndrome - Gigantism - Short stature (Laron syndrome, Psychogenic dwarfism) - Multiple endocrine neoplasia (1, 2) - Progeria - Woodhouse-Sakati syndrome

Primary hyperaldosteronism: Difference between revisions

Latest revision as of 16:03, 18 October 2017

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