Conn syndrome (CS), next to bilateral adrenal hyperplasia, is one of the most common causes of primary hyperaldosteronism. It leads to potentially curable secondary hypertension.
The 54-year-old woman underwent an abdominal computed tomography (CT) examination for symptomatic nephrolithiasis. A focal lesion of the left adrenal gland was found with a diameter of 16 mm and a density of 34 Hounsfield units (HU). The lesion was under observation, and the next magnetic resonance imaging (MRI) scans showed a slight enlargement of the lesion to a size of 18 x 12 mm. The lesion was interpreted as an atypical adenoma of the adrenal gland. According to the course, the patient was referred to the endocrinology clinic. The patient's symptoms included hypertension and paresthesia. During two separate hospitalizations, Conn syndrome was diagnosed using a specific laboratory test. The patient was successfully treated by surgical intervention, resulting in remission of all symptoms.
This case illustrates the difficulties in diagnosing primary hyperaldosteronism. The symptoms of Conn syndrome may vary in severity or may be absent. Early diagnosis and appropriate treatment can save many ill individuals from cardiovascular, metabolic, or renal complications. The case underscores the need for screening hypertensive patients using the aldosterone-renin ratio (ARR)
