Related Subjects:
|Adrenal Physiology
|Addisons Disease
|Phaeochromocytoma
|Adrenal Adenomas
|Adrenal Cancer
|Cushing Syndrome
|Cushing Disease
|Congenital Adrenal hyperplasia
|Primary hyperaldosteronism (Conn's syndrome)
|ACTH
|McCune Albright syndrome
Aldosterone induces sodium and water retention but this is followed within a few days by a spontaneous diuresis (called aldosterone escape) that returns excretion to the level of intake and partially lowers the extracellular fluid volume toward normal thus avoiding any clinically significant oedema
Aldosterone (pmol/L) to renin (mIU/L) ratio of greater than 30 where the aldosterone is greater than 300 pmol/L suggests primary aldosteronism(99% sensitivity, 79% specificity).
About
Aetiology
Causes
Clinical
Indications for screening
Investigations (test off diuretics, ACEIs and ARB)
Cause About
Conn’s adenoma 35% Age 30-60. Women > Men. Benign adenoma < 25 mm. Yellow with high cholesterol content on imaging. Laparascopic adrenalectomy is the treatment of choice for aldosterone secreting
adenomas and is associated with lower morbidity than open
adrenalectomy. Spironolactone may be used. Hypertension cured in 70%
Adrenal Hyperplasia 60% Age 50+. Usually bilateral. Macronodular or micronodular hyperplasia
Adrenal Carcinoma Rare. Elderly patient. Tumour > 4 cm Invasive. Can also be elevated cortisol, androgen, estrogen
Glucocorticoid
suppressible
hyperaldosteronism Rare Autosomal dominant. Childhood Hypertension. Fmaily history. bilateral hyperplasia of zona glomerulosa. 18OHcortisol and 18oxocortisol are elevated.
Differential
Management
References
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Primary hyperaldosteronism (Conn's syndrome)
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