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Primary aldosteronism subtype testing — SCE Endocrinology MCQ

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HardAdrenalPrimary aldosteronism subtype testingSCE Endocrinology

A 40-year-old man has severe hypertension and an adrenal mass. Plasma metanephrines are normal on two occasions. Aldosterone is high with suppressed renin and potassium is 2.7 mmol/L. What is the most appropriate next investigation for subtype classification?

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Correct answer: D — Adrenal venous sampling

Confirmed primary aldosteronism usually requires adrenal venous sampling to distinguish unilateral from bilateral secretion when surgery is considered. CT alone can be misleading because non-functioning nodules are common. The biochemical phenotype is not phaeochromocytoma because metanephrines are normal.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/diabetes-and-other-endocrinal-nutritional-and-metabolic-conditions