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- Title
Pediatric idiopathic intracranial hypertension and the underlying endocrine-metabolic dysfunction: a pilot study.
- Authors
Salpietro, Vincenzo; Mankad, Kshitij; Kinali, Maria; Adams, Ashok; Valenzise, Mariella; Tortorella, Gaetano; Gitto, Eloisa; Polizzi, Agata; Chirico, Valeria; Nicita, Francesco; David, Emanuele; Romeo, Anna Claudia; Squeri, Carlo Attilio; Savasta, Salvatore; Marseglia, Gian Luigi; Arrigo, Teresa; Johanson, Conrad Earl; Ruggieri, Martino
- Abstract
Aim: To unravel the potential idiopathic intracranial hypertension (IIH) endocrine-metabolic comorbidities by studying the natural (and targeted drug-modified) history of disease in children. IIH is a disorder of unclear pathophysiology, characterized by raised intracranial pressure without hydrocephalus or space-occupying lesion coupled with normal cerebrospinal fluid (CSF) composition. Methods: Retrospective study (years 2001-2010) of clinical records and images and prospective follow-up (years 2010-2013) in 15 children (11 girls, 4 boys; aged 5-16 years) diagnosed previously as 'IIH', according to the criteria for pediatric IIH proposed by Rangwala, at four university pediatric centers in northern, central, and southern Italy. Results: We identified six potential endocrine-metabolic comorbidities including, weight gain and obesity (n=5), recombinant growth hormone therapy (n=3), obesity and metabolic syndrome (n=1), secondary hyperaldosteronism (n=1), hypervitaminosis A (n=1), and corticosteroid therapy (n=1). Response to etiologically targeted treatments (e.g., spironolactone, octreotide) was documented. Conclusions: IIH is a protean syndrome caused by various potential (risk and) associative factors. Several conditions could influence the pressure regulation of CSF. An endocrine-metabolic altered homeostasis could be suggested in some IIH patients, and in this context, etiologically targeted therapies (spironolactone) should be considered
- Publication
Journal of Pediatric Endocrinology & Metabolism, 2014, Vol 27, Issue 1/2, p107
- ISSN
0334-018X
- Publication type
Article
- DOI
10.1515/jpem-2013-0156