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
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
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