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Case Reports
. 2021 Feb 2;15(1):45.
doi: 10.1186/s13256-020-02631-2.

Idiopathic intracranial hypertension presenting as iron deficiency anemia: a case report

Peng Yong Sim  1 , Priyal Taribagil  2 , Ione O C Woollacott  3 , Safina Rashid  4 , Desmond P Kidd  4   3
Affiliations
Case Reports

Idiopathic intracranial hypertension presenting as iron deficiency anemia: a case report

Peng Yong Sim et al. J Med Case Rep. .

Abstract

Background: The presentation of idiopathic intracranial hypertension (IIH) in association with iron deficiency anemia (IDA) is rare.

Case presentation: This case report depicts the unusual case of a 31-year-old woman of mixed Jamaican and English heritage with IIH who presented initially as IDA in the context of menorrhagia. Subsequent ophthalmic review, lumbar puncture, cerebrospinal fluid analysis and neuroimaging studies revealed severe bilateral optic disc swelling and raised intracranial pressure in keeping with IIH. Prompt treatment of IDA with blood transfusion and orally administered iron supplements, in addition to medical treatment for IIH, contributed to significant improvement of symptoms and prevented long-term visual deficits.

Conclusion: The possibility of IDA, albeit rare, should always be considered and investigated appropriately in all patients with IIH, as the treatment of the anemia alone may be sight-saving.

Keywords: Case report; Idiopathic intracranial hypertension; Iron deficiency anemia; Optic neuropathy; Papilledema; Vision loss.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Clinical timeline of a 31-year-old woman of mixed Jamaican and English heritage diagnosed with IIH and IDA. OCT optical coherence tomography, MRI magnetic resonance imaging, MRV magnetic resonance venography, CVST cerebral venous sinus thrombosis, IIH idiopathic intracranial hypertension, IDA iron deficiency anemia
Fig. 2
Fig. 2
Initial optical coherence tomography (OCT) demonstrating peripapillary and macular subretinal fluid (white arrows). Color fundus photographs (b right; d left) highlighting the position of the line scan for the OCT images (a right; c left). Initial Goldmann visual field maps (e right; f left) showing constricted fields and an enlarged left blind spot
Fig. 3
Fig. 3
Severe papilledema as demonstrated on Optos ultra-widefield imaging. a Right eye. b Left eye
Fig. 4
Fig. 4
Follow-up optical coherence tomography (OCT) and color fundus photography demonstrating resolution of papilledema. Color fundus photographs (b right; d left) highlighting the position of the line scan for the OCT images (a right; c left). Follow-up Goldmann visual field maps (e right; f left) showing improvement of visual field in both eyes, with a residual central defect in the right eye
See this image and copyright information in PMC

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