A Rare Cause of Hypertension and Hypokalemia During Pregnancy: A Case Report

Abstract There is a high prevalence of hypertensive disorders of pregnancy in Africa. We describe a young woman who presented with severe hypertension and hypokalemia during pregnancy, detailing the diagnostic and therapeutic challenges encountered. A 17-year-old primigravida, who was diagnosed with primary membranous nephropathy one month earlier, presented with pre-eclampsia associated with profound hypokalemia during the third trimester of pregnancy. A spot urine sample indicated renal potassium wasting, and blood tests revealed low-normal plasma renin and low aldosterone concentrations. A diagnosis of Geller syndrome (GS) was made. After fetal delivery and potassium supplementation, there was rapid resolution of hypokalemia. To our knowledge, this is the first reported case of GS from Africa. Although other hypertensive disorders of pregnancy are more common, clinicians must maintain a high index of suspicion for other causes of hypertension, especially when it is associated with severe hypokalemia.