[Secondary forms of hypertension. 5. Hypertension caused by Cushing syndrome and Conn's disease].
The Conn syndrome and the Cushing syndrome are major differential diagnoses in the investigation of hypertension. Primary aldosteronism (Conn syndrome) is found in < 0.5% of hypertensives. In addition to the usual laboratory investigations, magnetic resonance angiography should be performed at the start of the diagnostic work-up, since it enables a very good representation of the adrenals, and saves many diagnostic tests. Minimally invasive microsurgical techniques and the development of new drugs have greatly simplified the treatment of this form of secondary hypertension. In the case of the Cushing syndrome, which leads to hypertension in about 70% of the patients, the general practitioner should look for the typical cutaneous changes that inevitably accompany this syndrome. Only when the Cushing syndrome has been confirmed clinically and biochemically, should an imaging procedure be performed.
Füessl
H S
HS
Ltd. Arzt Innere Abt., Bezirkskrankenhaus Haar, Ringstr. 33a, D-85540 Haar. HFuessl@compuserve.com
D000236:Adenoma / Q000175:diagnosis / Q000601:surgery; D000310:Adrenal Gland Neoplasms / Q000175:diagnosis / Q000601:surgery; D000315:Adrenalectomy; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000465:Algorithms; D003480:Cushing Syndrome / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D003937:Diagnosis, Differential; D013196:Dihydrotestosterone / Q000031:analogs & derivatives / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D006801:Humans; D006929:Hyperaldosteronism / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery; D006973:Hypertension / Q000209:etiology* / Q000628:therapy; D018810:Magnetic Resonance Angiography; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D010911:Pituitary Neoplasms / Q000601:surgery; D013148:Spironolactone / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed
D004232:Diuretics; D004791:Enzyme Inhibitors; D000451:Mineralocorticoid Receptor Antagonists; D013196:Dihydrotestosterone; D013148:Spironolactone; D000324:Adrenocorticotropic Hormone; C009954:trilostane
Sekundäre Hypertonieformen, Folge 5. Hochdruck durch Cushing und Conn.