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Reversible benign intracranial hypertension in a child with hyperthyroidism
Andreas Merkenschlager1, Oliver Ehrt, Wolfgang Müller-Felber
1Children Hospital of the University of Leipzig, Department of Neuropediatrics, Leipzig, Germany.
Journal of Pediatric Endocrinology & Metabolism : JPEM
|February 5, 2009
Summary
Autoimmune hyperthyroidism can cause benign intracranial hypertension (BIH) in children. Prompt diagnosis and treatment of hyperthyroidism led to the resolution of BIH symptoms in a pediatric case.
Area of Science:
- Pediatric Endocrinology
- Neuro-ophthalmology
Background:
- Endocrine dysfunction is a rare cause of benign intracranial hypertension (BIH) in adults.
- BIH is infrequently reported in the pediatric population.
Observation:
- A 12-year-old girl presented with a 3-month history of headaches and bilateral papilledema.
- Elevated cerebrospinal fluid (CSF) opening pressure confirmed BIH.
- Laboratory tests revealed elevated free triiodothyronine (fT3) and free thyroxine (fT4) with suppressed thyroid-stimulating hormone (TSH).
- Elevated TSH receptor stimulating antibodies (TSHR-Ab) confirmed Graves' disease.
Findings:
- The patient was diagnosed with autoimmune hyperthyroidism (Graves' disease).
- Treatment with carbimazole and propranolol improved hyperthyroidism within two weeks.
- Headaches subsided, and papilledema resolved over two months.
Implications:
- This case highlights hyperthyroidism as a potential cause of BIH in children.
- Early consideration of endocrine causes is crucial for diagnosing pediatric BIH.
- Effective management of hyperthyroidism can lead to the resolution of BIH.
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