The Value of LC-MS/MS in Apparent Bilateral Aldosterone Suppression in Adrenal Venous Sampling for Primary Aldosteronism
Authors' conclusion
LC-MS/MS measurement of aldosterone and cortisol is a new resolution when ABAS occurs.
Study context
- Population
- Patients with primary aldosteronism (PA) undergoing adrenal venous sampling (AVS); 111 non-ACTH, 60 ACTH-stimulated, 48 both
- Participants
- 219 patients
- Comparison
- LC-MS/MS vs immunoassay for aldosterone and cortisol in AVS samples
- Outcome
- ABAS occurrence and misdiagnosis rate of PA subtyping
Performance
As reported in the abstract
ABAS occurrence, unstimulated AVS
- LC-MS/MS reduced apparent bilateral aldosterone suppression (ABAS) occurrence vs immunoassay (IA) in unstimulated AVS (n = 159)
Further findings
Misdiagnosis rate of PA subtyping, unstimulated AVS with final diagnosis from postoperative outcomes
- Misdiagnosis rate of PA subtyping, unstimulated AVS with final diagnosis from postoperative outcomes: 77 patients with final subtyping diagnosis
Misdiagnosis by ABAS status
- IA: ABAS patients misdiagnosed
- 5 out of 6
- IA: non-ABAS patients misdiagnosed
- 3/71
- LC-MS/MS: ABAS patients with follow-up, misdiagnosed
- 1 of 1
- LC-MS/MS: non-ABAS patients misdiagnosed
- 6 of 76
- Misdiagnosis more common with ABAS than without ABAS
ACTH-stimulated AVS
- Similar results found in ACTH-stimulated AVS
Original publication
The Value of LC-MS/MS in Apparent Bilateral Aldosterone Suppression in Adrenal Venous Sampling for Primary Aldosteronism. J Clin Endocrinol Metab. Published 23 December 2024. doi:10.
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