title: Mycophenolate mofetil-induced pseudotumor cerebri in a boy with autoimmune lymphoproliferative disease.
abstract: BACKGROUND
  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).
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.affiliation: Department of Pediatrics, Division of Pediatric Hematology and Oncology, Faculty of Medicine, Erciyes University, 38039, Talas, Kayseri, Turkey.
authors.forename: Turkan
authors.initials: T
authors.lastname: Patiroglu
authors.forename: Alper
authors.initials: A
authors.lastname: Ozcan
authors.forename: Musa
authors.initials: M
authors.lastname: Karakukcu
authors.forename: Mehmet Akif
authors.initials: MA
authors.lastname: Ozdemir
authors.forename: Gamze
authors.initials: G
authors.lastname: Poyrazoglu
authors.forename: Mehmet
authors.initials: M
authors.lastname: Canpolat
authors.forename: Ekrem
authors.initials: E
authors.lastname: Unal
mesh_terms: D000086:Acetazolamide / Q000627:therapeutic use; D056735:Autoimmune Lymphoproliferative Syndrome / Q000188:drug therapy* / Q000503:physiopathology; D002257:Carbonic Anhydrase Inhibitors / Q000627:therapeutic use; D002675:Child, Preschool; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008297:Male; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives*; D011559:Pseudotumor Cerebri / Q000139:chemically induced* / Q000628:therapy; D013129:Spinal Puncture
chemical_list: D002257:Carbonic Anhydrase Inhibitors; D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid; D000086:Acetazolamide