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Published 17 March 2009
Cite this as: BMJ Case Reports 2009 [doi:10.1136/bcr.06.2008.0346]
Copyright © 2009 by the BMJ Publishing Group Ltd.

Unusual presentation of more common disease/injury

Iron deficiency masquerading as idiopathic intracranial hypertension

Bhavna Kaul1, Sivaramakrishnan R2, Himanshu Mahapatra3, Tarsheen Kaur Sethi4, Ravi Ahlawat5

1 Maulana Azad Medical College, C-48, Pamposh Enclave, Greater Kailash-1, New Delhi, 110048, India
2 Maulana Azad Medical College, Medicine, Room No 49, Pg Men’s Hostel, Delhi, 110002, India
3 Lok Nayak Hospital, New Delhi, 110002, India
4 Maulana Azad Medical College, Hemkunt Colony, New Delhi, 110048, India
5 Lok Nayak Hospital, Lok Nayak Hospital, New Delhi, 110002, India

Correspondence to:
Bhavana Kaul, kaulbhavna{at}yahoo.com

SUMMARY

A 13-year-old female presented with complaints of headache, vomiting, diplopia and progressive blurring of vision developing sequentially over 1 month. Examination revealed marked pallor and bilateral lateral rectus palsy with a visual acuity of 6/12 and 6/36 in the left and the right eye, respectively. Fundus examination showed late stage papilloedema in both eyes. Investigation for anaemia revealed severe iron deficiency. MRI of the brain was normal. The cerebrospinal fluid opening pressure was markedly raised at 320 mm of water but fluid analysis did not reveal any abnormality. Thus, a diagnosis of iron deficiency anaemia with idiopathic intracranial hypertension was made. The patient responded dramatically to intravenous iron treatment. Physicians must be aware of this rare presentation of the common problem of iron deficiency, the rapid correction of which plays an instrumental role in salvaging the patient’s vision and preventing a recurrence of disease.


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