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Low cerebrospinal fluid protein in prepubertal children with idiopathic intracranial hypertension.

Publication ,  Journal Article
Margeta, MA; Buckley, EG; El-Dairi, MA
Published in: J AAPOS
April 2015

PURPOSE: To evaluate a clinical observation that prepubertal children with idiopathic intracranial hypertension (IIH) have low cerebrospinal fluid (CSF) protein levels compared to healthy children and pubertal patients with IIH. METHODS: The medical records of prepubertal and pubertal IIH patients and controls seen in the pediatric neuro-ophthalmology clinic at Duke between 2003 and 2013 were retrospectively reviewed. The control group consisted of children who had normal intracranial pressure on lumbar puncture performed to evaluate for headaches or anomalous-looking optic nerves. The records were analyzed with attention to demographic characteristics, clinical presentation, course, and lumbar puncture results. RESULTS: A total of 23 prepubertal children with IIH (age range, 0.75-13 years), 16 pubertal patients with IIH (age range, 13-21 years), and 12 controls (age range 3-14 years) were included. CSF analysis revealed that prepubertal children with IIH had significantly lower CSF protein levels (17.3 ± 5.7 mg/dL) compared to pubertal subjects with IIH (23.4 ± 8.4 mg/dL; P = 0.019) or healthy controls (23.5 ± 6.4 mg/dL; P = 0.011). Furthermore, 9 of 23 prepubertal IIH patients (39%) had abnormally low CSF protein level (<15 mg/dL), compared to zero pubertal IIH patients (P = 0.005) and zero controls (P = 0.015). Acetazolamide increased CSF protein level in 100% of patients who underwent repeat lumbar puncture after starting the medication (average increase, 10.3 ± 6.6 mg/dL). CONCLUSIONS: Low CSF protein level may have diagnostic utility as a biomarker for prepubertal IIH. Furthermore, this finding suggests that some cases of prepubertal IIH may be caused by CSF overproduction rather than decreased CSF resorption.

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Published In

J AAPOS

DOI

EISSN

1528-3933

Publication Date

April 2015

Volume

19

Issue

2

Start / End Page

135 / 139

Location

United States

Related Subject Headings

  • Young Adult
  • Spinal Puncture
  • Retrospective Studies
  • Puberty
  • Pseudotumor Cerebri
  • Papilledema
  • Ophthalmology & Optometry
  • Male
  • Intracranial Pressure
  • Infant
 

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Margeta, M. A., Buckley, E. G., & El-Dairi, M. A. (2015). Low cerebrospinal fluid protein in prepubertal children with idiopathic intracranial hypertension. J AAPOS, 19(2), 135–139. https://doi.org/10.1016/j.jaapos.2015.01.006
Margeta, Milica A., Edward G. Buckley, and Mays A. El-Dairi. “Low cerebrospinal fluid protein in prepubertal children with idiopathic intracranial hypertension.J AAPOS 19, no. 2 (April 2015): 135–39. https://doi.org/10.1016/j.jaapos.2015.01.006.
Margeta MA, Buckley EG, El-Dairi MA. Low cerebrospinal fluid protein in prepubertal children with idiopathic intracranial hypertension. J AAPOS. 2015 Apr;19(2):135–9.
Margeta, Milica A., et al. “Low cerebrospinal fluid protein in prepubertal children with idiopathic intracranial hypertension.J AAPOS, vol. 19, no. 2, Apr. 2015, pp. 135–39. Pubmed, doi:10.1016/j.jaapos.2015.01.006.
Margeta MA, Buckley EG, El-Dairi MA. Low cerebrospinal fluid protein in prepubertal children with idiopathic intracranial hypertension. J AAPOS. 2015 Apr;19(2):135–139.
Journal cover image

Published In

J AAPOS

DOI

EISSN

1528-3933

Publication Date

April 2015

Volume

19

Issue

2

Start / End Page

135 / 139

Location

United States

Related Subject Headings

  • Young Adult
  • Spinal Puncture
  • Retrospective Studies
  • Puberty
  • Pseudotumor Cerebri
  • Papilledema
  • Ophthalmology & Optometry
  • Male
  • Intracranial Pressure
  • Infant