Presumed levothyroxine-induced pseudotumor cerebri in a pediatric patient being treated for congenital hypothyroidism

Crystal Strickler¹, Andrew F Pilon^1,2

¹Illinois College of Optometry, Chicago, IL, USA; ²Southern California College of Optometry, Fullerton, CA, USA

Abstract: Papilledema is considered a neuro-ophthalmic emergency because of its capacity to induce irreversible end-organ damage and the often grave nature of its precipitating factor. Even more concern is warranted when papilledema presents in a pediatric setting. After excluded the contributions of intracranial masses, congenital malformations, ischemic insults and acute infections, the investigation must focus on determining the contributions of other uncharacteristic causes of pediatric pseudotumor cerebri. Pediatric pseudotumor cerebri is a rare clinical entity which shares few commonalities to the adult condition in regards to its predicating factors or symptoms. Without adequate medical history questioning, funduscopic evaluation and ancillary testing, the possibility of an erroneous diagnosis is plausible. This case report aims to disclose the toxic role levothyroxine sodium tablets (Synthroid^®, Abbott Laboratories, Abbott Park, IL, USA) played in inducing pseudotumor cerebri in a pediatric patient being treated for congenital hypothyroidism.

Keywords: pseudotumor cerebri, papilledema, levothyroxine, Synthroid^®, hypothyroidism