RESUMEN
Geller syndrome is a rare disease and part of Mendelian forms of hypertension. This syndrome is caused by a mutation in the mineralocorticoid receptor with a resultant gain of function. It is characterized by hypertension and hypokalemia, which is exacerbated by the effect of progesterone and thereby presenting during pregnancy. Our patient is a 22-year-old female diagnosed with preeclampsia who presented with hypokalemia, refractory to treatment toward the end of her third trimester. The patient's hypokalemia resolved once she delivered her infant. Genetic testing is available, which can confirm the diagnosis of Geller syndrome. The management is supportive therapy and requires close monitoring of the patient and her fetus. Delivery of the fetus results in the resolution of both hypertension and hypokalemia.
RESUMEN
Drug-induced lupus erythematosus (DILE) is a syndrome that manifests with symptoms similar, but with less severity, to that of systemic lupus erythematosus (SLE). Many medications are reported to be involved in DILE; however, terbinafine (Lamisil) is not a well-known causative agent of this syndrome. In this case report, we present a 22-year-old male patient with no prior medical history presented with worsening fever, rash, joint pain, and weight loss a couple of weeks after starting terbinafine. He underwent an extensive workup which revealed worsening kidney function, proteinuria, and microscopic hematuria, for which he underwent a renal biopsy which revealed class IV lupus nephritis. He was treated with prednisone taper and immunosuppressants with subsequent resolution of his symptoms. Close monitoring for the development of DILE symptoms is recommended after starting terbinafine, especially in patients with a known personal or family history of SLE.