title: Overweight and obesity in pediatric secondary pseudotumor cerebri syndrome.
abstract: OBJECTIVE
  To examine the clinical, demographic, and anthropometric patient characteristics of secondary pseudotumor cerebri syndrome in children and adolescents based on the recently revised diagnostic criteria.
  
  
  METHODS
  Retrospective observational case series.
  
  
  METHODS
  Patients seen at a tertiary children's hospital for pseudotumor cerebri syndrome were classified as having either primary idiopathic (n = 59) or secondary pseudotumor cerebri syndrome (n = 16), as rigorously defined by recently revised diagnostic criteria. Outcomes included body mass index Z-scores (BMI-Z), height and weight Z-scores, demographics, and clinical features at presentation, such as headache, sixth nerve palsy, and cerebrospinal fluid (CSF) opening pressure.
  
  
  RESULTS
  In this cohort, the associated conditions and exposures seen in definite secondary pseudotumor cerebri syndrome included tetracycline-class antibiotics (n = 11), chronic kidney disease (n = 3), withdrawal from chronic glucocorticoids (n = 1), and lithium (n = 1). Other associations observed in the possible secondary pseudotumor cerebri syndrome group included Down syndrome, vitamin A derivatives, and growth hormone. In comparison with primary pseudotumor cerebri syndrome, definite secondary pseudotumor cerebri syndrome patients were on average older (15.0 vs 11.6 years; P = .003, Mann-Whitney test). According to US Centers for Disease Control (CDC) classifications, 79% of children with secondary pseudotumor cerebri syndrome were either overweight or obese (36% overweight [n = 5] and 43% obese [n = 6]), as compared to 32% nationally.
  
  
  CONCLUSIONS
  Even when a potential inciting exposure is identified for pediatric pseudotumor cerebri syndrome, the possible contribution of overweight and obesity should be considered.
authors.affiliation: Departments of Neurology and Ophthalmology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Grace L
authors.initials: GL
authors.lastname: Paley
authors.affiliation: Departments of Neurology and Ophthalmology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Claire A
authors.initials: CA
authors.lastname: Sheldon
authors.affiliation: Center for Biomedical Informatics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Evanette K
authors.initials: EK
authors.lastname: Burrows
authors.affiliation: Center for Biomedical Informatics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Marianne R
authors.initials: MR
authors.lastname: Chilutti
authors.affiliation: Departments of Neurology and Ophthalmology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; Division of Ophthalmology, Neuro-ophthalmology Service, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: liug1@email.chop.edu.
authors.forename: Grant T
authors.initials: GT
authors.lastname: Liu
authors.affiliation: Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Shana E
authors.initials: SE
authors.lastname: McCormack
mesh_terms: D000293:Adolescent; D001824:Body Constitution; D015992:Body Mass Index; D015170:Cerebrospinal Fluid Pressure; D002648:Child; D002675:Child, Preschool; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007427:Intracranial Pressure; D008297:Male; D009765:Obesity / Q000150:complications*; D050177:Overweight / Q000150:complications; D011559:Pseudotumor Cerebri / Q000150:complications* / Q000175:diagnosis; D012189:Retrospective Studies