Discrepant Results of Adrenal Venous Sampling in Seven Patients with Primary Aldosteronism

Background: Adrenal venous sampling serves as a discrimination between uni- and bilateral forms of primary aldosteronism (PA). Even correctly performed adrenal venous sampling may lead to non-diagnostic results in some cases. Results: We describe 7 subjects with PA in whom correct cannulation of adrenal veins (high selectivity index defined as cortisol(adrenal)/cortisol(periphery) ratio) was associated with aldosterone (ALDO) suppression (ALDO/cortisol(adrenal)/ALDO/cortisol(periphery) ratio (right)/ALDO/cortisol(left) 1.78). Conclusions: Our results document some uncertainties in interpreting results of adrenal venous sampling in subjects with PA which may result from deep catheter insertion, anomalous venous drainage, or fluctuations in ALDO secretion.