Conn’s Syndrome (Primary Hyperaldosteronism)

Conn’s Syndrome, also known as Primary Hyperaldosteronism, is a hormonal disorder in which the adrenal glands produce excessive amounts of aldosterone, a hormone that helps regulate blood pressure by controlling sodium and potassium levels. The overproduction of aldosterone leads to hypertension (high blood pressure) and an imbalance in electrolytes, which can cause various complications if left untreated.

Understanding the causes, symptoms, and treatment options for Conn’s Syndrome is crucial, as early diagnosis and management can prevent long-term health risks such as heart disease, stroke, and kidney damage.

Causes of Conn’s Syndrome

Conn’s Syndrome is primarily caused by abnormalities in the adrenal glands. The most common causes include:

1. Adrenal Adenoma

• A benign tumor in one adrenal gland that produces excess aldosterone.
• Also called aldosterone-producing adenoma (APA) or Conn’s adenoma.

2. Bilateral Adrenal Hyperplasia (BAH)

• Both adrenal glands are enlarged and overproduce aldosterone.
• This is a common cause of Conn’s Syndrome and may be hereditary.

3. Familial Hyperaldosteronism

• A genetic condition that results in excessive aldosterone production.
• Type I (Glucocorticoid-Remediable Aldosteronism – GRA) responds to steroid treatment.
• Type II does not respond to steroids and requires different treatments.

4. Adrenal Carcinoma

• A rare but serious cancerous tumor in the adrenal gland that leads to excessive hormone production.
• Usually aggressive and requires immediate medical intervention.

Symptoms of Conn’s Syndrome

The symptoms of Conn’s Syndrome vary depending on the severity of aldosterone overproduction and its effect on blood pressure and electrolytes. Common symptoms include:

1. High Blood Pressure (Hypertension)

• Persistent elevated blood pressure that is difficult to control with standard medications.
• Increased risk of heart disease, stroke, and kidney problems.

2. Low Potassium Levels (Hypokalemia)

• Fatigue and muscle weakness
• Frequent urination and excessive thirst (due to potassium imbalance)
• Tingling or numbness in muscles
• Leg cramps and irregular heartbeats (arrhythmias)

3. Other Symptoms

• Headaches and dizziness due to high blood pressure
• Mood changes, irritability, or depression
• Blurred vision in severe cases

Diagnosis of Conn’s Syndrome

Early diagnosis is crucial to prevent complications. Diagnosis typically involves:

1. Blood Tests

• Aldosterone-to-Renin Ratio (ARR): Measures aldosterone and renin levels to detect hyperaldosteronism.
• Potassium Levels: Hypokalemia is a common sign of Conn’s Syndrome.

2. Saline Infusion or Oral Sodium Loading Test

• Confirms whether aldosterone levels remain high despite salt intake, indicating primary hyperaldosteronism.

3. Imaging Tests

• CT Scan or MRI: Detects adrenal tumors or hyperplasia.
• Adrenal Vein Sampling (AVS): Determines whether excess aldosterone is coming from one or both adrenal glands.

Treatment Options for Conn’s Syndrome

The treatment of Conn’s Syndrome depends on its underlying cause and severity.

1. Surgery (Adrenalectomy)

• Recommended for adrenal adenomas or carcinomas.
• The affected adrenal gland is surgically removed to normalize aldosterone levels.
• Cure rate: High, with significant improvement in blood pressure and potassium levels.

2. Medications

For patients who are not candidates for surgery or have bilateral adrenal hyperplasia, medications can help manage symptoms:

Aldosterone Antagonists

• Spironolactone: Blocks aldosterone effects and lowers blood pressure.
• Eplerenone: Similar to spironolactone but with fewer side effects.

Blood Pressure Medications

• Used if aldosterone blockers alone are not sufficient.
• Common options: Calcium channel blockers, ACE inhibitors, or ARBs.

3. Lifestyle Modifications

• Low-sodium diet to help control blood pressure.
• Potassium-rich foods like bananas, spinach, and avocados.
• Regular exercise to maintain overall health and prevent complications.

Complications of Untreated Conn’s Syndrome

If left untreated, Conn’s Syndrome can lead to severe health risks:

• Uncontrolled hypertension, increasing the risk of stroke and heart failure.
• Kidney damage due to chronic high blood pressure.
• Cardiovascular issues, including left ventricular hypertrophy.
• Severe electrolyte imbalances, leading to paralysis or life-threatening arrhythmias.

Conn’s Syndrome, or Primary Hyperaldosteronism, is a serious but treatable condition that significantly impacts blood pressure and overall health. Early detection through proper screening and diagnostic tests is crucial for effective management. Whether through surgery, medications, or lifestyle changes, proper treatment can help patients lead a healthy life while reducing long-term complications.

If you experience symptoms of uncontrolled hypertension or low potassium, consult a healthcare professional for evaluation and appropriate treatment options.

To consult an Endocrinologist at Sparsh Diagnostic Centre, call our helpline number 9830117733.

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