4180 HYPERTENSION, HYPOKALEMIA AND PREGNANCY: A CASE OF GELLER SYNDROME

Abstract Background and Aims Hypokalemia is not a common laboratory finding in pregnancy, with a recent study revealing a prevalence of less than 1%, nationwide [1]. In a pregnant patient with newfound hypertension and hypokalemia, it is important to consider causes that would affect the Renin-Angiotension-Aldosterone pathway. Although these causes are usually suspected in patients with a triad of hypertension, hypokalemia and metabolic alkalosis, the latter finding may not be present in pregnant patients given metabolic compensation for their respiratory alkalosis of pregnancy. Method A 27 year old, 36 week and 5 day pregnant female presented to her OBGYN follow up appointment at the beginning of the year. At that time, she was found to be hypokalemic and was admitted overnight for potassium repletion, consisting of 40 mEq of oral potassium chloride and 40 mEq of intravenous potassium. She was discharged after that with a follow up appointment scheduled the next month. At that clinic visit, her potassium was 2.6 mmol/L and she was admitted for further workup. The patient was also hypertensive, with a blood pressure markedly increased from her baseline value. The patient endorsed having elevated blood pressures during her previous pregnancy with normalization after delivery. She stated that she was followed at a different outpatient clinic at that time, so she did not have all the records, however was told she suffered from pre-eclampsia. During this current admission, patient did note dyspnea, fatigue and generalized weakness. She denied any diarrhea or gastrointestinal distress. Her physical examination was unremarkable. Spot urine potassium was 19 with a serum potassium of 2.8 mmol/L after 40 mEq of potassium supplementation. Aldosterone was