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Abstract

Conn’s syndrome is characterized by an increase in aldosterone level causes sodium retention and an increase in urine excretion of potassium. This syndrome is characterized by trias hypokalemia, hypertension, and metabolic alkalosis. This article discussed a case report of a patient with uncontrolled hypertension with neuromuscular symptoms caused by recurrent hypokalemia. After an evaluation of the imaging test, we found a left adrenal tumor then we performed unilateral adrenalectomy surgery. Histopathology examination from the excised tumor revealed the adrenal adenoma. After unilateral adrenalectomy, the patient showed clinical and laboratory improvement.

References

1. Adi S, Pranoto A. Gangguan korteks adrenal. Dalam: Setiati S, Alwi I, Sudoyo AW, Simadibrata M, Setiyohadi B, Syam AF, editors. Buku ajar ilmu penyakit dalam jilid II. Jakarta: Interna Publishing; 2014. hal.2484-513. 2. Kountiadis P, Petroglou D, Kolettas V, Karvounis H. Primary aldosteronism of late onset. Hippokratia. 2014;18(2):180–2. 3. Nainggolan G. Hiperaldosteronisme primer. Dalam: Setiati S, Alwi I, Sudoyo AW, Simadibrata M, Setiyohadi B, Syam AF, editors. Buku ajar ilmu penyakit dalam jilid II. Jakarta: Interna Publishing; 2014. hal.2203-5. 4. Williams GH, Dluhy RG. Disorders of the adrenal cortex. In: Fauci AS, Braunwald E, Jameson JL, editors. Harrison’s endocrinology. 2nd edition chapter 5. New York: McGraw-Hill Professional Publishing. p.99-132. 5. Buffolo F, Monticone S, Williams TA, Rossato D, Burrello J, Tetti M, et al. Subtype diagnosis of primary aldosteronism: is adrenal vein sampling always necessary? Int J Mol Sci. 2017;18(4):848-54. 6. Kim K, Lee JH, Kim SC, Cha DR, Kang YS. A case of primary aldosteronism combined with acquired nephrogenic diabetes insipidus. Kidney Res Clin Pract. 2014;33(4):229-33. 7. Butt W, Butt M, Gauhar M, Khawaja A, Afzal A, Ahmed A, et al. Conn’s syndrome: a diagnostic dilemma. Internet J Surg. 2009;24(1):1-4. 8. Siregar P. Sixteen years experiences in six cases of Conn syndrome in Jakarta. Acta Med Indonesiana. 2012;44(2):150-3. 9. Pemayun TGD, Naibaho R, Wiyati MW, Santosa A, Amarwati S. Primary hyperaldostenism due to adrenocortical adenoma: a case report. Acta Med Indonesiana 2017; 49(3): 249-54. 10. Kai K, Tominaga N, Uchida D, Fukai N, Matsuura Y, Uda S, et al. Aldosterone response in severe hypokalemia and volume depletion: A case report and review of the recent research. Case Gambar 2. Diagnosis dan tata laksana Conn’s syndrome20 Rep Nephrol. 2016;2016:2036503. 11. Viera AJ, Wouk N. Potassium disorder: Hypokalemia and hyperkalemia. Am Fam Physician. 2015; 92(6): 487-95. 12. Singer GG, Brenner BM. Fluid and electrolyte disturbances. In: Fauci AS, editor. Harrison’s principle of internal medicine. 18th edition. New York: McGrawHill; 2008. p.282-5. 13. Blanchard A, Bockenhauer D, Bolignano D, Calò LA, Cosyns E, Devuyst O, et al. Gitelman syndrome: consensus and guidance from a kidney disease: Improving global outcomes (KDIGO) controversies conference. Kidney Int. 2017;91(1):24-33. 14. Fremont OT, Chan JC. Understanding Barrter syndrome and Gitelman syndrome. World J Pediatr. 2012; 8(1):25-30. 15. Patel P, Kuriacose R. Liddle’s syndrome: A case report. Saudi J Kidney Dis Transpl. 2015;26(4):769-72. 16. Viella LA, Almeida MQ. Diagnosis and management of primary aldosteronism. Arch Endocrinol Metab. 2017;61(3):305-12. 17. Cheng CJ, Kuo E, Huang CL. Extracellular potassium hemostasis: Insight from hypokalemic periodic paralysis. Semin Nephrol. 2013;33(3):237–47. 18. Acelajado MC, Calhoun DA. Aldosteronism and resistant hypertension. Int J Hypertens. 2011;2011:837817. 19. Galla JH. Metabolic alkalosis. J Am Soc Nephrol. 2000;11(2):369-75. 20. Funder JW, Carey RM, Mantero F, Murad MH, Reincke M, Shibata H, et al. The management of primary aldosteronism: case detection, diagnosis and treatment: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2016;101(5):1889–916. 21. Wu VC, Chao CT, Kuo CC, Lin YH, Chueh SJ, Wu KD. Diagnosis and management of primary aldosteronism. Acta Nephro. 2012; 26(3):111-20. 22. Young WF. Minireview: Primary aldosteronism-changing concept in diagnosis and treatment. Endocrinology. 2005;144(6):2208-13. 23. Jansen PM, Born BJ, Frenkel WJ, de Bruijne EL, Deinum J, Kerstens MN, et al. Test characteristic of the aldosterone to renin ratio as ascreening test for primary aldosteronism. J hypertens. 2014;32(1):115-26. 24. Chao CT, Wu VC, Kuo CC, Lin YH, Chang CC, Chueh SJ, et al. Diagnosis and management of primary aldosteronism: an update review. Ann Med. 2013;45:375–83. 25. Hyla-Klekot L, Kokot F. Primary aldosteronism: A new insight into pathogenesis, diagnosis and treatment in hypertensive patients. Pol Arch Med Wewn. 2013;123(10):547-51. 26. Sanchez CE, Sanchez EP. Aldosterone producing adenoma. Hypertension. 2010;55:1306-7. 27. Dick SM, Queiroz M, Bernadi BL, Dall’Agnol A, Brondani LA, Silveiro SP. Update in diagnosis and management of primary aldosteronism. Clin Chem Lab Med. 2018;56(3):360–72. 28. Aronova A, Fahey TJ, Zarnegar R. Management of hypertension in primary aldosteronism. World J Cardiol. 2014;6(5):227–33. 29. Chuang TH, Wang CH, Tseng BY, Hsu YH, Tsai JP, Hsu BG, et al. Conn’s Syndrome with an unusual presentation of rhabdomyolysis secondary to severe hypokalemia. Tzu Chi Med J. 2008;20(4):327- 31. 30. Amar L, Plouin F, Steichen O. Aldosterone-producing adenoma and other surgically correctable forms of primary aldosteronism. Orp J Rare Dis. 2010;5(9):1-12.

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