Hyperaldosteronism

Definition

Hyperaldosteronism is a disorder which is defined by the body's overproduction of aldosterone, a hormone that controls sodium and potassium levels in the blood. Its overproduction leads to retention of salt and loss of potassium, which leads to hypertension (high blood pressure).

Description

Also known as Conn's syndrome, primary aldosteronism, and secondary aldosteronism, this disorder takes several forms. It often begins with a tumor that produces aldosterone. In fact, approximately 60–70% of the cases of primary aldosteronism result from tumors in the adrenal gland area. Aldosterone is normally produced by the adrenal cortex, or the outer portion of the gland that rests on top of each kidney. Primary aldosteronism is due to adenoma, a typically benign tumor in which the cells form to act as glands or cause the glands on which they rest to overproduce. It can cause a number of problems, most notably hypertension. In secondary aldosteronism, factors outside the adrenal gland may cause overproduction tion of aldosterone, or overproduction of renin, an enzyme stored in the kidney area that stimulates aldosterone and raises blood pressure. Obstructive renal artery disease may also cause hypertension from elevated renin stimulating aldosterone. Oral contraceptives have been known to increase the secretion of aldosterone in some patients. This disorder is more common in women.

— Teresa Norris, RN

(medicine) Hypersecretion of aldosterone by the adrenal cortex.

An abnormality of electrolyte metabolism produced by excessive secretion of aldosterone; it may be primary (Conn's syndrome) or occur secondarily in response to extra-adrenal disease. There may be hypertension, hypokalemia, alkalosis, muscular weakness, polyuria and polydipsia. Called also aldosteronism.

The noun has one meaning:

Meaning #1: a condition caused by over-production of aldosterone
  Synonym: aldosteronism

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 1 Types 2 Primary (hyporeninemic hyperaldosteronism) 3 Secondary (hyperreninemic hyperaldosteronism) 4 Symptoms 5 See also 6 Treatment 7 References 8 External links

Types

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 (hyporeninemic hyperaldosteronism)

• E26.0: Primary aldosteronism 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.

Features

• hypertension
• hypokalaemia (e.g. muscle weakness)
• alkalosis

Investigations

• high serum aldosterone
• low serum renin
• high-resolution CT abdomen

Management

• adrenal adenoma: surgery
• bilateral adrenocortical hyperplasia: aldosterone antagonist e.g. spironolactone

One form has been linked to 7p22.^[2]

Secondary (hyperreninemic hyperaldosteronism)

• E26.1: Secondary hyperaldosteronism is due to overactivity of the renin-angiotensin system.

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.

Symptoms

It can be asymptomatic, but the following symptoms can be present

• Fatigue
• Headache
• High blood pressure
• Hypokalemia
• Intermittent or temporary paralysis
• Muscle spasms
• Muscle weakness
• Numbness
• Polyuria
• Polydipsia
• Tingling
• Hypernatraemia
• Metabolic alkalosis^[3]

See also

• Hypoaldosteronism
• Glucocorticoid remediable aldosteronism

Treatment

Treatment includes Spironolactone, a K+ sparing diuretic that works by acting as an aldosterone antagonist.

References

1. ^ aldosteronism at Dorland's Medical Dictionary
2. ^ Lafferty AR, Torpy DJ, Stowasser M, et al. (November 2000). "A novel genetic locus for low renin hypertension: familial hyperaldosteronism type II maps to chromosome 7 (7p22)". J. Med. Genet. 37 (11): 831–5. PMID 11073536. PMC 1734468. http://jmg.bmj.com/cgi/pmidlookup?view=long&pmid=11073536. 
3. ^ "Hyperaldosteronism: eMedicine Pediatrics: General Medicine". http://emedicine.medscape.com/article/920713-overview. Retrieved 2009-06-16. 

External links

• Merck Manual

v • d • e Endocrine pathology: endocrine diseases (E00-35, 240-259) Pancreas/ glucose metabolism Hypofunction Diabetes mellitus types: (type 1, type 2, MODY 1 2 3 4 5 6) · complications (coma, angiopathy, ketoacidosis, nephropathy, neuropathy, retinopathy, cardiomyopathy) insulin receptor (Rabson-Mendenhall syndrome) · Insulin resistance Hyperfunction Hypoglycemia · beta cell (Hyperinsulinism) · G cell (Zollinger-Ellison syndrome) Hypothalamic/ pituitary axes Hypothalamus gonadotropin (Kallmann syndrome, Adiposogenital dystrophy) · CRH (Tertiary adrenal insufficiency) · vasopressin (Neurogenic diabetes insipidus) · general (Hypothalamic hamartoma) Pituitary Hyperpituitarism anterior (Acromegaly, Hyperprolactinaemia, Pituitary ACTH hypersecretion) · posterior (SIADH) · general (Nelson's syndrome) Hypopituitarism anterior (Kallmann syndrome, Growth hormone deficiency, ACTH deficiency/Secondary adrenal insufficiency) · posterior (Neurogenic diabetes insipidus) · general (Empty sella syndrome, Pituitary apoplexy, Sheehan's syndrome, Lymphocytic hypophysitis) Thyroid Hypothyroidism Iodine deficiency · Cretinism (Congenital hypothyroidism) · Myxedema · Euthyroid sick syndrome Hyperthyroidism Hyperthyroxinemia (Thyroid hormone resistance, Familial dysalbuminemic hyperthyroxinemia) · Hashitoxicosis · Thyrotoxicosis factitia · Graves' disease Thyroiditis Acute infectious · Subacute (De Quervain's, Subacute lymphocytic) · Autoimmune/chronic (Hashimoto's, Postpartum, Riedel's) Goitre Endemic goitre · Toxic nodular goitre · Toxic multinodular goitre Thyroid nodule Parathyroid Hypoparathyroidism Pseudohypoparathyroidism Hyperparathyroidism Primary · Secondary · Tertiary · Osteitis fibrosa cystica Adrenal Hyperfunction aldosterone: Hyperaldosteronism/Primary aldosteronism (Conn syndrome, Bartter syndrome, Glucocorticoid remediable aldosteronism) · AME · Liddle's syndrome · 17α CAH cortisol: Cushing's syndrome (Pseudo-Cushing's syndrome) sex hormones: 21α CAH · 11β CAH Hypofunction/ Adrenal insufficiency (Addison's, WF) aldosterone: Hypoaldosteronism (21α CAH, 11β CAH) cortisol: CAH (Lipoid, 3β, 11β, 17α, 21α) sex hormones: 17α CAH Gonads ovarian: Polycystic ovary syndrome · Premature ovarian failure testicular: enzymatic (5-alpha-reductase deficiency, 17-beta-hydroxysteroid dehydrogenase deficiency) · Androgen receptor (Androgen insensitivity syndrome) general: Hypogonadism (Delayed puberty) · Hypergonadism (Precocious puberty) Height Gigantism · Dwarfism/Short stature (Laron syndrome, Psychogenic dwarfism) Multiple Autoimmune polyendocrine syndrome (APS1, APS2) · Carcinoid syndrome · Multiple endocrine neoplasia (1, 2A, 2B) · Progeria · Woodhouse-Sakati syndrome endocrine navs: anat/physio/dev/hormones, noncongen/congen/neoplasia, symptoms+signs/eponymous, proc

This entry is from Wikipedia, the leading user-contributed encyclopedia. It may not have been reviewed by professional editors (see full disclaimer)