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. 2015:7C:141-4.
doi: 10.1016/j.ijscr.2015.01.013. Epub 2015 Jan 10.

Aldosterone deficiency after unilateral adrenalectomy for Conn's syndrome: a case report and literature review

Ekua Yorke  1 , Sara Stafford  2 , Daniel Holmes  3 , Sachiv Sheth  3 , Adrienne Melck  4
Affiliations

Aldosterone deficiency after unilateral adrenalectomy for Conn's syndrome: a case report and literature review

Ekua Yorke et al. Int J Surg Case Rep. 2015.

Abstract

Introduction: Approximately 35% of cases of Conn's syndrome (primary aldosteronism) result from a solitary functioning adrenal adenoma, and these patients are best managed by adrenalectomy. Postoperative hypoaldosteronism after unilateral adrenalectomy is uncommon.

Case presentation: We present a case and literature review of hypoaldosteronism after unilateral adrenalectomy for Conn's syndrome, which demonstrates the insidious and sometimes delayed presentation.

Discussion: In this clinical case we summarize the previously published cases of post-adrenalectomy hypoaldosteronism based on a PUBMED and EBSCOhost search of all peer-reviewed publications (original articles and reviews) on this topic. A few cases of aldosterone insufficiency post-adrenalectomy for Conn's syndrome were identified. The etiological factors for prolonged selective suppression of aldosterone secretion after unilateral adrenalectomy remain unclear.

Conclusion: It is important to be aware of the risk of postoperative hypoaldosteronism in this patient population. Close postoperative follow-up is necessary and strongly recommended, especially in patients with certain risk factors. Patients may need mineralocorticoid supplementation during this period.

Keywords: Adrenalectomy; Aldosterone; Conn’s; Hypertension; Hypokalemia.

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Figures

Fig. 1
Fig. 1
CT image of left 1.8 cm adrenal nodule with an average attenuation of 2.6 Hounsfield units.
Fig. 2
Fig. 2
Low power view (2× objective) of an adenoma with expansive smooth borders (yellow arrow) sharply demarcated from the adjacent normal adrenal cortex (black arrow).
Fig. 3
Fig. 3
High power view (40× objective) demonstrating bland appearing large, lipid-rich cells composing most of the adenoma.
See this image and copyright information in PMC

References

    1. Young W.F., Jr. Endocrine Hypertension. In: Gardner D.G., Shoback D., editors. Greenspan’s Basic & Clinical Endocrinology, 9e. McGraw-Hill; New York,NY: 2011. http://accessmedicine.mhmedical.com/content.aspx?bookid=380Sectionid=397... Accessed on: 14. 12. 2014. chapter 10.
    1. Kempers M.J.E., Lenders J.W.M., van Outheusden L., van der Wilt G.J., Kool L.J.S., Hermus A.R.M.M., Deinum J., Systematic Review J.R. diagnostic procedures to differentiate unilateral from bilateral adrenal abnormality in primary aldosteronism. Ann. Intern. Med. 2009;151:329–337. - PubMed
    1. Gill J.R., Jr. Hyperaldosteronism. In: Becker K.L., Bilezikian J.P., Bremner W.J., Hung W., Kahn C.R., Loriaux D.L., Nylén E.S., Rebar R.W., Robertson G.L., Wartofsky L.J.B., editors. Principles and Practice of Endocrinology and Metabolism. 2nd ed. Lippincott Co.; Philadelphia: 1995. pp. 716–734.
    1. Kaplan N.M., Victor R.G. Clinical Hypertension. 7th ed. Lippincott Williams & Wilkins; Baltimore: 1998. Primary Aldosteronism; pp. 365–382.
    1. Huang W.T., Chau T., Wu S.T., Lin S.H. Prolonged hyperkalemia following unilateral adrenalectomy for primary hyperaldosteronism. Clin. Nephrol. 2010;5:392–397. - PubMed

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