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. 2022 Sep 1;42(3):323-327.
doi: 10.1097/WNO.0000000000001536. Epub 2022 Mar 25.

Increased Incidence of Pseudotumor Cerebri Syndrome Among Users of Tetracycline Antibiotics

Samuel F Passi  1 , Ryan Butcher, Daniel R Orme, Judith E A Warner, Gregory J Stoddard, Alison V Crum, Ramkiran Gouripeddi, Brian H Kirk, Kathleen B Digre, Bradley J Katz
Affiliations

Increased Incidence of Pseudotumor Cerebri Syndrome Among Users of Tetracycline Antibiotics

Samuel F Passi et al. J Neuroophthalmol. .

Abstract

Background: To determine whether the use of a tetracycline-class antibiotic is associated with an increased risk of developing pseudotumor cerebri syndrome (PTCS).

Methods: We identified patients in the University of Utah Health system who were prescribed a tetracycline-class antibiotic and determined what percentage of those individuals were subsequently diagnosed with PTCS secondary to tetracycline use. We compared this calculation to the number of patients with PTCS unrelated to tetracycline use.

Results: Between 2007 and 2014, a total of 960 patients in the University system between the ages of 12 and 50 were prescribed a tetracycline antibiotic. Among those, 45 were diagnosed with tetracycline-induced PTCS. We estimate the incidence of tetracycline-induced PTCS to be 63.9 per 100,000 person-years. By comparison, the incidence of idiopathic intracranial hypertension (IIH) is estimated to be less than one per 100,000 person-years (Calculated Risk Ratio = 178).

Conclusions: Although a causative link between tetracycline use and pseudotumor cerebri has yet to be firmly established, our study suggests that the incidence of pseudotumor cerebri among tetracycline users is significantly higher than the incidence of IIH in the general population.

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Conflict of interest statement

S. F. Passi and D. R. Orme were supported by T35 EY026511 (NEI/NIH) “Medical Student Research Program in Eye Health and Disease”; Principal Investigator Mary Elizabeth Hartnett. FURTHeR is supported by NCRR/ NCATS Grants UL1RR025764 and 3UL1RR025764-02S2, National Center for Clinical and Translational Science 1UL1TR001067, University of Utah Research Foundation, grant 1D1BRH20425 (DHHS), and R01 HS019862 from AHRQ, (DHHS). K. B. Digre, J. E. A. Warner and B. J. Katz are named on a patent or patents related to the treatment of photophobia. B. J. Katz is CEO of Axon Optics, LLC, an internet company that sells eyewear for the treatment of photophobia. B. J. Katz provides expert medical testimony in legal proceedings and some of these proceedings involve the treatment of PTCS. The remaining authors report no conflicts of interest.

References

    1. Thurtell MJ, Wall M. Idiopathic intracranial hypertension (pseudotumor cerebri): recognition, treatment, and ongoing management. Curr Treat Options Neurol 2013;15(1):1–12. - PMC - PubMed
    1. Biousse V, Bruce BB, Newman NJ. Update on the pathophysiology and management of idiopathic intracranial hypertension. J Neurol Neurosurg Psychiatry 2012;83(5):488–494. - PMC - PubMed
    1. Halmagyi GM, Ahmed RM, Johnston IH. The pseudotumor cerebri syndrome: A unifying pathophysiological concept for patients with isolated intracranial hypertension with neither mass lesion nor ventriculomegaly. Neuroophthalmology 2014;38(5):249–253. - PMC - PubMed
    1. Monaco F, Agnetti V, Mutani R. Benign intracranial hypertension after minocycline therapy. Eur Neurol 1978;17(1):48–49. - PubMed
    1. Walters BN, Gubbay SS. Tetracycline and benign intracranial hypertension: report of five cases. Br Med J (Clin Res Ed) 1981;282(6257):19–20. - PMC - PubMed

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