What is Conn's Syndrome?

Conn's syndrome is a rare health

problem that occurs when the adrenal
glands make too much aldosterone.
This problem is also known as primary
hyperaldosteronism. Aldosterone is a
hormone that controls salt and
potassium levels in the blood. Too
much leads to high blood pressure.

Only 1 out of 100 or fewer of all cases

of high blood pressure are caused by
Conn's syndrome. It is more common in
females than in males. It can happen at
any age, but more often in people in
their 30s and 40s.

What Happens Under

Normal Conditions?
The adrenal glands are found above
each kidney. They are triangle-shaped,
Anatomy of the Adrenal Glands
and measure about half an inch in © 2013 Terese Winslow LLC, U.S. Govt. has certain rights
height and 3 inches in length. Each
adrenal gland has 2 layers.

• The adrenal medulla (inner part) makes epinephrine (also called adrenaline).
• The adrenal cortex (outer part) makes steroid hormones (such as cortisone and aldosterone).

The adrenal glands control many

processes in the body. Their job is to
keep the body in balance by making
various hormones that are critical for
maintaining good health.

These hormones do many important

things. For example, they help regulate
fluid and salt levels in the body that
affect blood volume and blood
pressure. They also help the body react
to stress and change. They cause a
faster heart rate and boost other
systems that help you to react quickly
with a burst of energy when needed.
Problems in the cortex or the medulla,
then, can result in high blood pressure.
What are the Symptoms of Conn’s Syndrome?
Most often, patients have higher than normal blood pressure. Blood tests help to tell if high blood
pressure is from Conn’s Syndrome or something else. The usual treatment for high blood pressure
doesn’t generally help treat hyperaldosteronism.

The abnormal electrolyte levels often seen with too much aldosterone lead to signs such as:

• Lack of muscle strength

• Frequent voiding
• Nighttime voiding
• Headache
• Increased thirst
• Pins and needles feeling
• Eyesight problems
• Paralysis that comes and goes
• Muscle twitching and cramps

The severity may depend on the degree of the electrolyte abnormality.

What are the Causes of Conn’s Syndrome?

Most cases are random but some are passed down from a parent. Conn’s Syndrome could be due to a
tumor on the adrenal gland (a benign cortical adenoma). It may be caused by an odd growth in both
adrenal glands (known as a bilateral adrenal hyperplasia). Both health problems cause too much
aldosterone to be released.

Sometimes excess aldosterone is caused by another health issue that lowers blood flow to the kidney.
For example:

• Fluid loss
• Kidney artery narrowing
• Heart failure
 • Shock
• Liver disease
• Pregnancy
• Some kidney tumors

These cases are called "secondary hyperaldosteronism." This term is used because the excess hormone is
not from a problem with the adrenal gland.

How is Conn’s Syndrome Diagnosed?

Blood and urine tests can check for high aldosterone and other blood levels. Your health care provider
may order a CT scan or MRI to find the side of an adenoma or hyperplasia. Patients who have adrenal
masses only need to be screened for Conn’s syndrome if they are known to have blood pressure issues.
If patients with an adrenal mass are found to have a special test known as adrenal vein sampling is
mandatory before the adrenal gland with the mass is removed, since in up to one third of patients the
problem can stem from both or the opposite adrenal gland.

How is Conn’s Syndrome Treated?

Depending on the type of Conn's Syndrome you have the treatment may vary. Below are the common
treatments.

Primary hyperaldosteronism caused by a tumor is most often treated by removing the adrenal gland
(unilateral adrenalectomy). Remember that adrenal vein sampling is mandatory before the adrenal
gland with the mass is removed, since in up to one third of patients the problem can stem from both or
the opposite adrenal gland. This surgery is almost always done laparoscopically.

• Bilateral hyperplasia is treated with diuretics (water pills), which help manage fluid buildup in
the body.
• Secondary hyperaldosteronism is most often treated with drugs.

It's important to know that adrenal surgery is complex. It helps to choose a surgeon who has significant
experience with surgery in the area around the kidneys and adrenal glands. Talk with a few surgeons
before you choose one to work with.

What Can Be Expected after Treatment?

Most patients have a rapid and uneventful recovery from surgery. High blood pressure is greatly
improved in 80 out of 100 to 90 out of 100 of cases. But even after surgery, you may still have high
blood pressure. You may need drugs for hours or weeks until your blood pressure returns to normal.
The reason for this is not fully understood. It may be the result of kidney damage from primary
hyperaldosteronism.

You should continue to see your health care provider after treatment so they can monitor you blood
pressure and electrolytes levels.