T.G. SAKOVETS, E.I. BOGDANOV

Kazan State Medical University of the Ministry of Health of the Russian Federation, Kazan

Contact details:

Sakovets T.G. — Ph. D. (medicine), Associate Professor of the Department of Neurology and Rehabilitation

Address: 49 Butlerova St., Kazan, Russian Federation, 420012, tel.: +7-917-924-99-79, e-mail: tsakovets@yandex.ru 

Conn’s syndrome (primary hyperaldosteronism), a description of which was first presented in the literature in 1955 by the American endocrinologist J.W. Conn, occurs with excessive production of aldosterone by the adrenal glands, regardless of the functioning of the renin-angiotensin-aldosterone system that is involved in regulation of blood pressure, renal excretion of electrolytes. Primary hyperaldosteronism determines the development of arterial hypertension against the background of low levels of renin and excessive excretion of potassium in the renal tubules. The clinical symptom complex of primary hyperaldosteronism is represented by neuro-muscular disorders in the form of tetraparesis, damage to the cranial and respiratory skeletal muscles against the background of hypokalemia, renal syndrome, and arterial hypertension.

The purpose — to study the characteristics of treatment of secondary hypokalemic paralysis in case of primary hyperaldosteronism.

Results. In case of reliable verification of the diagnosis of primary hyperaldosteronism, the choice of treatment method is determined by the severity of the lesion: in case of hyperaldosteronism due to aldosterone-producing adrenal adenoma, the most obvious is the use of surgical intervention (laparoscopic and/or robotic endoscopic adrenalectomy, visualization of the tumor and its spatial relationship with surrounding organs and vessels, followed by percutaneous radiofrequency thermoablation, injection of an ablative agent). Taking oral medications can be used for idiopathic adrenal hyperplasia, unilateral adrenal hyperplasia.

Pharmacological treatment of Cohn’s syndrome is used in case of failure and/or impossibility of surgical treatment and includes the use of antagonists of mineralocorticoid receptors: spironolactone as a first-line drug, in case of side effects or pregnancy — eplerenone.

Conclusion. Thus, primary hyperaldosteronism, determining the occurrence of secondary hypokalemic paralysis, is a complex problem and requires a multidisciplinary approach, the awareness of doctors of various profiles.

Key words: primary hyperaldosteronism, treatment, secondary hypokalemic paralysis.

(For citation: Sakovets T.G., Bogdanov E.I. Treatment of secondary hypokalemic paralysis in case of primary hyperaldosteronism. Practical Medicine. 2019. Vol. 17, № 7, P. 51-54)

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