ReviewIndian journal of endocrinology and metabolism
Idiopathic Intracranial Hypertension following Levothyroxine Replacement Therapy: Systematic Review and a Case Report.
Review in Indian journal of endocrinology and metabolism. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 13 citations in OpenAlex.
- Structural MRI Biomarkers of Intracranial Pressure in IIH: Linking Optic Nerve Sheath, Pituitary Morphology, and Hormonal Changes.Clinical neuroradiology · 2026Article
- Severe headache as the initial manifestation of painless thyroiditis: a pediatric case report.Clinical pediatric endocrinology : case reports and clinical investigations : official journal of the Japanese Society for Pediatric Endocrinology · 2026Article
- Case Report: Intracranial hypertension occurring in association with subacute thyroiditis.Frontiers in neurology · 2026Article
- Pseudotumor Cerebri and Hemolytic Uremic Syndrome, A Rare Association.Clinical case reports · 2025Article
- Severe Undiagnosed Congenital Hypothyroidism Due to Missed Newborn Screening.JCEM case reports · 2025Article
- A Rare Endocrinological Emergency in Children with Hypothyroidism: Clinical Evaluation of Cases Presenting with Myxedema Coma.Turkish archives of pediatrics · 2025Article
- Fulminant Idiopathic Intracranial Hypertension-Clinical Characteristics and Continuous Drainage as a Novel Treatment Approach.European journal of neurology · 2025Article
- Systemic Medications and Their Ocular Side Effects.Cureus · 2024Review
- When the Expected Becomes Unexpected: An Acute Presentation of Hypothyroidism.JCEM case reports · 2024Article
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
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Abstract
The data on the characteristics of patients with idiopathic intracranial hypertension (IIH) following levothyroxine (LT4) replacement are limited. Here, we report a case and systematically review published cases of idiopathic intracranial hypertension (IIH) following levothyroxine (LT4) replacement. The systematic review was performed as per the PRISMA guidelines. Our patient is a 46-year-old lady with hypothyroidism (thyrotropin: 319 mIU/L, free thyroxine: 0.04 ng/dl), treated with 100 μg.d of LT4 and presented a month later with headache, visual diminution, bilateral lateral rectus palsies, and papilledema. Cerebrospinal fluid (CSF) pressure was 32 cmH2O. Drainage of CSF, oral acetazolamide, and modification of LT4 dose resulted in prompt symptomatic improvement and complete reversal of IIH. In the systematic review (n = 21), the median age of patients (7 males) was 13 (IQR: 8.8- 26.5) years. The median duration of hypothyroid symptoms was 4 (n = 10, IQR: 0.44-6.25) years whereas that from initiation of LT4 replacement to the diagnosis of IIH was 2 (n = 20, IQR: 1.17-4) months. Initial median serum thyrotropin and thyroxine were 100 (n = 14, IQR: 72.5-421.6) mIU/L, and 1.13 (n = 12, IQR: 1.0-2.45) μg/dl which changed to 2.2 (n = 7; IQR: 0.23-3.40) mIU/L and 8.90 μg/dl (n = 8, IQR: 6.43-14.85 μg/dl), respectively at diagnosis of IIH after LT4 treatment with median daily LT4 doses of 0.89 (n = 8, IQR: 0.60 - 1.17) times the maximum recommended dose for age. To conclude, we report an adult woman with IIH following LT4 replacement for primary hypothyroidism, a rare entity. Pediatric age, prolonged symptom duration, and use of higher LT4 replacement dose may be associated with IIH following LT4 replacement.
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