Case series of idiopathic intracranial hypertension in three patients with immune-complex glomerulonephritis

Abstract

Background Idiopathic intracranial hypertension (IIH) is defined by an increased cerebrospinal fluid pressure in the absence of inflammation, structural obstructions, or mass lesions. Although the underlying pathogenesis of IIH is not fully understood, associations with specific risk factors as obesity, obstruction of cerebral venous sinuses, medications, endocrine or systemic conditions and chronic kidney disease have been described. Immune-complex glomerulonephritis as IgA-nephropathy is a frequent cause of chronic kidney failure, which was reported previously in one IIH patient. To date, there is no knowledge about the variable relation of immune-complex nephritis, kidney function and the course of IIH. Case presentation We report three cases (two females) of concurrent diagnosis of IIH and immune-complex glomerulonephritis. All patients presented with typical IIH symptoms of headache and visual disturbances. Two patients had been diagnosed with IgA-nephropathy only few weeks prior to IIH diagnosis. The third patient had been diagnosed earlier with terminal kidney failure due to a cryoglobulin glomerulonephritis. Conclusion We propose a possible link between renal deposition of immune-complexes and increased cerebrospinal fluid pressure. Pathophysiological hypotheses and clinical implications are discussed. We recommend clinical awareness and further systematic research to obtain more information on the association of IIH and immune-complex glomerulonephritis.

Anesthetic Implications of Nephrotic Syndrome in Neurosurgical Practice

“…3 5 Also paraneoplastic NS is described in a patient with meningioma who achieved remission following surgery. 6 IIH (headache, papilledema, raised CSF pressure) can occur in NS associated renal failure, corticosteroids, or cyclosporine therapy more common in fertile obese females, 5 7 8 similar to our patient. CSF pressure reduction either medically, serial lumbar punctures, or surgery would preserve vision.…”

Phenotyping non-idiopathic pseudotumor cerebri syndrome – A prospective cohort study

“…Few studies have investigated the most frequent causes of sPTCS or any phenotypical differences between sPTCS and IIH patients. The majority of the existing studies have been retrospective and/or case studies (5)(6)(7)(8)(9)(10)(11)(26)(27)(28), and no previous studies have prospectively evaluated the most common causes of sPTCS. Here, we present a prospective cohort study investigating various causes of sPTCS in a population of patients with clinically suspected new-onset PTCS.…”