Hyperaldosteronism

Hyperaldosteronism, also aldosteronism, is a medical condition where too much aldosterone is produced by the adrenal glands, which can lead to lowered levels of potassium in the blood.

Types

In endocrinology, the terms primary and secondary are used to describe the abnormality (e.g., elevated aldosterone) in relation to the defect, i.e., the tumor's location.

Primary

Primary aldosteronism (hyporeninemic hyperaldosteronism) was previously thought to be most commonly caused by an adrenal adenoma, termed Conn's syndrome. However, recent studies have shown that bilateral idiopathic adrenal hyperplasia is the cause in up to 70% of cases. Differentiating between the two is important as this determines treatment.Adrenal carcinoma is an extremely rare cause of primary hyperaldosteronism.Two familial forms have been identified: Type I ( dexamethasone suppressible ) and Type II ( that has been linked to 7p22. )

Features

• hypertension
• hypokalemia (e.g. may cause muscle weakness)
• alkalosis

Investigations

• high serum aldosterone
• low serum renin
• high-resolution CT abdomen

Management

• adrenal adenoma: surgery
• bilateral adrenocortical hyperplasia: aldosterone antagonist e.g. spironolactone

Secondary

• Secondary hyperaldosteronism (hyperreninemic hyperaldosteronism) is due to overactivity of the renin-angiotensin system.

Secondary refers to an abnormality that indirectly results in pathology...
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