Endocrine Abstracts

Introduction: Primary aldosteronism (PHA), also known as primary hyperaldosteronism or Conn’s syndrome, refers to the excess production of the hormone aldosterone from the adrenal glands.

Study objectives: To show clinical, biochemical, and morphological data of 09 patients with primary hyperaldosteronism as well as the therapeutic choice for each patient

Mehtods: it is aretrospective and descriptive study of 09 cases with primary hyperaldosteronism, which were admitted between 2014 and 2019.

Results: Our series included 5 women and 4 men. The mean age of our patients was 44 years. All had severe blood pressure at the time of diagnosis with a median of 190/101 mm Hg varying between 240 and 150 mm Hg for systole and between 120 and 80 for diastole. The mean age of onset of hypertension was 32 years. The context of screening of PHA was severe and resistant hypertension in 89% of the cases followed by the association of hypertension and hypokalemia in 67% of the cases. Sixty-seven percent of our patients had hypokalemia at the time of diagnosis, while 33% had normal serum potassium.

PAH was mentioned and then confirmed by a high aldosterone / renin ratio in 89% of patients with values varying between 63 and 195 (122.42 on average) when standing and then lying down with values varying between 25 and 840 (178 on average). CT scan showed bilateral adrenal hyperplasia in 4 cases, Conn’s adenoma in 3 cases, and unilateral hyperplasia in one case. Four patients had an adrenalectomy under laparoscopy while 5 patients were put on medical treatment. Seventy-five percent of our operated patients had complete remission with normalization of blood pressure while only 40% for patients on medical treatment. The serum potassium level normalized for all patients.

Conclusion: At the end of this work, concerning the management of the 9 cases of PAH treated at the Avicenna Military Hospital in Marrakech, it seems important to insist on the methods of management of this pathology, which must be multidisciplinary including endocrinologists, cardiologists, radiologists, urologists and biologists.