The Journal of Clinical Endocrinology & Metabolism has published a clinical research trial to assess presence of discordant results between immunoassays and LC-MS/MS during the SIT and its impact on the diagnosis of primary aldosteronism.

The diagnosis of primary aldosteronism involves:

  1. Screening: the measurement of aldosterone-to-renin ratio (ARR)
  2. Confirmatory testing: various, for example saline infusion test (SIT)
  3. Subtype differentiation by adrenal venous sampling (AVS)
    1. Unilateral: cured by adrenalectomy
    2. Bilateral: mineralocorticoid receptor antagonist therapy

Study findings

The study concluded that the discordance to LC-MS/MS was more prevalent for the Liaison than iSYS immunoassay (32% vs 16%); i.e. more false positives on Liaison.

This means:

  1. Unnecessary, invasive, additional testing for the patient
  2. Less credibility for the results provided by the lab/hospital

You can read the full study on PubMed.