We describe two cases of Conns syndrome both of whom had hyperprolactinaemia of which one was associated with pituitary adenoma, possibly as part of MEN 1.
The first patient was a man aged 52 who presented with hypertension present for 10 years and a marginally low serum potassium. He was on doxazosin, lisinopril, candesartan and celiprolol. His Aldosterone/Renin ratio (8500:1) was very high suggestive of primary hyperaldosteronism. The patient was treated effectively with spironolactone. CT scan showed right adrenal adenoma. He also had erectile dysfunction and a very high prolactin level (18019 mU/l; normal: 70511) and low testosterone. His serum calcium was normal. MRI scan showed a pituitary adenoma (1.2 cm). The patient was treated effectively with cabergoline. The patient underwent adrenal surgery successfully and currently is on no antihypertensive.
The second patient was a woman aged 56 who presented with a 16-year history of hypertension and profound hypokalaemia. She was on atenolol, amlodipine and HRT following hysterectomy. Her blood test showed a very high Aldosterone/Renin ratio (7075:1) and CT scan showed a right adrenal adenoma. She was successfully treated with spironolactone and other antihypertensives were withdrawn. She was maintained only on 50 mg of spironolactone. A pituitary screen showed a high prolactin level (2992). MRI scan showed a normal pituitary. She also underwent adrenal surgery successfully and currently is on oestradiol 1 mg and is normotensive.
Both patients were cured with adrenal surgery. Rarely, prolactinoma may be associated with Conns syndrome as part of MEN 1.
01 - 05 Apr 2006
European Society of Endocrinology