<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0001-6002</journal-id>
<journal-title><![CDATA[Acta Médica Costarricense]]></journal-title>
<abbrev-journal-title><![CDATA[Acta méd. costarric]]></abbrev-journal-title>
<issn>0001-6002</issn>
<publisher>
<publisher-name><![CDATA[Colegio de Médicos y Cirujanos de Costa Rica]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0001-60022019000200081</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Hipertensión resistente en un paciente con aldosteroninsmo primario. Una presentación clínica inusual]]></article-title>
<article-title xml:lang="en"><![CDATA[Resistant hypertension in a patient with primary aldosteroninsm. An unusual clinical presentation]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Jiménez-Montero]]></surname>
<given-names><![CDATA[Jose G.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Moya-Sancho]]></surname>
<given-names><![CDATA[Eduardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Brenes-Pino]]></surname>
<given-names><![CDATA[Fernando]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rivera-Aguerri]]></surname>
<given-names><![CDATA[Ariel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Servicio de Endocrinología.  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af2">
<institution><![CDATA[,Departamento de Radiología.  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af3">
<institution><![CDATA[,Departamento de Patología.  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af4">
<institution><![CDATA[,Hospital CIMA Departamento de Cirugía General ]]></institution>
<addr-line><![CDATA[San José. ]]></addr-line>
</aff>
<aff id="Af5">
<institution><![CDATA[,Universidad de Ciencias Médicas (UCIMED).  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2019</year>
</pub-date>
<volume>61</volume>
<numero>2</numero>
<fpage>81</fpage>
<lpage>84</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S0001-60022019000200081&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S0001-60022019000200081&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S0001-60022019000200081&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen En este reporte se presenta el caso de una paciente con hipertensión resistente que requería triple terapia antihipertensiva. Presentaba episodios súbitos de hipertensión, de predominio nocturno, cefalea, disnea, palpitaciones, dolor precordial, y se documentó ultrasonográficamente una masa suprarrenal izquierda. Estas manifestaciones clínicas podrían corresponder a hipertensión endocrina debida a feocromocitoma. No obstante, las pruebas de laboratorio mostraron hipocalemia, elevación de la aldosterona plasmática y supresión de la actividad de renina plasmática. Estos resultados fueron consistentes con aldosteronismo primario. Con la resección laparoscópica del adenoma suprarrenal, se normalizaron las cifras tensionales y las concentraciones de aldosterona y actividad de renina plasmática.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract In this report we present a case of a patient with resistant hypertension treated with triple antihypertensive medication. The patient suffered of sudden episodes of nocturnal hypertension, headache, dyspnoea, palpitations, precordial pain and a left suprarenal mass was found in the abdominal ultrasound. These findings suggested endocrine hypertension due to pheochromocytoma.However, the laboratory tests showed hypokalemia, high plasma aldosterone concentrations and suppressed plasma renin activity. This results were consistent with primary aldosteronism. After the laparoscopic removal of the suprarenal adenoma blood pressure, plasma aldosterone concentrations and plasma renine activity returned to normal.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[hipertensión resistente]]></kwd>
<kwd lng="es"><![CDATA[aldosterona plasmática]]></kwd>
<kwd lng="es"><![CDATA[adenoma suprarrenal]]></kwd>
<kwd lng="es"><![CDATA[aldosteronismo primario]]></kwd>
<kwd lng="en"><![CDATA[Resistant hypertension]]></kwd>
<kwd lng="en"><![CDATA[Plasma aldosterone]]></kwd>
<kwd lng="en"><![CDATA[Suprarenal adenoma]]></kwd>
<kwd lng="en"><![CDATA[Primary aldosteronism]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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