Conn Syndrome Differential Diagnoses

  • Author: Serge A Jabbour, MD; Chief Editor: George T Griffing, MD   more...
 
Updated: Dec 13, 2011
 
 

Diagnostic Considerations

Conditions to consider in the differential diagnosis of Conn syndrome include the following:

  • Liddle syndrome - This is a rare autosomal dominant disorder resulting in a continuously activated sodium channel, with excessive sodium reabsorption in the renal distal tubule; levels of renin and aldosterone are low
  • Renin-secreting tumor - These are rare tumors arising from the juxtaglomerular apparatus
  • Exogenous mineralocorticoid
  • Excessive licorice intake - In this situation, the glycyrrhizinic acid component inhibits 11beta-hydroxysteroid dehydrogenase, impairing conversion of cortisol to cortisone in the kidneys; hence, cortisol binds to mineralocorticoid receptors and acts as a mineralocorticoid

Differential Diagnoses

Proceed to Workup
 
 
Contributor Information and Disclosures
Author

Serge A Jabbour, MD  Associate Professor, Department of Medicine, Division of Endocrinology, Jefferson Medical College of Thomas Jefferson University

Serge A Jabbour, MD is a member of the following medical societies: American Association of Clinical Endocrinologists, American College of Physicians-American Society of Internal Medicine, American Diabetes Association, American Medical Association, American Thyroid Association, Endocrine Society, and Pennsylvania Medical Society

Disclosure: Nothing to disclose.

Chief Editor

George T Griffing, MD  Professor of Medicine, St Louis University School of Medicine

George T Griffing, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Medical Practice Executives, American College of Physician Executives, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical Research, Endocrine Society, International Society for Clinical Densitometry, and Southern Society for Clinical Investigation

Disclosure: Nothing to disclose.

Additional Contributors

Arthur B Chausmer, MD, PhD, FACP, FACE, FACN, CNS Professor of Medicine (Endocrinology, Adj), Johns Hopkins School of Medicine; Affiliate Research Professor, Bioinformatics and Computational Biology Program, School of Computational Sciences, George Mason University; Principal, C/A Informatics, LLC

Arthur B Chausmer, MD, PhD, FACP, FACE, FACN, CNS is a member of the following medical societies: American Association of Clinical Endocrinologists, American College of Endocrinology, American College of Nutrition, American College of Physician Executives, American College of Physicians, American College of Physicians-American Society of Internal Medicine, American Medical Informatics Association, American Society for Bone and Mineral Research, American Society of Law, Medicine & Ethics, Endocrine Society, and International Society for Clinical Densitometry

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Reference Salary Employment

References

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  2. Bernini G, Galetta F, Franzoni F, et al. Arterial stiffness, intima-media thickness and carotid artery fibrosis in patients with primary aldosteronism. J Hypertens. Dec 2008;26(12):2399-405. [Medline].

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  14. Gill JR. Primary aldosteronism: Strategies for diagnosis and treatment. The Endocrinologist. 1991;1:365-9.

  15. Hirohara D, Nomura K, Okamoto T, et al. Performance of the basal aldosterone to renin ratio and of the renin stimulation test by furosemide and upright posture in screening for aldosterone-producing adenoma in low renin hypertensives. J Clin Endocrinol Metab. Sep 2001;86(9):4292-8. [Medline].

  16. Jabbour SA, De Papp AE. Pitfalls in the diagnosis and management of primary hyperaldosteronism. The Endocrinologist. 1999;9:395-8.

  17. Montori VM, Schwartz GL, Chapman AB, et al. Validity of the aldosterone-renin ratio used to screen for primary aldosteronism. Mayo Clin Proc. Sep 2001;76(9):877-82. [Medline].

  18. Rose BD, Kaplan NM. Approach to the patient with hypertension and hypokalemia. UpToDate [CD-ROM and online]. 1997;1-8.

 
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Magnetic resonance imaging (MRI) scan in a patient with Conn syndrome showing a left adrenal adenoma.
Scintigram obtained by using iodine-131-6β-iodomethylnorcholesterol (NP-59) in a 59-year-old man with hypertension shows fairly intense radionuclide uptake in the right adrenal tumor. At surgery, a Conn tumor was confirmed.
 
 
 
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