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一名14岁女性患者的特发性颅内高压伴视乳头水肿和缺铁性贫血:中东地区首例报告病例

Idiopathic Intracranial Hypertension With Papilledema and Iron Deficiency Anemia in a 14-Year-Old Female Patient: A Case Report of First Presentation in the Middle East.

作者信息

Awatramani Gunjan, Sait Ruzaina, Saeed Ghazal Talal, Vidha Sara, Al-Abdullah Zainab, Ghaffaripour Ghazaleh, Marashi Mahmoud, Warhekar Pramod

机构信息

College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, ARE.

Neuroscience Research Center, Iran University of Medical Sciences, Tehran, IRN.

出版信息

Cureus. 2025 Apr 16;17(4):e82346. doi: 10.7759/cureus.82346. eCollection 2025 Apr.

Abstract

Idiopathic intracranial hypertension (IIH) in the setting of iron deficiency anemia (IDA) is a rare association, possibly attributed to changes in cerebrospinal fluid (CSF) dynamics due to either iron homeostasis or blood hyperviscosity, although a definitive causal relationship continues to be speculated upon. This case report presents a rare instance of IDA causing IIH with accompanying papilledema in a 14-year-old female patient, who is a known case of polycystic ovarian syndrome. The patient presented to an outpatient clinic with tension-like headaches. Neurological examination, including fundoscopy, was significant for bilateral papilledema. Investigations revealed IDA. The patient was managed with acetazolamide and iron supplementation for her concurrent anemia. Despite initial management, her headaches persisted, and her papilledema progressed. Due to this progression, lumbar puncture was performed and confirmed elevated intracranial pressure (ICP). After completing an adjusted regimen of acetazolamide and iron supplementation, both the patient's symptoms and papilledema resolved and did not recur. This report encourages further research to support the potential connection of IDA with IIH and aid clinicians in promptly diagnosing and managing similar cases.

摘要

缺铁性贫血(IDA)背景下的特发性颅内高压(IIH)是一种罕见的关联情况,可能归因于铁稳态或血液高黏滞度导致的脑脊液(CSF)动力学变化,尽管确切的因果关系仍在推测之中。本病例报告呈现了一例罕见的IDA导致IIH并伴有视乳头水肿的病例,患者为一名14岁女性,已知患有多囊卵巢综合征。该患者因紧张性头痛就诊于门诊。包括眼底镜检查在内的神经系统检查显示双侧视乳头水肿。检查发现为IDA。患者接受乙酰唑胺治疗并补充铁剂以治疗同时存在的贫血。尽管进行了初始治疗,但其头痛持续存在,视乳头水肿进展。由于这种进展,进行了腰椎穿刺并证实颅内压(ICP)升高。在完成调整后的乙酰唑胺和铁补充治疗方案后,患者的症状和视乳头水肿均消失且未复发。本报告鼓励进一步研究以支持IDA与IIH之间的潜在联系,并帮助临床医生及时诊断和处理类似病例。

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