Peritoneally dialysed patient with pseudotumour cerebri
Klinika Pediatrii i Immunologii z Pododdziałem Nefrologii, Instytut Centrum Zdrowia Matki Polki w Łodzi.
Kierownik Kliniki: prof. dr hab. n. med. Krzysztof Zeman
Adres do korespondencji: Klinika Pediatrii i Immunologii z Pododdziałem Nefrologii, Instytut Centrum Zdrowia Matki Polki w Łodzi, ul. Rzgowska 281/289, 93‑338 Łódź, tel.: 42 271 20 15, e‑mail: annakrakowska@onet.pl
Praca finansowana ze środków własnych
Pediatr Med rodz Vol 8 Numer 2, p. 172-175
ABSTRACT
Introduction: Pseudotumour cerebri (idiopathic intracranial hypertension) is diagnosed when several symptoms coexist: headaches, papilledema, increased cerebrospinal fluid pressure (without any cytologic or chemical abnormalities in it). Neuroimaging shows no pathology either. Aim: The aim of this work is to present a case of 16‑year‑old girl who has been receiving peritoneal dialysis. End stage renal disease developed on the basis of focal segmental glomerulosclerosis. Despite of many therapeutic methods used (steroids, cyclophosphamide, angiotensin convertase inhibitors, plasmapheresis), after three years she required dialysis. Few month after commencing dialysis, in ophthalmologic consultation (routine one, which was required for renal transplantation qualification), papilledema was diagnosed. The patient did not report any symptoms that could suggest intracranial hypertension. The magnetic resonance did not reveal any focal pathology. Neurologist suggested the diagnosis of pseudotumour cerebri and applied acetazolamide with increased dose of antihypertensives. The papilledema resolved after 3 months. Conclusions: Pseudotumour cerebri symptoms are rare but can be the reason for such pathology as papilledema or headaches among dialysed children. There are single cases in the literature. Poorly regulated hypertension or fluid overload can be risk factors for idiopathic intracranial hypertension.
Keywords: pseudotumour cerebri, idiopathic intracranial hypertension, peritoneal dialysis, end stage renal disease, children