Conn's syndrome with normal plasma renin aldosterone ratio

w Despite two normal plasma renin aldosterone ratios, clinical suspicion of Conn’s disease led to further investigations. Saline infusion test revealed failure of aldosterone suppression at 225 pmol/l with relatively normal renin aldosterone ratio of 450 post saline infusion. w Subsequently, he underwent adrenal venous sampling which showed a signifi cant gradient of aldosterone to the right adrenal gland.