ConnSyndrom

ConnSyndrom, commonly called Conn syndrome, is a form of primary hyperaldosteronism characterized by autonomous production of aldosterone from the adrenal cortex, most often due to an aldosterone-producing adenoma (Conn’s tumor) or bilateral adrenal hyperplasia. Excess aldosterone causes sodium retention and potassium loss, leading to hypertension and hypokalemia; renin levels are suppressed due to negative feedback.

Clinical features include hypertension that is often resistant to standard therapies, fatigue, muscle weakness or cramps, polyuria, headaches, and sometimes no symptoms aside from high blood pressure. Hypokalemia can contribute to arrhythmias and metabolic alkalosis.

Diagnosis starts with screening for primary hyperaldosteronism using the aldosterone-to-renin ratio (ARR). A high ARR suggests autonomous aldosterone secretion and is followed by confirmatory testing, such as saline suppression or oral sodium loading. Imaging (CT or MRI) helps identify adrenal lesions but cannot reliably distinguish unilateral from bilateral disease. Adrenal venous sampling is commonly used to localize unilateral versus bilateral involvement when surgery is considered.

Treatment depends on the subtype. Unilateral aldosterone-producing adenoma is typically treated with surgical removal of the affected adrenal gland (adrenalectomy), which can cure or improve hypertension and normalize potassium. Bilateral adrenal hyperplasia is managed medically with mineralocorticoid receptor antagonists, such as spironolactone or eplerenone, often in combination with other antihypertensives. Potassium supplementation may be needed and general cardiovascular risk reduction is important.

Epidemiology and prognosis: ConnSyndrom is a significant cause of secondary hypertension, estimated to affect a portion of hypertensive patients (more common in resistant hypertension). With appropriate treatment, potassium levels normalize and cardiovascular risk decreases. The condition was first described by Jerome W. Conn in the mid-20th century.