What're the treatments for Conn's syndrome (primary hyperaldosteronism)?
Conn's syndrome resulting from a tumor is usually treated by removing an adrenal gland (unilateral adrenalectomy). This surgery may be performed with an open or laparoscopic approach.
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The commonest cause of high blood pressure is essential hypertension, and this may mimic Conn's syndrome. Thus, high blood pressure and low blood potassium may be due to essential hypertension, which is being treated with diuretic drugs that cause a loss of potassium in the urine. In addition, plasma renin activity may be suppressed by some drugs that are commonly used to treat hypertension (for example, beta-blockers). The suppression may mislead physicians to an incorrect diagnosis of primary hyperaldosteronism (Conn's syndrome). There are also a few very rare conditions your doctor might need to exclude.
In general, patients experience rapid and uneventful postoperative recovery. Of the patients who undergo unilateral adrenalectomy for primary hyperaldosteronism, hypertension is completely resolved or significantly improved in 80 to 90 percent. The preoperative plasma renin activity (PRA) level is the best predictor of postoperative blood pressure outcome. As a result, the cured patients have lower pre-surgical PRA levels than those who are not cured. Even after surgery, some patients have high blood pressure and require medication for hours or weeks until their blood pressure returns to normal. Blood pressure and serum electrolytes should be monitored after surgery and/or after the start of medical therapy.
Up to 5 percent of patients may suffer from ongoing high blood pressure. The reason for this is not fully understood, but some experts believe this may be a result of chronic, irreversible kidney damage from the primary hyperaldosteronism. |
