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Saline suppression test interpretation — SCE Endocrinology MCQ

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HardEndocrine emergencies/dynamic testsSaline suppression test interpretationSCE Endocrinology

A 45-year-old man with suspected primary aldosteronism undergoes saline infusion test. Aldosterone remains unsuppressed after infusion and renin is suppressed. What is the most likely interpretation?

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Correct answer: B — Confirmed autonomous aldosterone secretion

Failure of aldosterone suppression during saline loading supports autonomous aldosterone secretion. Renin suppression fits mineralocorticoid excess. Subtype evaluation is needed before deciding between adrenalectomy and mineralocorticoid receptor antagonism.

Reference: Endocrine Society Primary Aldosteronism Guideline