Aldosterone/Conn's Syndrome

Q: What is an aldosteronoma?

  • Most commonly a benign, small tumor of the adrenal gland that produces excessive amounts of the hormone aldosterone
  • You can have a single tumor (tw-thirds of patients) or bilateral hyperplasia (one-third of patients) where both entire adrenal glands are involved.
  • Aldosterone works by retaining sodium and water in the body and getting rid of potassium.

Q: What are the symptoms?

  • Hypertension that can be difficult tcontrol and requires multiple medications
  • Low potassium, which can lead tmuscle weakness or cramps, fatigue, and numbness

Q: How is it diagnosed?

  • The first parts of diagnosis are a series of blood tests and imaging. There is nrole for needle biopsy and it is contraindicated.
  • Some patients may require more extensive blood tests or an interventional radiology procedure called adrenal vein sampling tcomplete the work-up.

Q: What is adrenal vein sampling? Will I need this procedure?

  • Adrenal vein sampling is performed by interventional radiologists usually as an outpatient procedure. It involves sampling the blood in both of your adrenal veins via a large guide wire-directed catheter and comparing the level of aldosterone on the right and left sides.
  • Patients whare over 40 and those without definitive evidence of a solitary tumor on imaging are referred for this procedure.

Q: What is the treatment?

  • All patients need tbe treated thelp prevent and/or diminish potential cardiovascular complications of untreated high blood pressure.
  • Unilateral (one side) adrenal tumor: laparoscopic surgical removal is the treatment of choice.
  • Bilateral disease: medical treatment with aldosterone-antagonist drugs and a low-salt diet.

Q: Will I be off all my high blood pressure medication after the surgery?

  • The rule of thumb is one-third of patients are able tstop all their blood pressure medications, one-third are able tdecrease the number of medications, and one-third show improvement in symptoms and ability tcontrol the blood pressure but need tstay on their medications. However, your body generally needs time treregulate itself syour medication may be weaned off slowly.

Q: DI need regular follow-up visits?

  • Yes. After your post-op visit, your follow-up will continue with your endocrinologist and primary physician.