The medical history (history of illness) represents an important component in the diagnosis of Conn syndrome. Family history Social history Current anamnesis/systemic anamnesis (somatic and psychological complaints). What symptoms have you noticed? Do you suffer from headaches? Do you feel tired, constantly exhausted? Do you suffer from muscle weakness? Are you prone to constipation? Have … Conn Syndrome: Medical History
Endocrine, nutritional, and metabolic diseases (E00-E90). Adrenogenital syndrome (AGS)-autosomal recessive inherited metabolic disorder characterized by disorders of hormone synthesis in the adrenal cortex; these disorders result in deficiencies of aldosterone and cortisol; virilization (masculinization) in girls and pubertas praecox (premature sexual development) in boys, respectively. Bilateral adrenal hyperplasia – overdevelopment of the adrenal glands (bilateral). … Conn Syndrome: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by Conn syndrome: Endocrine, nutritional, and metabolic diseases (E00-E90). Diabetes mellitus type 2 Dyslipidemia (lipid metabolism disorder) Metabolic syndrome – clinical name for the symptom combination obesity (overweight), hypertension (high blood pressure), increased fasting glucose (fasting blood sugar) and fasting insulin … Conn Syndrome: Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin, mucous membranes and sclerae (white part of the eye). Auscultation (listening) of the heart [arrhythmia?] Palpation (palpation) of the abdomen (abdomen) (tenderness?, knocking pain?, coughing pain?, defensive tension?, … Conn Syndrome: Examination
1st order laboratory parameters – obligatory laboratory tests. Aldosterone, renin Serum aldosterone–renin ratio (ARR) [> 200] Caution. Various drugs (eg, ACE inhibitors, sartans, beta-blockers, potassium-sparing diuretics) affect the result and must be discontinued 2 weeks before (see under: “Serum aldosterone renin quotient”)Note: Blood collection ideally in the morning at least two hours before getting up; … Conn Syndrome: Test and Diagnosis
Therapy goals Normotension (normal blood pressure) Normokalemia (normal level of potassium in the blood). Therapy recommendations Therapeutic depending on the diagnosis: Diagnosis Pharmacotherapy Surgery NNR (adrenal gland) adenoma and unilateral hyperplasia (unilateral excessive cell formation) Aldosterone antagonists After blood pressure reduction and normalization of serum potassium levels, surgical removal of the tumor or affected adrenal … Conn Syndrome: Drug Therapy
Note: Diagnostic imaging before laboratory evidence of the disease is not indicated! Optional medical device diagnostics – depending on the results of the history, physical examination, and obligatory laboratory parameters – for differential diagnostic clarification in case of a positive confirmatory test. Computed tomography (CT; sectional imaging procedure (X-ray images from different directions with computer-based … Conn Syndrome: Diagnostic Tests
1st order for unilateral hyperplasia of the adrenal gland or aldosterone-producing adenoma (APA). Laparoscopic adrenalectomy – removal of the adrenal gland with a minimally invasive procedure.
Patients are usually oligo- or asymptomatic. Therefore, the diagnosis of Conn syndrome is an incidental finding. The following symptoms and complaints may indicate Conn syndrome: Leading symptoms Arterial hypertension ((often presenting as difficult-to-control hypokalemic hypertension) /hypertension) – most commonly manifested by headache. Hypokalemia (potassium deficiency) – usually results in the following symptoms: Muscle weakness, rapid … Conn Syndrome: Symptoms, Complaints, Signs
Pathogenesis (disease development) Conn syndrome involves primary hyperaldosteronism (overproduction of aldosterone). The group of forms of primary hyperaldosteronism* includes: Idiopathic hyperaldosteronism (IHA) with bilateral adrenocortical hyperplasia (65%). Aldosterone-producing adenoma (APA) (Conn syndrome; 30%). Primary unilateral adrenal hyperplasia (3%). Aldosterone-producing adrenocortical carcinoma (malignant tumor; 1%). Aldosterone-producing tumor of the ovary/ovary (<1%). Glucocorticoid-suppressible primary hyperaldosteronism (GSH; synonym: … Conn Syndrome: Causes
Regular check-ups Regular medical checkups Nutritional medicine Nutritional counseling based on nutritional analysis Nutritional recommendations according to a mixed diet taking into account the disease at hand. This means, among other things: A total of 5 servings of fresh vegetables and fruit daily (≥ 400 g; 3 servings of vegetables and 2 servings of fruit). … Conn Syndrome: Therapy
