A 52-year-old woman is taken to the hospital because she has become completely paralyzed. By the time she is examined, the paralysis has begun to clear, and it has completely resolved an hour later. She states that she has had previous episodes of severe transient weakness, but that this was the first time that she felt actually unable to move. She has also been experiencing paresthesias. On physical examination, her blood pressure is 160/100 mmHg. Blood tests reveal serum a sodium of 155 mEq/L, potassium of 2.8 mEq/L, and decreased serum renin. Which of the following is the most likely diagnosis?
Primary aldosteronism, or Conn syndrome, is a syndrome of hyperaldosteronism originating in the adrenal gland. The causes include an aldosterone-secreting adrenocoical adenoma, hyperplasia of the zona glomerulosa, and very rarely, an adrenal carcinoma. It is characterized by hypeension secondary to sodium retention, hypokalemia, and decreased serum renin due to negative feedback of increased blood pressure on renin secretion. Clinical manifestations can include episodic weakness, paresthesias, transient paralysis, tetany, and personality disturbances. Cushing syndrome is the result of increased glucocoicoid production, paicularly coisol. Physical signs typically include "moon facies", truncal obesity, "buffalo hump", and purple abdominal striae. Mallory-Weiss syndrome is a laceration of the lower end of the esophagus induced by severe vomiting. May-White syndrome is a form of familial progressive myoclonus epilepsy with lipomas, deafness, and ataxia.
Conn syndrome
Cushing syndrome
Mallory-Weiss syndrome
May-White syndrome