Conn's Syndrome
Conn's syndrome is a condition associated with the development of high blood pressure in the presence of low potassium levels in the blood. This is usually due to the presence of a tumor in the adrenal cortex, the outer part of the adrenal gland.
The tumor causes excessive amounts of the hormone aldosterone to be released. This is also called hyperhyperaldosteronism. Aldosterone is a hormone that helps to regulate the amount of salt in the body. In patients who have overproduction of this hormone, excessive salt is retained and potassium lost, leading to high blood pressure and low potassium levels.
Not all patients with a Conn's syndrome have a tumor. In some patients, the abnormal function of the adrenal cortex results from a less serious condition called adrenal hyperplasia. However, this may ultimately lead to Conn's syndrome.
Diagnosis
Computed Tomography (CT or CAT Scan) of the adrenal glands can diagnose all but the smallest tumors that causes Conn's syndrome.
Where diagnosis is suspected, i.e. the patient has both high blood pressure and low potassium levels, but the tumor is not seen on CT scan, a test called differential venous sampling for aldosterone may provide the diagnosis. A radiologist inserts a small catheter into the adrenal vein to measure the amount of aldosterone in the blood. In patients with a tumor, the side with the tumor will show excessive amounts of aldosterone.
Treatment
Surgical removal of the tumor is the definitive treatment for Conn's syndrome. The procedure, called an adrenalectomy, usually cures the high blood pressure and low potassium levels, which usually return to normal in most patients.Occasionally, in patients with longstanding tumors, persistent elevation in blood pressure continue after surgery because of damage to blood vessels.In patients with only adrenal hyperplasia, surgery is often not recommended.
In most cases, a laparoscopic adrenalectomy can be performed, a minimally invasive surgery using tiny incisions and a small scope connected to a video camera. The camera sends a magnified image from inside the body to a monitor, giving the surgeon a close-up view of the adrenal anatomy. The surgeon then operates manipulating miniature surgical instruments that were passed through the scope.
Laparoscopic adrenalectomy has key advantages for patients including:
- Less post-operative pain
- Faster recovery from surgery
- Shorter hospital stay
- A more rapid return to work and normal activities
