New insights on the relationship between pseudotumor cerebri and secondary hyperaldosteronism in children

Over the year 2011, we followed up, at our Institution, a 14-year-old girl with renal congenital hypoplasia, tubular dysfunction and chronic solute imbalance coupled with hypokalemia and hypomagnesaemia. The girl, over the first months after referral (i.e. by late February 2011), developed secondary hyperaldosteronism (SAL) and mild hypertension, both likely related to her underlying disease and well documented by mildly high plasma aldosterone levels [upright (8.30 a.m.): 28 ng/dl, supine (8.45 a.m.): 17 ng/dl], and blood pressure monitoring (SBP 155mmHg, DBP 95mmHg). By middle of March 2011, she complained of throbbing headache and visual disturbances. A MRI study of the brain and full ophthalmologic examination, obtained at that time, revealed increased intracranial pressure with partial empty sella and optic disc swelling (grade II papilledema): the girl was diagnosed with idiopathic intracranial hypertension (IIH or pseudotumor