Department of Hematology at Fattouma Bourguiba Hospital, Monastir, Tunisia.
Neurology at Ruspina Neurology Clinic, Monastir, Tunisia.
BMC Neurol. 2022 May 2;22(1):163. doi: 10.1186/s12883-022-02689-z.
Idiopathic intracranial hypertension is a rare neurological condition among children. Its manifestations vary from mild headaches to loss of vision. Although rare, COVID-19 infection and high dose cytosine arabinoside have been reported as risk factors for this neurological disorder. In patients with acute leukemia, idiopathic intracranial hypertension diagnosis is simple, but finding its etiology can be difficult.
We report a case of a 9-year-old boy with an ongoing treatment for T-acute lymphoblastic leukemia presenting with persistent headaches and diplopia. A diagnosis of idiopathic intracranial hypertension was retained based on clinical, imaging and laboratory findings. Due to its rarity, we describe its clinical and therapeutic features and highlight the challenging etiological dilemma between COVID-19 infection and high dose cytosine arabinoside administration.
Persistent headache in a pediatric patient with leukemia can be due to many neurological disorders other than leukemic relapse. Given the improvement of the neurological symptoms after the SARS-CoV-2 PCR negativization and the successful re-introduction of high dose cytosine Arabinoside, the diagnosis of idiopathic intracranial hypertension associated with Covid-19 infection was withheld.
特发性颅内高压是儿童中罕见的神经系统疾病。其表现从轻度头痛到视力丧失不等。尽管罕见，但 COVID-19 感染和高剂量阿糖胞苷已被报道为这种神经障碍的危险因素。在急性白血病患者中，特发性颅内高压的诊断很简单，但找到病因可能很困难。
我们报告了一例正在接受 T 型急性淋巴细胞白血病治疗的 9 岁男孩，他持续头痛和复视。根据临床、影像学和实验室发现，诊断为特发性颅内高压。由于其罕见性，我们描述了其临床和治疗特征，并强调了 COVID-19 感染和高剂量阿糖胞苷给药之间的具有挑战性的病因学难题。
白血病患儿持续头痛可能是由于除白血病复发以外的许多神经系统疾病引起的。鉴于 SARS-CoV-2 PCR 转阴后神经系统症状的改善以及高剂量阿糖胞苷的成功重新引入，与 COVID-19 感染相关的特发性颅内高压的诊断被搁置。
