Description Conn’s syndrome
Conn’s syndrome or primary aldosteronism is not quite rare hormone (endocrine) a disease that is characterized by elevated levels of aldosterone in blood. Aldosterone is an important hormone produced by the adrenal glands. When primary aldosteronism adrenal glands produce a variety of reasons aldosterone excess and consequence for the organism unpleasant consequences of the most serious of which is probably just increase blood pressure. Even currently Conn’s syndrome reportedly the leading cause of so-called secondary hypertension (primary, idiopathic hypertension, is an inherited susceptibility to this problem, which, of course, especially helped by inappropriate lifestyle). Although previously considered a rare disease, lately increasingly Conn’s syndrome is a variety of doctors diagnosed as an explanation of a series of high blood pressure patients not adequately respond to antihypertensive therapy.
Prevention Conn’s syndrome
Against Conn’s syndrome, there is no really effective way of prevention, perhaps only timely seek medical care at the primary difficulty that they can be rapidly deployed and treatment of symptoms and the patient has difficulty unnecessarily longer bother, and also to prevent damage to other organs.
Conn’s Syndrome Risk Factors
Affected are mainly women between thirty and fifty years of age, you should therefore be particularly vigilant. Of course the risk factors for this syndrome are already mentioned various changes and abnormalities of the adrenal gland, enlarge, congenital hyperplasia, benign and malignant tumors and the like.
Signs and symptoms of primary aldosteronism
While organs adrenals are very small but have a very great importance for the entire body. They are paired triangular body retroperitoneally located (at the back of the abdominal cavity retroperitoneal) of both kidneys. These bodies produce a variety hormonů- some are in the bark, others in the bone marrow. In the marrow are produced catecholamines (adrenaline and noradrenaline) are produced in the cortex of glucocorticoids, androgens and mineralocorticoid – aldosterone. The function of aldosterone is to maintain ionic equilibrium and thus also contributes to the economy of water. Its action occurring in the kidney to the reabsorption of sodium and potassium excretion vice versa. Therefore increases the level of sodium and reduces the level of potassium in the blood. Since together with sodium and water moves, it is also water retention in the body, thereby increasing blood volume and hence blood pressure. Secretion of aldosterone is dependent upon secretion of the hormone renin in the kidney.
Causes of Conn’s Syndrome, the primary hyperaldosteronism (primary because it originates in the adrenal glands) are often benign example, a benign, growth adrenals, ie primarily of aldosterone-producing cells (this tumor is then called aldosterone). The most common reason to e seventy percent may be hyperplasia, or thickening and high reactivity of both adrenal glands. Rarely, it can lead to a syndrome on the basis of genetic mutation or malignant cancerous growths in the adrenal cortex. A rare type of primary aldosteronism has a familiar occurrence, affects entire families, including children from an early age have a very high blood pressure. Quite often the cause not ever find out, then talk about idiopathic Conn’s syndrome.
The main symptoms are high blood pressure and hypokalemia, a low potassium level in the blood. Was associated with increased blood pH, ie metabolic alkalosis since kidneys secrete more hydrogen cations. In this situation, it is reducing the availability of calcium for tissue and působuje symptoms as hypocalcaemia (snožené calcium levels). Rarely is also reflected hypernatremia, increased levels of sodium. The patient should then visit the doctor when it sees problems such asfrequent urination (especially at night) and therefore greater thirst, weakness, fatigue, muscle spasms, temporary and migrating paralysis, heart palpitations and striking pulse, headache, * * ** tingling and prickling in the muscles.
Primary aldosteronism should be distinguished from the secondary. This comes as a result of any processes that increase the level of renin in the blood (Renin is a hormone produced by the kidneys and has a major impact on the formation, release and aldosterone levels). The reason for increased levels of renin may be, for example, reduced blood flow to the kidneys, low blood pressure and low levels of sodium in the urine. The most important and the most common cause but it is narrowing and obstruction kidney arteries that withdraws from the aorta and kidney blood supply. Includes but congestive heart failure, liver cirrhosis, kidney disease and pregnancy.
Diagnosing Conn’s syndrome
Diagnosis of this disease is very important because one of the few causes of high blood pressure can be effectively treated.
Think of this option is necessary, particularly in patients who do not respond to conventional antihypertensive treatment.
Basic laboratory tests are tests which consist of blood sampling and detection levels mainly of renin and aldosterone, which is detected in the urine within twenty-four hours. What is important is the ratio of levels of renin and aldosterone: if the level is low renin and aldosterone high ratio is considerably increased, and this suggests primary hyperaldosteronism. Furthermore doctor may then do another test, after administration at which for example sodium chloride monitor that reduces the level of aldosterone.
Furthermore, we measure electrolytes, typical is therefore to reduce the level of potassium chloride and carbon dioxide increases. In that case, the doctor on trial lodge spironolactone, which bolukje aldosterone activity, and see if the balance is again Constitution.
These tests can still complement CT (central computerized tomography) adrenal glands, where we are looking for a possible tumor. Here you can see a doctor benign tumors of the adrenal glands, which are mainly the elderly surprisingly common. It is observed also that the adrenal glands areswollen, but it is difficult because the size of normal adrenal in individual humans vary considerably. So if a doctor suspects one of these, may proceed with the testing of venous blood leaving the adrenal glands. These track again mainly aldosterone, cortisol sometimes (then monitors the ratio aldosterone / cortisol) and are compared with the results of both adrenal glands. If varies significantly, it can be assumed that one of them is affected by the adenoma (a benign tumor of the adrenal glands from rising).
Conn’s Syndrome Treatment
The goal of treatment of primary aldosteronism is primarily to alleviate its main and most dangerous symptom, ie mainly high blood pressure, reduce excessively high levels of aldosterone and re-adjust electrolyte balance, therefore, the level of sodium and potassium. Administered treatment depends mainly on how much aldosterone levels are out of whack. When because of one benign tumor of the adrenal gland, the treatment of choice is surgical removal. This often is sufficient to cure hypertension, but sometimes it is even necessary additional treatment with additional agents.
In rare cases where Conn’s syndrome caused by malignant tumor of the adrenal gland should be carefully examined during the procedure and secondary organs such as the kidneys, and it is possible that you will need to remove more than just the adrenal glands.
If the cause of Conn’s syndrome can not be ascertained, he goes about his so-called idiopathic variant, or if there is a hypertrophy of both adrenal glands, surgical treatment is recommended. The treatment is used only medications such as spironolactone or eplerenone that block the function of aldosterone. A side effect of spironolactone administration in men can be gynaecomastia, ie breast enlargement for eplerenone this does not occur.
Furthermore, your doctor may prescribe a variety of antihypertensive drugs, substances lowering blood pressure.
Complication
Again it should be emphasized that the main complication is high blood pressure. He then has a whole range of their own complications that can be very serious. When untreated, it can lead toheart attack or even heart failure, enlargement of the heart – especially the left ventricle, which then has several times thicker wall. It may even cause stroke, kidney damage to develop the image of renal failure, and unfortunately can lead to premature death. All this is possible but obviously timely and targeted therapy very effectively prevented. If it is significantly reduced sodium levels in the blood, the patient may experience symptoms such as muscle cramps, fatigue, excessive urination and heart are often manifested as cardiac arrhythmia.
Other names: primary aldosteronism