Diplopia, Convergent Strabismus, and Eye Abduction Palsy in a 12-Year-Old Boy with Autoimmune Thyroiditis

Joint Authors

Marques, Pedro
Jacinto, Sandra
Pinto, Maria do Carmo
Limbert, Catarina
Lopes, Lurdes

Source

Case Reports in Pediatrics

Issue

Vol. 2016, Issue 2016 (31 Dec. 2016), pp.1-4, 4 p.

Publisher

Hindawi Publishing Corporation

Publication Date

2016-06-09

Country of Publication

Egypt

No. of Pages

4

Main Subjects

Medicine

Abstract EN

Pseudotumor cerebri (PTC) is defined by clinical criteria of increased intracranial pressure, elevated intracranial pressure with normal cerebrospinal fluid (CSF) composition, and exclusion of other causes such tumors, vascular abnormalities, or infections.

The association of PTC with levothyroxine (LT4) has been reported.

A 12-year-old boy has been followed up for autoimmune thyroiditis under LT4.

Family history was irrelevant for endocrine or autoimmune diseases.

A TSH level of 4.43 μUI/mL (0.39–3.10) motivated a LT4 adjustment from 75 to 88 μg/day.

Five weeks later, he developed horizontal diplopia, convergent strabismus with left eye abduction palsy, and papilledema.

Laboratorial evaluation revealed elevated free thyroxine level (1.05 ng/dL [0.65–1.01]) and low TSH, without other alterations.

Lumbar puncture was performed and CSF opening pressure was 24 cm H2O with normal composition.

Blood and CSF cultures were sterile.

Brain MRI was normal.

LT4 was temporarily discontinued and progressive improvement was observed, with a normal fundoscopy at day 10 and reversion of diplopia one month later.

LT4 was restarted at lower dose and gradually titrated.

The boy is currently asymptomatic.

This case discloses the potential role of LT4 in inducing PTC.

Despite its rarity and unclear association, PTC must be seen as a potential complication of LT4, after excluding all other intracranial hypertension causes.

American Psychological Association (APA)

Marques, Pedro& Jacinto, Sandra& Pinto, Maria do Carmo& Limbert, Catarina& Lopes, Lurdes. 2016. Diplopia, Convergent Strabismus, and Eye Abduction Palsy in a 12-Year-Old Boy with Autoimmune Thyroiditis. Case Reports in Pediatrics،Vol. 2016, no. 2016, pp.1-4.
https://search.emarefa.net/detail/BIM-1102419

Modern Language Association (MLA)

Marques, Pedro…[et al.]. Diplopia, Convergent Strabismus, and Eye Abduction Palsy in a 12-Year-Old Boy with Autoimmune Thyroiditis. Case Reports in Pediatrics No. 2016 (2016), pp.1-4.
https://search.emarefa.net/detail/BIM-1102419

American Medical Association (AMA)

Marques, Pedro& Jacinto, Sandra& Pinto, Maria do Carmo& Limbert, Catarina& Lopes, Lurdes. Diplopia, Convergent Strabismus, and Eye Abduction Palsy in a 12-Year-Old Boy with Autoimmune Thyroiditis. Case Reports in Pediatrics. 2016. Vol. 2016, no. 2016, pp.1-4.
https://search.emarefa.net/detail/BIM-1102419

Data Type

Journal Articles

Language

English

Notes

Includes bibliographical references

Record ID

BIM-1102419