title: Pseudotumor Cerebri in a Child with Idiopathic Growth Hormone Insufficiency Two Months after Initiation of Recombinant Human Growth Hormone Treatment.
abstract: Purpose. To report a rare case of pseudotumor cerebri (PTC) in a child two months after receiving treatment with recombinant human growth hormone (rhGH) and to emphasize the need of close collaboration between ophthalmologists and pediatric endocrinologists in monitoring children receiving rhGH. Methods. A 12-year-old boy with congenital hypothyroidism started treatment with rhGH on a dose of 1,5 mg/daily IM (4.5 IU daily). Eight weeks later, he was complaining of severe headache without any other accompanying symptoms. The child was further investigated with computed tomography scan and lumbar puncture. Results. Computed tomography scan showed normal ventricular size and lumbar puncture revealed an elevated opening pressure of 360 mm H2O. RhGH was discontinued and acetazolamide 250 mg per os twice daily was initiated. Eight weeks later, the papilledema was resolved. Conclusions. There appears to be a causal relationship between the initiation of treatment with rhGH and the development of PTC. All children receiving rhGH should have a complete ophthalmological examination if they report headache or visual disturbances shortly after the treatment. Discontinuation of rhGH and initiation of treatment with acetazolamide may be needed and regular follow-up examinations by an ophthalmologist should be recommended.
authors.affiliation: Department of Ophthalmology, Makarios Hospital, 2012 Nicosia, Cyprus.
authors.forename: Eleni
authors.initials: E
authors.lastname: Loukianou
authors.affiliation: Department of Ophthalmology, Makarios Hospital, 2012 Nicosia, Cyprus.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Tasiopoulou
authors.affiliation: Department of Ophthalmology, Makarios Hospital, 2012 Nicosia, Cyprus.
authors.forename: Constantinos
authors.initials: C
authors.lastname: Demosthenous
authors.affiliation: 1st University Eye Clinic, 11527 Athens, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Brouzas