使用醋酸亮丙瑞林治疗中枢性性早熟的患者出现了假性脑瘤。
Pseudotumor cerebri in patient on leuprolide acetate for central precocious puberty.
作者信息
Omar Anjumanara Anver, Nyaga Godfrey, Mungai Lucy N Wainaina
机构信息
Department of Paediatrics and Child Health-Nairobi, University of Nairobi, Nairobi, Kenya.
Optimal Health KMA Centre-Nairobi, Nairobi, Kenya.
出版信息
Int J Pediatr Endocrinol. 2020 Dec 3;2020(1):22. doi: 10.1186/s13633-020-00092-4.
BACKGROUND
Gonadotropin releasing hormone agonists (GnRHa) are well established as a standard of care for the treatment of central precocious puberty (CPP) worldwide. While numerous delivery systems and routes of administration exist, depot intramuscular injections or sustained-release preparations have been most widely used. Leuprolide acetate is well tolerated among children though some can develop some complications.
CASE PRESENTATION
We present a case report of a 6.5 year old girl with central precocious puberty who developed signs of pseudotumor cerebri after 2 doses of leuprolide acetate 3.75 mg given monthly. Systemic exam and other tests to look for the cause did not yield anything. However, fundoscopy showed marked papilloedema with blurred disc margins. After six weeks' treatment with acetazolamide and withdrawal of the GRNHa the papilloedema resolved.
CONCLUSIONS
If a patient presents with complaints such as headache, nausea, vomiting, and double vision in pediatric patients treated with GnRH analogue one should highly consider the presence of pseudotumor cerebri and fundus examination be performed.
背景
促性腺激素释放激素激动剂（GnRHa）作为全球治疗中枢性性早熟（CPP）的护理标准已得到广泛认可。虽然存在多种给药系统和给药途径，但长效肌内注射或缓释制剂应用最为广泛。醋酸亮丙瑞林在儿童中耐受性良好，不过有些儿童可能会出现一些并发症。
病例报告
我们报告一例6.5岁中枢性性早熟女孩的病例，该女孩在每月注射2剂3.75毫克醋酸亮丙瑞林后出现了假性脑瘤的症状。全身检查和其他寻找病因的检查均未发现异常。然而，眼底检查显示明显的视乳头水肿，视盘边缘模糊。在使用乙酰唑胺治疗六周并停用GnRHa后，视乳头水肿消退。
结论
如果接受GnRHa治疗的儿科患者出现头痛、恶心、呕吐和复视等症状，应高度怀疑假性脑瘤的存在，并进行眼底检查。
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