Postoperative adrenal insufficiency in Conn’s syndrome—does it occur frequently?

Adrenal

10.1093/med/9780198851899.003.0003 ◽

2021 ◽

pp. 249-328

Author(s):

Jeremy Tomlinson

Keyword(s):

Adrenal Gland ◽

Adrenal Insufficiency ◽

Imaging Techniques ◽

Addison’S Disease ◽

Autoimmune Disorders ◽

Conn’S Syndrome ◽

Anatomy And Physiology ◽

Adrenal Tumours ◽

Term Management

This chapter covers the adrenal gland. It begins with the anatomy and physiology of the adrenal gland, then continues with imaging techniques. It then covers adrenal disorders, including Conn’s syndrome, adrenal Cushing’s syndrome, Adrenal insufficiency, Addison’s disease, and multiple autoimmune disorders. The investigation, treatment, and long-term management of primary insufficiency is covered. Various adrenal tumours and associated disorders, along with their management, are described.

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URINARY EXCRETION OF TETRAHYDROALDOSTERONE IN NORMAL SUBJECTS AND IN PATIENTS WITH ADRENAL INSUFFICIENCY AND CONN'S SYNDROME

Acta Endocrinologica ◽

10.1530/acta.0.0710498 ◽

1972 ◽

Vol 71 (3) ◽

pp. 498-511 ◽

Cited By ~ 17

Author(s):

Meta Damkjær Nielsen ◽

Jens Otto Lund ◽

Ole Munck

Keyword(s):

Adrenal Insufficiency ◽

Fold Increase ◽

Normal Subjects ◽

Mean Value ◽

Normal Children ◽

Conn’S Syndrome ◽

Group 3 ◽

The Mean ◽

Paper Chromatographic Separation

ABSTRACT A description is given of a method for paper chromatographic separation and spectrophotometric determination of urinary tetrahydroaldosterone (3α,11β,21-trihydroxy-5β-pregnan-20-on-18-al). Commercially available tritiated tetrahydroaldosterone was used for localization on paper throughout the procedure. Quantitation was performed after blue tetrazolium reaction using deoxycorticosterone acetate as standard. The coefficient of variation of duplicates was 12 per cent. In normal adult subjects, on a free diet and with no restrictions in physical activity, the urinary tetrahydroaldosterone averaged 33 μg/24 h, range 3–70 μg/24 h. On a diet with 110 mEq. sodium per 24 h and ordinary hospital regimen, the mean value was 31 μg/24 h, range 11–59 μg/24 h. In normal children up to the age of 3 years, the urinary tetrahydroaldosterone averaged 10 μg/24 h, range 0–29 μg/24 h. In the age group 3–14 years, the mean excretion was 20 μg/24 h, range 8–43 μg/24 h. During sodium restriction, a 2–3 fold increase in urinary tetrahydroaldosterone was observed in normal subjects. In patients with adrenal insufficiency, the values were below 9 μg/24 h, and in four patients with Conn's syndrome, the excretion of tetrahydroaldosterone was 72–284 μg/24 h. The method was found suitable for routine clinical use.

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Spectrum of adrenal disorders in a referral hospital of Bangladesh

BIRDEM Medical Journal ◽

10.3329/birdem.v11i2.53124 ◽

2021 ◽

Vol 11 (2) ◽

pp. 103-107

Author(s):

Kazi Nazmul Hossain ◽

SM Ashrafuzzaman ◽

Md Faruque Pathan ◽

Md Feroz Amin ◽

Sultana Marufa Shefin ◽

...

Keyword(s):

Adrenal Insufficiency ◽

Cushing’S Syndrome ◽

Tertiary Care ◽

Gastrointestinal Symptoms ◽

Adrenal Incidentaloma ◽

Cushing's Syndrome ◽

Care Hospital ◽

Conn’S Syndrome ◽

Endocrine Hypertension ◽

Study Population

Background: Adrenal diseases are common and their presentations are variable. This study aimed to determine the frequency and presenting features of various adrenal diseases in a tertiary care hospital of Bangladesh. Methods: This retrospective descriptive study was carried out in Endocrinology in-patient department of BIRDEM General Hospital, Dhaka, Bangladesh, from October 2017 to December 2018. During this time, total 745 patients were screened; out of whom 91 had adrenal diseases. Results: Mean age of the study population was 39.6±11.5 years. Among them, 65.9% were male. Most (75.8%) cases had adrenal insufficiency, followed by endogenous Cushing’s syndrome (8.8%), Conn’s syndrome (6.6%), non-functioning adenoma (3.3%), congenital adrenal hyperplasia (CAH) (2.2%), pheochromocytoma (1%), myelolipoma (1%) and adrenal carcinoma (1%). According to functional status, most (75.8%) were hypofunctional. Of the patients with adrenal insufficiency, secondary adrenal insufficiency was the most common (78.3%). Among the secondary adrenal insufficiencies, 75.9% had iatrogenic adrenal insufficiency and 24.1% had pituitary diseases. Regarding the cases of primary adrenal insufficiency, 20% cases were due to adrenal tuberculosis, 6.6% were due to adrenal histoplasmosis and 73.3% were idiopathic. Most of the adrenal insufficiency patients presented with hypotension (66.7%), followed by gastrointestinal symptoms (76.8%), weight loss (55.1%), hyponatraemia (42%), pigmentation (13%) and hypoglycemia (10%). In this study, 9.9% patients had adrenal incidentaloma. Most of them (88.9%) were benign. Causes of Cushing’s syndrome among the study population were, iatrogenic (66.7%), adrenal (16.7%) and pituitary cause (16.7%). In this study, 16.5% patients had endocrine hypertension and the causes were endogenous Cushing’s syndrome (53.3%), Conn’s syndrome (40%) and pheochromocytoma (6.7%). Of the hypertensive patients, 60% had co-existing hypokalemia. Conclusion: Adrenal insufficiency was the most common adrenal disorder followed by endogenous Cushing’s syndrome, Conn’s syndrome, non-functioning adenoma and other adrenal disorders. Presentations of adrenal disorders are variable. Among the cause of adrenal insufficiency iatrogenic adrenal insufficiency was the most common. Birdem Med J 2021; 11(2): 103-107

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The importance of postoperative control: adrenal insufficiency after unilateral adrenalectomy for Conn’s syndrome. A case study

Arterial Hypertension ◽

10.5603/ah.2016.0012 ◽

2016 ◽

Vol 20 (2) ◽

pp. 73-74

Author(s):

Marta Sołtysiak ◽

Paweł Sołtysiak ◽

Anna Brzeska ◽

Krystyna Widecka

Keyword(s):

Adrenal Insufficiency ◽

Unilateral Adrenalectomy ◽

Conn’S Syndrome ◽

Postoperative Control

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A case with a combination of Conn’s syndrome and diffuse toxic goiter

Problems of Endocrinology ◽

10.14341/probl12144 ◽

1994 ◽

Vol 40 (4) ◽

pp. 38-39 ◽

Cited By ~ 1

Author(s):

V. A. Yakovlev ◽

S. B. Shustov ◽

Yu. Sh. Khalimov

Keyword(s):

Thyroid Cancer ◽

Thyroid Gland ◽

Adrenal Insufficiency ◽

Adrenal Glands ◽

Primary Hyperaldosteronism ◽

Type Ii ◽

Conn’S Syndrome ◽

Autoimmune Polyglandular Syndrome ◽

Toxic Goiter

The combination of pathology of the adrenal glands and thyroid gland is very rare and, as a rule, is characterized by adrenal insufficiency and hypothyroidism / Schmidt syndrome), which develop in type II autoimmune polyglandular syndrome. There is a single description of low-krenin aldosteronism due to thyroid cancer. In the available literature, we have not found information about the combination of primary hyperaldosteronism and diffuse toxic goiter.

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