Hemolytic anemia presenting as idiopathic intracranial hypertension
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We report the case of a patient presenting with headache, increased intracranial pressure, and papilledema who was found to have profound hemolytic anemia. The idiopathic intracranial hypertension–like state resolved with correction of the underlying anemia.
Case Report.
A 20-year-old male college student experienced intermittent headaches, blurred vision, and poor concentration over a period of several weeks. He reported progressive fatigue over a period of 3 months and a significant decline in his recent scholastic performance. He had been healthy otherwise, with no prior medical history. He was of Indian extraction and had no family history of anemia. His only medication was occasional acetaminophen. Headaches became intolerable and brought him to the emergency department. On examination, he was thin and lethargic and had mild scleral and mucosal icterus. His conjunctivae were pale and his skin was slightly jaundiced. He was normotensive at 130/65 but tachycardic at 120 beats per minute. Pulmonary, cardiac, and abdominal examinations were unremarkable. There was no hepato- or splenomegaly. Neuro-ophthalmic examination showed a visual acuity of 20/25 in both eyes, mildly constricted visual fields, and moderately increased blind spots. His ocular motility and pupillary responses were normal. Funduscopic examination revealed bilateral optic disc swelling with venous …
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