Aldosteronism Screening and Diagnosis

In this talk, Dr. Holmes discusses the critical role the lab plays in case-finding and diagnosis of primary aldosteronism (PA). He also reviews the challenges that immunoassays have created in clearly defining PA with respect to confirmatory (salt loading) test thresholds. The value of mass spectrometry is also highlighted in terms of the identification of rarer conditions and the avoidance of GFR-related interferences plaguing immunoassays. The technical challenges of adrenal venous sampling for tumor localization are covered in addition to the invaluable role the lab can play in mitigating these challenges so that PA cases caused by adrenal adenoma can be clearly identified and potentially cured.

After viewing this lecture, participants should be able to:
1. Describe the clinical presentation of primary aldosteronism and describe which diagnostic tests are used to establish the diagnosis.
2. Identify the clinical contexts in which immunoassays will give inaccurate test results.
3. List two rare diagnoses that can be made serendipitously when tandem mass spectrometry is used for primary aldosteronism screening.
4. Discuss the technical challenges of adrenal venous sampling and how the laboratorian can mitigate these.

Dan Holmes, MD, FRCPC, division head, Clinical Chemistry, Assistant Department Head, St. Paul's Hospital Department of Pathology and Laboratory Medicine

10/25/17

http://depts.washington.edu/labweb/Education/ContEdu/
http://uwtv.org

Видео Aldosteronism Screening and Diagnosis канала UW Video