Benign intracranial hypertension in children following renal transplantation.
Benign intracranial hypertension (BIH) is a condition characterized by headache, papilledema, and a raised cerebrospinal fluid pressure with normal cranial imaging. It is uncommon in childhood. Previously, there have been reports that children with chronic impairment of renal function may be at greater risk of developing BIH. This study involved retrospective case note analysis of children undergoing renal transplantation over the last 11 years at our institution. Nine children developed BIH after renal transplantation. The prevalence of the condition in our series was 4.4%. Several etiologically relevant risk factors were identified, including medication (nitrofurantoin, minocycline) and excess weight gain. Our results suggest that BIH may be a more frequent complication of the post-operative care of pediatric renal transplant recipients than previously thought. We hope to alert pediatric nephrologists that examination of the fundus for papilledema in all renal transplant patients complaining of headache is essential. If the diagnosis of BIH is delayed, irretrievable visual loss may not be avoided.
Eye Department, Guy's Hospital, St Thomas' Street, London, UK, peterjamesfrancis@ukonline.co.uk
Peter J
PJ
Francis
Sarah
S
Haywood
Susan
S
Rigden
David M
DM
Calver
Godfrey
G
Clark
D000293:Adolescent; D015170:Cerebrospinal Fluid Pressure / Q000502:physiology; D002648:Child; D005260:Female; D006261:Headache / Q000209:etiology; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D010211:Papilledema / Q000175:diagnosis / Q000209:etiology; D011183:Postoperative Complications / Q000453:epidemiology; D011559:Pseudotumor Cerebri / Q000150:complications / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D014786:Vision Disorders / Q000209:etiology; D015430:Weight Gain