Mycophenolate mofetil-induced pseudotumor cerebri in a boy with autoimmune lymphoproliferative disease.

Abstract

INTRODUCTION:

Pseudotumor cerebri (PTC) is a syndrome characterized with increased intracranial pressure, normal cerebrospinal fluid content (CSF), and a normal brain on imaging studies. In this case report, PTC has been linked to mycophenolate mofetil (MMF) that has been used for autoimmune lymphoproliferative syndrome (ALPS).

CASE REPORT:

A 5-year-old boy, who was using MMF for 4 months because of the ALPS, suffered from occipital headache and vomiting with no other symptom. The initial physical examination was normal expect bilateral papilledema. The patient underwent a lumbar puncture which showed elevated opening pressure (590 mmH₂O) but no laboratory abnormalities of the CSF. A diagnosis of PTC was established. MMF was stopped, and the child was started on an acetazolamide treatment for 2 weeks. His symptoms and complaints recovered after this treatment.

DISCUSSION:

According to our knowledge, we report the first case of MMF-induced PTC in a boy with ALPS. This case illustrates that despite the rarity of MMF-induced PTC, the physicians should be aware of this possibility. Furthermore, in the setting of new-onset headaches or visual changes, early ophthalmologic examination for papilledema is recommended for early diagnosis.

• Authors: Turkan Patiroglu, Alper Ozcan, Musa Karakukcu, Mehmet Akif Ozdemir, Gamze Poyrazoglu, Mehmet Canpolat, Ekrem Unal
• Journal: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery (Childs Nerv Syst) Vol. 27 Issue 5 Pg. 853-5 (May 2011) ISSN: 1433-0350 [Electronic] Germany
• PMID: 21305306 (Publication Type: Case Reports, Journal Article)

Chemical References

• Carbonic Anhydrase Inhibitors
• Immunosuppressive Agents
• Mycophenolic Acid
• Acetazolamide

Topics

• Acetazolamide (therapeutic use)
• Autoimmune Lymphoproliferative Syndrome (drug therapy, physiopathology)
• Carbonic Anhydrase Inhibitors (therapeutic use)
• Child, Preschool
• Humans
• Immunosuppressive Agents (adverse effects)
• Male
• Mycophenolic Acid (adverse effects, analogs & derivatives)
• Pseudotumor Cerebri (chemically induced, therapy)
• Spinal Puncture