Primary aldosteronism: Difference between revisions
From WikiMD's Wellness Encyclopedia
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Primary | {{SI}} | ||
{{Infobox medical condition | |||
[[File:Aldosterone-2D-skeletal.svg| | | name = Primary aldosteronism | ||
[[File:Adrenal gland Conn syndrome4.jpg|thumb|Adrenal gland showing Conn syndrome]] | | image = [[File:Aldosterone-2D-skeletal.svg|alt=Aldosterone structure]] | ||
| caption = Structure of [[aldosterone]] | |||
| synonyms = Conn's syndrome, primary hyperaldosteronism | |||
| pronounce = | |||
| specialty = [[Endocrinology]] | |||
| symptoms = [[Hypertension]], [[hypokalemia]], [[muscle weakness]], [[fatigue (medical)|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 = [[Essential hypertension]], [[Cushing's syndrome]], [[pheochromocytoma]] | |||
| prevention = | |||
| treatment = [[Spironolactone]], [[eplerenone]], [[surgery]] | |||
| medication = | |||
| prognosis = | |||
| frequency = | |||
| deaths = | |||
}} | |||
[[File:Adrenal gland Conn syndrome4.jpg|left|thumb|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). | '''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== | ==Pathophysiology== | ||
Primary aldosteronism is caused by an abnormality in the adrenal glands. The most common causes include: | 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. | * '''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. | * '''Bilateral adrenal hyperplasia (BAH)''': Enlargement of both adrenal glands leading to increased aldosterone production. | ||
* '''Unilateral adrenal hyperplasia''': Enlargement of one adrenal gland. | * '''Unilateral adrenal hyperplasia''': Enlargement of one adrenal gland. | ||
* '''Adrenal carcinoma''': A rare cause where a malignant tumor produces aldosterone. | * '''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. | 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== | ==Symptoms== | ||
The symptoms of primary aldosteronism can vary but often include: | The symptoms of primary aldosteronism can vary but often include: | ||
* Hypertension that is difficult to control | * Hypertension that is difficult to control | ||
* Muscle weakness | * Muscle weakness | ||
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* Numbness | * Numbness | ||
* Increased thirst and urination | * Increased thirst and urination | ||
==Diagnosis== | ==Diagnosis== | ||
Diagnosis of primary aldosteronism involves several steps: | 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). | 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. | 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. | 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. | 4. '''Adrenal vein sampling''': To differentiate between unilateral and bilateral disease. | ||
==Treatment== | ==Treatment== | ||
Treatment options for primary aldosteronism depend on the underlying cause: | Treatment options for primary aldosteronism depend on the underlying cause: | ||
* '''Surgical removal''': Adrenalectomy is recommended for patients with an aldosterone-producing adenoma. | * '''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. | * '''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. | * '''Lifestyle changes''': Dietary modifications, such as reducing sodium intake, can help manage symptoms. | ||
==Prognosis== | ==Prognosis== | ||
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. | 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== | ==Also see== | ||
* [[Hypertension]] | * [[Hypertension]] | ||
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* [[Endocrinology]] | * [[Endocrinology]] | ||
* [[Hypokalemia]] | * [[Hypokalemia]] | ||
{{Endocrine system}} | {{Endocrine system}} | ||
{{Hypertension}} | {{Hypertension}} | ||
[[Category:Endocrine disorders]] | [[Category:Endocrine disorders]] | ||
[[Category:Hypertension]] | [[Category:Hypertension]] | ||
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 | |
|---|---|
| |
| 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 | |
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) | ||||||||||||||||||||||||||||||||||||||
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| Hypertension and related topics | ||||||||||
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This Hypertension related article is a stub.
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