Endocrine Abstracts

Introduction: Primary hyperaldosteronism is the first cause of secondary hypertension during pregnancy. The diagnosis is too difficult due to the changes in the renin angiotensin system.

Observation: We report the case of a 37 years old women with a history of pre-eclampsia during her pregnancy who consulted the emergency 20 days after delivery for severe hypertension (23/11) and severe hypokalemia (2.2 mmol/l ) resistant to intravenous treatment. The aldosterone level was at 2668 pmol/l and the renin level was <0.5 mUI/l with a high ratio at 534 (n < 64 ) confirming the diagnosis of primary hyperaldosteronism. A CT-scaan identified an adenoma in the left adrenal gland with low density at 5 UH. The patient received spironolactone at the dose of 50 mg per day and we noticed a fully correction of hypokalemia and a normalization of the blood pressure. Then a laparoscopic adrenalectomy was performed. On the examination of the removed left adrenal gland , the adenoma appeared well circumscribed yellow, 12×18 mm in diameter.

Conclusion: Despite the fact that Conn’s adenoma is a rare pathology during pregnancy, it needs to be indentified sooner to avoid maternal and foetal complications.