Aldosterone deficiency after unilateral adrenalectomy for Conn’s syndrome: a case report and literature review

•We report a case of postoperative hypotension and hyperkalemia in a unilateral adrenalectomy for Conn’s syndrome.•We highlight that there are factors that may make certain populations more at risk for developing this complication.•Increasing awareness about this complication and its consequences highlights the needfor close monitoring in increased risk patients.

IntroductionApproximately 35% of cases of Conn’s syndrome (primary aldosteronism) result from a solitary functioning adrenal adenoma, and these patients are best managed by adrenalectomy. Postoperative hypoaldosteronism after unilateral adrenalectomy is uncommon.Case presentationWe present a case and literature review of hypoaldosteronism after unilateral adrenalectomy for Conn’s syndrome, which demonstrates the insidious and sometimes delayed presentation.DiscussionIn this clinical case we summarize the previously published cases of post-adrenalectomy hypoaldosteronism based on a PUBMED and EBSCOhost search of all peer-reviewed publications (original articles and reviews) on this topic. A few cases of aldosterone insufficiency post-adrenalectomy for Conn’s syndrome were identified. The etiological factors for prolonged selective suppression of aldosterone secretion after unilateral adrenalectomy remain unclear.ConclusionIt is important to be aware of the risk of postoperative hypoaldosteronism in this patient population. Close postoperative follow-up is necessary and strongly recommended, especially in patients with certain risk factors. Patients may need mineralocorticoid supplementation during this period.