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= Primary Aldosteronism (PA) =
{{SI}}
 
{{Infobox medical condition
'''Primary Aldosteronism (PA)''', also known as '''primary hyperaldosteronism''' or '''Conn's syndrome''', is a condition characterized by the excessive production of aldosterone, a hormone produced by the adrenal glands. Aldosterone helps regulate blood pressure by controlling the balance of sodium and potassium in the blood. When too much aldosterone is produced, it leads to low levels of renin (a hormone that regulates blood pressure and water balance), high blood pressure (hypertension), potassium deficiency, and a range of other symptoms.
| name            = Primary aldosteronism
 
| image          = [[File:Aldosterone-2D-skeletal.svg|alt=Aldosterone structure]]
<youtube>
| caption        = Structure of [[aldosterone]]
title='''{{PAGENAME}}'''  
| synonyms        = Conn's syndrome, primary hyperaldosteronism
movie_url=http://www.youtube.com/v/og8ea9ggxic
| pronounce      =
&rel=1
| specialty      = [[Endocrinology]]
embed_source_url=http://www.youtube.com/v/og8ea9ggxic
| symptoms        = [[Hypertension]], [[hypokalemia]], [[muscle weakness]], [[fatigue (medical)|fatigue]]
&rel=1
| complications  = [[Cardiovascular disease]], [[stroke]], [[kidney damage]]
wrap = yes
| onset          =
width=750
| duration        =
height=600
| types          =
</youtube>
| causes          = [[Adrenal adenoma]], [[bilateral adrenal hyperplasia]]
 
| risks          =
== Causes ==
| diagnosis      = [[Blood test]], [[urine test]], [[CT scan]], [[adrenal vein sampling]]
PA can be caused by one or more factors, including:
| differential    = [[Essential hypertension]], [[Cushing's syndrome]], [[pheochromocytoma]]
* '''Adrenal Hyperplasia''': The enlargement of both adrenal glands.
| prevention      =
* '''Adrenal Adenoma''': A benign tumor in one of the adrenal glands.
| treatment      = [[Spironolactone]], [[eplerenone]], [[surgery]]
In rare cases, PA can result from familial genetic conditions.
| medication      =
 
| prognosis      =
[[File:Adrenal Gland detail - English.png|thumb|500px|Diagram showing the location of the adrenal glands.]]
| frequency      =  
 
| deaths          =
== Symptoms ==
}}
Symptoms of primary aldosteronism may vary and include:
[[File:Adrenal gland Conn syndrome4.jpg|left|thumb|Adrenal gland showing Conn syndrome]]
* High blood pressure that is difficult to control with medication.
'''Primary aldosteronism''', also known as '''Conn's syndrome''', is a condition characterized by excessive production of the hormone [[aldosterone]] by the adrenal glands, leading to low renin levels. This overproduction of aldosterone causes the body to retain sodium and lose potassium, resulting in hypertension (high blood pressure) and hypokalemia (low potassium levels).
* Fatigue and muscle weakness.
==Pathophysiology==
* Muscle spasms and cramps.
Primary aldosteronism is caused by an abnormality in the adrenal glands. The most common causes include:
* Low back and flank pain.
* '''Aldosterone-producing adenoma (APA)''': A benign tumor in the adrenal gland that produces aldosterone.
* Trembling and tingling sensations.
* '''Bilateral adrenal hyperplasia (BAH)''': Enlargement of both adrenal glands leading to increased aldosterone production.
* Dizziness or vertigo.
* '''Unilateral adrenal hyperplasia''': Enlargement of one adrenal gland.
* Nocturia (excessive urination at night) and frequent urination.
* '''Adrenal carcinoma''': A rare cause where a malignant tumor produces aldosterone.
* Poor vision, confusion, or headaches due to high blood pressure.
The excess aldosterone leads to increased reabsorption of sodium and water in the kidneys, which increases blood volume and blood pressure. It also causes increased excretion of potassium, leading to hypokalemia.
 
==Symptoms==
== Diagnosis ==
The symptoms of primary aldosteronism can vary but often include:
Diagnosis of PA involves a series of tests, including:
* Hypertension that is difficult to control
* Blood tests to measure aldosterone and renin levels.
* Muscle weakness
* Imaging tests (CT scan or MRI) to identify any abnormalities in the adrenal glands.
* Fatigue
* Adrenal vein sampling to determine which gland is overproducing aldosterone.
* Headaches
 
* Numbness
== Treatment ==
* Increased thirst and urination
Treatment for PA depends on the underlying cause and may include:
==Diagnosis==
* '''Medication''': Drugs that block the action of aldosterone can be effective in controlling blood pressure and correcting potassium levels.
Diagnosis of primary aldosteronism involves several steps:
* '''Surgery''': In cases where a tumor is present, surgical removal of the affected adrenal gland may be recommended.
1. '''Screening tests''': Measurement of plasma aldosterone concentration (PAC) and plasma renin activity (PRA) to calculate the aldosterone-to-renin ratio (ARR).
* '''Lifestyle Changes''': Dietary adjustments, particularly reducing salt intake, can help manage symptoms.
2. '''Confirmatory tests''': Saline infusion test, oral sodium loading test, or fludrocortisone suppression test to confirm the diagnosis.
 
3. '''Imaging studies''': CT scan or MRI of the adrenal glands to identify adenomas or hyperplasia.
== Complications ==
4. '''Adrenal vein sampling''': To differentiate between unilateral and bilateral disease.
If left untreated, PA can lead to serious health issues, including:
==Treatment==
* Cardiovascular disease (stroke, myocardial infarction).
Treatment options for primary aldosteronism depend on the underlying cause:
* Kidney failure.
* '''Surgical removal''': Adrenalectomy is recommended for patients with an aldosterone-producing adenoma.
* Abnormal heart rhythms (arrhythmias).
* '''Medications''': Mineralocorticoid receptor antagonists such as spironolactone or eplerenone are used to treat bilateral adrenal hyperplasia or when surgery is not an option.
 
* '''Lifestyle changes''': Dietary modifications, such as reducing sodium intake, can help manage symptoms.
== External Links ==
==Prognosis==
* [https://www.niddk.nih.gov/health-information/endocrine-diseases/primary-aldosteronism National Institute of Diabetes and Digestive and Kidney Diseases - Primary Aldosteronism]
With appropriate treatment, the prognosis for primary aldosteronism is generally good. Surgical removal of an adenoma can cure hypertension in many patients, while medication can effectively control blood pressure and potassium levels in others.
* [https://www.mayoclinic.org/diseases-conditions/primary-aldosteronism/symptoms-causes/syc-20355205 Mayo Clinic - Primary Aldosteronism]
==Also see==
 
* [[Hypertension]]
== References ==
* [[Adrenal gland]]
<references/>
* [[Endocrinology]]
* ''The Diagnosis and Treatment of Primary Aldosteronism in the Hypertensive Patient'' by the American College of Cardiology.
* [[Hypokalemia]]
* ''Primary Aldosteronism: Practical Approach to Diagnosis and Management'' by the Circulation Journal.
{{Endocrine system}}
 
{{Hypertension}}
[[Category:Endocrine disorders]]
[[Category:Endocrine disorders]]
[[Category:Hypertension]]
[[Category:Hypertension]]
[[Category:Adrenal gland disorders]]
{{stub}}

Latest revision as of 20:50, 8 April 2025

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Primary aldosteronism
Aldosterone structure
Synonyms Conn's syndrome, primary hyperaldosteronism
Pronounce
Specialty Endocrinology
Symptoms Hypertension, hypokalemia, muscle weakness, fatigue
Complications Cardiovascular disease, stroke, kidney damage
Onset
Duration
Types
Causes Adrenal adenoma, bilateral adrenal hyperplasia
Risks
Diagnosis Blood test, urine test, CT scan, adrenal vein sampling
Differential diagnosis Essential hypertension, Cushing's syndrome, pheochromocytoma
Prevention
Treatment Spironolactone, eplerenone, surgery
Medication
Prognosis
Frequency
Deaths


Adrenal gland showing Conn syndrome

Primary aldosteronism, also known as Conn's syndrome, is a condition characterized by excessive production of the hormone aldosterone by the adrenal glands, leading to low renin levels. This overproduction of aldosterone causes the body to retain sodium and lose potassium, resulting in hypertension (high blood pressure) and hypokalemia (low potassium levels).

Pathophysiology[edit]

Primary aldosteronism is caused by an abnormality in the adrenal glands. The most common causes include:

  • Aldosterone-producing adenoma (APA): A benign tumor in the adrenal gland that produces aldosterone.
  • Bilateral adrenal hyperplasia (BAH): Enlargement of both adrenal glands leading to increased aldosterone production.
  • Unilateral adrenal hyperplasia: Enlargement of one adrenal gland.
  • Adrenal carcinoma: A rare cause where a malignant tumor produces aldosterone.

The excess aldosterone leads to increased reabsorption of sodium and water in the kidneys, which increases blood volume and blood pressure. It also causes increased excretion of potassium, leading to hypokalemia.

Symptoms[edit]

The symptoms of primary aldosteronism can vary but often include:

  • Hypertension that is difficult to control
  • Muscle weakness
  • Fatigue
  • Headaches
  • Numbness
  • Increased thirst and urination

Diagnosis[edit]

Diagnosis of primary aldosteronism involves several steps: 1. Screening tests: Measurement of plasma aldosterone concentration (PAC) and plasma renin activity (PRA) to calculate the aldosterone-to-renin ratio (ARR). 2. Confirmatory tests: Saline infusion test, oral sodium loading test, or fludrocortisone suppression test to confirm the diagnosis. 3. Imaging studies: CT scan or MRI of the adrenal glands to identify adenomas or hyperplasia. 4. Adrenal vein sampling: To differentiate between unilateral and bilateral disease.

Treatment[edit]

Treatment options for primary aldosteronism depend on the underlying cause:

  • Surgical removal: Adrenalectomy is recommended for patients with an aldosterone-producing adenoma.
  • Medications: Mineralocorticoid receptor antagonists such as spironolactone or eplerenone are used to treat bilateral adrenal hyperplasia or when surgery is not an option.
  • Lifestyle changes: Dietary modifications, such as reducing sodium intake, can help manage symptoms.

Prognosis[edit]

With appropriate treatment, the prognosis for primary aldosteronism is generally good. Surgical removal of an adenoma can cure hypertension in many patients, while medication can effectively control blood pressure and potassium levels in others.

Also see[edit]

Diseases of the endocrine system (E00–E35, 240–259)
Pancreas/
glucose
metabolism
Hypothalamic/
pituitary axes
Hypothalamus
Pituitary
Thyroid
Parathyroid
Adrenal
Height
Multiple



Hypertension and related topics
Basics
Disorders
Diagnosis
Management
Complications
This Hypertension related article is a stub.
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