| Hyperaldosteronism | |
|---|---|
| Classification and external resources | |
Aldosterone |
|
| ICD-10 | E26 |
| ICD-9 | 255.1 |
| OMIM | 103900 605635 |
| DiseasesDB | 6187 |
| MedlinePlus | 000330 |
| eMedicine | radio/354 |
| MeSH | D006929 |
Hyperaldosteronism, also aldosteronism,[1] 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.
Contents |
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 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.[2] )
Features
Investigations
Management
Secondary refers to an abnormality that indirectly results in pathology through a predictable physiologic pathway, i.e., a renin producing tumor leads to increased aldosterone, as the body's aldosterone production is normally regulated by renin levels.
One cause is a juxtaglomerular cell tumor. Another is renal artery stenosis in which the reduced blood supply across the juxtaglomerular apparatus stimulates the production of renin. Also fibromuscular hyperplasia may cause secondary hyperaldosteronism. Other causes can come from the tubules: hyporeabsorption of sodium (as seen in Bartter and Gitelman syndromes) will lead to hypovolemia/hypotension, which will activate the RAA system.
It can be asymptomatic, but the following symptoms may be present:
When taking a blood test, the aldosterone-to-renin ratio is abnormally increased in primary hyperaldosteronism, and decreased or normal but with high renin in secondary hyperaldosteronism.
Treatment includes Spironolactone, a K+ sparing diuretic that works by acting as an aldosterone antagonist.
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