Hyperaldosteronism

Definition
  • Hyperaldosteronism is a syndrome resulting from excessive levels of the adrenocortical hormone aldosterone.
Etiologies
  • Primary Hyperaldosteronism (Conn Syndrome)
    • Usually due to an aldosterone-secreting Adrenocortical adenoma
  • Secondary Hyperaldosteronism
  • Differentiation of Etiologies
    • Primary and Secondary Hyperaldosteronism can be distinguished by measuring plasma renin levels
    • Primary Disease: Low renin levels observed as RAAS is inhibited due to hypertension
    • Secondary Disease: High renin levels observed as over-activity of the RAAS itself is to blame for hyperaldosteronism
Morphology
  • Primary Hyperaldosteronism (Conn Syndrome)
    • Usually small, solitary or multiple, well-encapsulated adenoma within a largely normal adrenal cortex
  • Secondary Hyperaldosteronism
    • No specific morphology to be aware of.
Clinical Consequences
  • The clinical consequences of Hyperaldosteronism are exaggerations of the Physiological Actions of Aldosterone
    • Hypertension: Due to excessive retention of Na+
    • Hypokalemia: Due to excessive secretion of K+
    • Metabolic Alkalosis: Due to excessive secretion of H+ (less common clinically)
Treatment
  • Primary Hyperaldosteronism (Conn Syndrome)
    • Surgical resection of adenoma
    • Conn Syndrome is rare but a very correctable form of hypertension
  • Secondary Hyperaldosteronism
    • Correction of underling pathophysiological process leading to excessive RAAS activity