Endocrine Abstracts

We describe two cases of Conn’s syndrome both of whom had hyperprolactinaemia of which one was associated with pituitary adenoma, possibly as part of MEN 1.

The first patient was a man aged 52 who presented with hypertension present for 10 years and a marginally low serum potassium. He was on doxazosin, lisinopril, candesartan and celiprolol. His Aldosterone/Renin ratio (8500:1) was very high suggestive of primary hyperaldosteronism. The patient was treated effectively with spironolactone. CT scan showed right adrenal adenoma. He also had erectile dysfunction and a very high prolactin level (18019 mU/l; normal: 70–511) and low testosterone. His serum calcium was normal. MRI scan showed a pituitary adenoma (1.2 cm). The patient was treated effectively with cabergoline. The patient underwent adrenal surgery successfully and currently is on no antihypertensive.

The second patient was a woman aged 56 who presented with a 16-year history of hypertension and profound hypokalaemia. She was on atenolol, amlodipine and HRT following hysterectomy. Her blood test showed a very high Aldosterone/Renin ratio (7075:1) and CT scan showed a right adrenal adenoma. She was successfully treated with spironolactone and other antihypertensives were withdrawn. She was maintained only on 50 mg of spironolactone. A pituitary screen showed a high prolactin level (2992). MRI scan showed a normal pituitary. She also underwent adrenal surgery successfully and currently is on oestradiol 1 mg and is normotensive.

Both patients were cured with adrenal surgery. Rarely, prolactinoma may be associated with Conn’s syndrome as part of MEN 1.