Journal of Research & Innovation in Anesthesia

Register      Login

VOLUME 7 , ISSUE 1 ( January-June, 2022 ) > List of Articles

CASE REPORT

Anesthesia Considerations of a Case of Conn Syndrome

Pallavi Kharat, Naina P Dalvi, Tejaswini Bagde, Madhur M Chole

Keywords : Conn syndrome, Hyperaldosteronism, Hypertension, Hypokalemia, Spironolactone

Citation Information : Kharat P, Dalvi NP, Bagde T, Chole MM. Anesthesia Considerations of a Case of Conn Syndrome. Res Inno in Anesth 2022; 7 (1):22-24.

DOI: 10.5005/jp-journals-10049-2005

License: CC BY-NC 4.0

Published Online: 30-03-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Conn\'s syndrome is caused due to increased secretion of aldosterone from the adrenal glands. It could be because of an adrenal adenoma or adrenal hyperplasia. Excessive aldosterone levels lead to water retention, hypertension, and hypokalemia. We hereby report a case of a 37-year-old female who presented to the emergency department with quadriparesis and malignant hypertension. On investigating, she was found to have hypokalemia, metabolic alkalosis, rhabdomyolysis, raised aldosterone levels, and a right adrenal adenoma in the CT abdomen. Hypokalemia was treated and she was started on tablet spironolactone. She underwent laparoscopic adrenalectomy under general anesthesia. Her perioperative course was uneventful. Anesthesia management of a case of Conn\'s syndrome presents various challenges for the anesthesiologist. Good coordination between anesthesiologists, endocrinologists, and surgeons is required for the successful management of such a case.


PDF Share
  1. Williams GH, Dluhy RG. Disorders of the adrenal cortex. In: Fauci AS, Braunwald E, Isselbacher KJ, editors. Harrison's Principles of Internal Medicine. 17th edition. Chapter 336, page 2259–2260. New York, NY, USA: McGraw-Hill Professional Publishing.
  2. Stoelting RK, Stephen F, Dierdorf. Endocrine Diseases In: StoeltingAnesthesia and CoExisting Disease, Fourth Edition, Chapter 22, page 429. Elsevier Churchill Livingstone Publishing.
  3. Michael FR, Fleisher LA. Anesthetic Implications of Concurrent Diseases. In: Miller's Anesthesia, Sixth Edition, Chapter 27, page 1038. Elsevier Churchill Livingstone Publishing.
  4. Mattsson C, Young WF Jr. Primary aldosteronism: diagnostic and treatment strategies. Nat Clin Pract Nephrol 2006;2(4):198–208. DOI: 10.1038/ncpneph0151
  5. Conn JW, Louis LH. Primary aldosteronism: a new clinical entity. Ann Intern Med 1956; 44(1):1–15. DOI: 10.7326/0003-4819-44-1-1
  6. Domi R, Sula H, Kci M, Paparisto S, et al. Anaesthetic considerations on adrenal gland surgery. J Clin Med Res 2015;7(1):1–7. DOI: 10.14740/jocmr1960w
  7. Born-Frontsberg E, Reincke M, Rump LC, et al. Cardiovascular and cerebrovascular comorbidities of hypokalemic and normokalemic primary aldosteronism: results of the German Conn's Registry. J Clin Endocrinol Metab 2009;94(4):1125-1130. DOI: 10.1210/jc.2008-2116
  8. Harde M, Gyanesh P, Tiwatane S, et al. Peri-operative management of Conn's syndrome - a case report. The Internet Journal of Anesthesiology 2008;19:2.
  9. Davies M, Hardman J. Anaesthesia and adrenocortical disease. Continuing Education in Anaesthesia, Critical Care & Pain. 2005; Volume 5, Number 4:122–126.
  10. Harde M, Gyanesh P, Tiwatane S, et al. Peri-operative management of Conn's syndrome - a case report. The Internet Journal of Anesthesiology. 2008 Volume 19 Number 2.
  11. Gockel I, Heintz A, Kentner R, et al. Changing pattern of the intraoperative blood pressure during endoscopic adrenalectomy in patients with Conn's syndrome. Surg Endosc 2005;19(11):1491–1497. DOI: 10.1007/s00464-004-2286-0
  12. Miyaji Y, Kawabata Y, Joki H, et al. Primary aldosteronism in patients with acute stroke: prevalence and diagnosis during initial hospitalization. BMC Neurol 2016;16:177. DOI: 10.1186/s12883-016-0701-5
  13. Alseddeeqi E, Altinoz A, Ghashir NB. Seizure and coma secondary to Conn's syndrome: a case report. J Med Case Rep 2020;14(1):100. DOI: 10.1186/s13256-020-02434-5
  14. Jano A, Domi R, Berdica L, et al. Anaesthetic considerations of Conn syndrome: a case presentation and mini-review the anaesthesiologist and Conn syndrome. Clin Med Res 2014;3(5):132–135. DOI: 10.11648/J.CMR.20140305.14
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.