Endocrine Abstracts

Background: Conn’s syndrome is a curable condition if identified properly. It is characterized by autonomous secretion of aldosterone from the adrenal gland cortex. Its morbidity is related to the increased risk of cardiovascular diseases.

Case presentation: We report the case of a 48 years old male presenting with generalized tonic-clonic seizure and coma secondary to hypertensive encephalopathy. The biochemical evaluation revealed a very high aldosterone level and an undetectable renin level, both are compatible with primary aldosteronism. The presentation of the following: spontaneous hypokalemia, an undetectable renin level, and a high aldosterone level confirms the diagnosis of primary aldosteronism. Abdominal computed tomography revealed a left adrenal adenoma. Adrenal venous sampling confirmed lateralization of aldosterone excretion from the left adrenal gland. The patient underwent left laparoscopic adrenalectomy that confirmed a left functional adrenal adenoma. After 12 months of follow up, the patient’s hypertension was controlled on only one antihypertensive drug down from four drugs preoperatively.

Conclusion: Conn’s syndrome, in this case, was complicated by coma secondary to seizure. Adrenalectomy has normalized the hypokalemia and improved resistant hypertension. Potassium supplementation and several antihypertensives were discontinued as the patient became normokalemic and normotensive on one antihypertensive agent.