Primary hyperaldosteronism (Conn's syndrome): a report on two cases.

Introduction. The term hyperaldosteronism is actually defined as a syndrome characterised by hyperkaliemia, suppression of renin plasmatic activity, a nd by high levels of aldosterone in a patient suffering from arterial hyper tension (AHT). in this study, we report on our surgical experience of this disease. Patients and methods: Two clinical cases were involved: both were patients with long-standing AHT which had proved resistant to medical treatment, and who were followed up by our department for hypertensive episodes. The usua l analytical figures and plasmatic ion determination were normal in both ca ses. The aldosterone levels in the blood and the urine were, however, very high. The anatomical site of the lesion was determined by CT-scan, and show ed a nodular formation at the level of the left adrenal (about 1.5 cm in di ameter) in each patient. A radical excision of the adrenal gland was perfor med by left lobotomy. After 5 months, aldosterone and renin had reached nor mal levels. The two patients were clinically asymptomatic, and were placed on a hyposodic diet without the necessity for antihypertensive treatment. Discussion: A survey of the literature and our personal experience indicate s that the diagnosis of primary hyperaldosteronism should be considered in all patients with AHT. In the cases in question, the decision to operate wa s the treatment of choice. (C) 2000 Editions scientifiques et medicales Els evier SAS.