presence of renal artery stenosis this group of drugs are
contraindicated.B- Conn's Syndrome-Primary hyperaldosteronism:
This is characterized with excess aldosterone which is due to
excess secretion by adenoma or hyperplasia of the zona glomerulosa of the
adrenal cortex. This will result in hypokalaemia and metabolic alkalosis.
Plasma sodium will be high and bicarbonate will be above 30 mmol/L, also
plasma renin will be low. Patients with Conn's syndrome usually present
with muscle weakness and mild hypertension. In few cases with Conn's
syndrome, the course of this disease will be marked with malignant
hypertension and stroke.
Treatment depends mainly on surgical excision and in bilateral
cases steroid replacement may be needed.
C- Pheochromocytoma:
This is a tumour of chromaffin cells occurring in all age stages. In
children, the tumour is always highly malignant (neuroblastoma and
medulloblastoma), while in adults the tumour is always benign. Yet,
hypertension will have a sinister prognosis if untreated properly.
In 90% of cases the tumours is in adrenal medulla while in 10% the
tumour is extra-adrenal affecting the sympathetic chain. It could be
multiple and malignant. The extra-adrenal tumour could be abdominal or
even thoracic.