Learning from an AVS in a tertiary centre in Bangladesh: Lateralization of Primary Aldosteronism despite inconclusive imaging
DOI:
https://doi.org/10.3329/jacedb.v5i2.89445Keywords:
Primary aldosteronism, resistant hypertension, adrenal venous sampling, aldosterone-renin ratio, micronodular disease, normokalemiaAbstract
Primary hyperaldosteronism (PA) is a leading & treatable cause of secondary hypertension, yet many cases remain undiagnosed. Adrenal venous sampling (AVS) is the gold standard for subtype classification of PA when imaging is inconclusive, yet it remains underutilized due to technical difficulty and limited expertise. We report the first case of AVS performed at any medical college hospital in Bangladesh in a middle-aged woman with resistant hypertension and normal imaging, ultimately diagnosed with PA, supported by an elevated aldosterone–renin ratio (ARR, 184) on screening and confirmed by a saline suppression test. Subtype classification was confirmed by adrenal venous sampling, which demonstrated a significant lateralization index of 4.22 (≥4), consistent with unilateral aldosterone excess. Reporting early institutional experience facilitates quality improvement and skill development in emerging endocrine centres.
[J Assoc Clin Endocrinol Diabetol Bangladesh, July 2026; 5 (2): e89445]
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Copyright (c) 2026 Indrajit Prasad, Md Mahedi Hasan Khan, M Saifuddin, Mirza Sharifuzzaman, Firoj Hossain, Kamalesh Chandra Basu, Tanjina Zannat Shammee, K M Istiak Rohan, Farzana Alam, Noor Mohammed, Md Nasir Uddin Kazal, Md Mohiuddin Sarker, Minhaj Rahman, Touhiba Tasme Sara, Syeda Atika Sultana, Md Humayun Kabir, Farzana Haque Lotus, Md. Mahmud Hasan, Soma Sarkar, Md Ebrahim Khalil, Moinul Islam
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