Guide To The Causes Of Conn's Syndrome

Conn's syndrome, also called primary hyperaldosteronism, is a condition where an individual's adrenal glands produce an excess amount of the hormone called aldosterone. Potassium and salt levels in an individual's blood are dictated by the production and release of aldosterone. When levels of these electrolytes become imbalanced in the body, it can lead to long term high blood pressure. Too much aldosterone causes the body to release more potassium into the urine and retain more sodium in the blood. The increased sodium in the blood causes it to have a higher volume due to fluid retention. A greater blood volume causes more pressure exertion on the blood vessel walls, otherwise known as hypertension. Long-term hypertension carries a higher risk of experiencing a stroke and developing heart disease. Symptoms of high aldosterone levels include medication-resistant high blood pressure, severe high blood pressure, and hypokalemia.

Conn's syndrome has several potential underlying causes. Get to know them now.

Liver Disease

Individuals who have an advanced stage of liver disease may develop Conn's syndrome as a complication. Liver disease happens when some mechanism causes damage to the cells in the liver, and the body implicates its healing processes. The liver tissues are replaced by non-reversible dense, fibrous scar tissue (cirrhosis). This dense tissue in the liver causes the individual to develop hypertension in the vessels that feed to the portal vein that travels through the liver. As compensation for portal hypertension, the body develops new collateral blood vessels that skip the liver and feed to the other organs directly. The new blood vessels and altered circulatory configuration can cause reduced blood circulation to the kidneys. The kidneys mistake this decrease in blood supply as a case of dehydration and produce too much renin as a result. Excess renin activates an excess amount of angiotensin, which tells the adrenal glands to secrete too much aldosterone. It is the body detecting a low blood volume because of altered circulation that triggers the cascade that results in Conn's syndrome.

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Heart Failure

Conn's disease can be caused by the presence of heart failure due to the processes the body utilizes to cope and compensate for the loss of heart function. Heart failure occurs when the muscle of the heart cannot pump a sufficient amount of blood to tissues around the body. Fortunately, the brain, body, and heart itself can all work together through certain processes to make up for the shortcoming. These compensation processes can work so well that an affected individual may not experience symptoms until heart failure has progressed past its first stages. The poor function of the heart causes a shortage of blood and oxygen in the tissues, which signals to the brain more fluid is needed in the blood vessels. The brain initiates a chain sequence of events, including increased secretion of aldosterone to help the blood vessels constrict and blood retain more sodium. As heart failure progresses, these efforts by the nervous system, hormone system, and cardiovascular system become more intense. This intense compensation can cause Conn's syndrome because the glands continue secreting aldosterone even when its action has become ineffective at compensating for heart failure.

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Fluid Loss

An individual who has chronic fluid loss may develop Conn's syndrome as a result of their condition. One of the functions of the adrenal glands is to help the body when it is dehydrated. Dehydration occurs when less fluid is being consumed than is being excreted through the urine, sweat, feces, or vomit. Numerous factors can contribute to an individual's chronic dehydration or fluid loss, including infections, living conditions, malignancy, kidney problems, diarrhea, sweating too much, and urinating too much. When an individual loses too much fluid, the total blood volume decreases and causes a drop in blood pressure. Due to a decrease in blood pressure, blood does not make it to all of the tissues around the body. The kidneys filtering the blood receive signals from the brain indicating tissues are deprived of oxygen and there are low levels of sodium. Both processes tell the kidneys to produce more of a hormone called renin. Renin causes the activation of the hormone angiotensin, which then causes the adrenal glands to secrete more aldosterone. Chronic fluid loss triggers this cascade excessively, which can cause Conn's syndrome.

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Tumor On The Adrenal Gland

An individual may be affected by Conn's syndrome as a result of a growing tumor on their adrenal gland. The tumor may be a benign growth called an adenoma that produces excess amounts of aldosterone. Cancerous tumors growing in the adrenal gland may also produce excess aldosterone, but are statistically rare. The exact cause of adrenal adenoma is not clear, but it is thought aldosterone-producing adenomas initially form in the zona fasciculata. These tumors often feature a surrounding expansion of adrenal gland tissue with an absence of any concerning changes in the individual gland cells. It is suspected a clonal alteration occurs in a single cell within this expansion, which fosters the growth of or provides a growth advantage to the adenomatous tissue that forms a benign aldosterone-producing tumor. An adenoma that produces hormones is medically referred to as active or functioning. Inactive adenomas do not usually require treatment. However, active adenomas that cause the patient to have Conn's syndrome are treated by surgical excision or with certain medications.

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Genetics

Some cases of Conn's syndrome are the result of genetic mutations inherited from a patient's other biological family members. There are three variations of genetic causes of Conn's syndrome. The first variation occurs due to a gene product that forms when the promoter of the CYP11B1 gene and the coding section of the CYP11B2 gene are abnormally combined. This abnormality causes the body to produce too much aldosterone synthase, resulting in an increased production of aldosterone. The second familial genetic variation that causes Conn's syndrome occurs from a genetic abnormality that has not been pinpointed exactly, but it is thought to occur in band 7p22. The last variation of genetic attribution to this syndrome is the result of genetic inheritance of mutations that occur in the KCNJ5 genes of the segment of DNA responsible for encoding the information on how an individual's potassium channels function. Alternatively, the second variation of familial related causes of Conn's syndrome has been seen to manifest in the forms of adenomas or hyperplasia.