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Conn Syndrome — RACP Adult Medicine MCQ

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EasyEndocrinologyConn SyndromeRACP Adult Medicine

A 28-year-old man presents with hypertension (BP 180/110) refractory to triple therapy (amlodipine, ramipril, indapamide). He has headaches and hypokalaemia (K⁺ 3.0 mmol/L). Aldosterone:renin ratio is markedly elevated. CT adrenals shows a 1.5 cm left adrenal adenoma. Adrenal vein sampling confirms left-sided lateralisation. What is the most likely cause?

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Correct answer: C — Primary aldosteronism (Conn syndrome)

Resistant hypertension in a young man with hypokalaemia, elevated ARR, unilateral adrenal adenoma with lateralisation on AVS is aldosterone-producing adenoma (Conn syndrome). Laparoscopic adrenalectomy is curative. BP normalises or improves in ~60-70% post-adrenalectomy. Pre-operative treatment with spironolactone or eplerenone. Primary aldosteronism is the most common endocrine cause of secondary hypertension.

Reference: Endocrine Society – 2016 – PA; NHFA 2016