Primary Hyperaldosteronism (Conn Syndrome)
The increase in aldosterone levels due to the involvement of the glomerulosa layer of the adrenal cortex is responsible for the formation of a clinic such as hypertension, hypokalemia, hypernatremia, metabolic alkalosis and polyuria. Its prevalence in the hypertensive patient population has recently been reported to increase to 5-16%. The most common cause is bilateral adrenal hyperplasia. Other causes include aldosteronomas, adrenal carcinomas, and glucocorticoid-regulated hyperaldosteronism (16,17). Adrenal vein sampling is currently performed to confirm that the present mass is the pathology causing hyperaldosteronism.
In the differential diagnosis of an incidental adrenal mass, plasma potassium, renin and aldosterone levels should be checked for primary hyperaldosteronism. As a screening test, the ratio of serum aldosterone level (ng/dL)/plasma renin activity (ng/mL/hour) is used. If this ratio is above 20, it is necessary to proceed to confirmatory tests and subtyping tests. Since the renin-angiotensin-aldosterone system can also be affected by postural changes, some rules must be followed while performing the test. The patient should be called for sampling in the morning hungry, at least half an hour must have passed after getting out of bed, and sampling should be done after the patient has been sitting for at least 15 minutes. Some drugs and renal dysfunction may affect the result of the test. For this reason, antihypertensive treatments used by the patient should also be reviewed and discontinued before the procedure (14,18).