Pseudotumor Cerebri Caused by All-Trans-Retinoic Acid : A Case Report

SOMSAK TIAMKAO, M.D.*, CHITTIMA SIRUIRACHAI, M.D.**

Affiliation : * Division of Neurology, Department of Medicine, ** Division of Hematology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.

AbstractPseudotumor cerebri is a condition characterized by increased intracranial pressure with normal cerebrospinal fluid composition. It is usually associated with many medical conditions and drugs. It has been reported that all-trans-retinoic acid can induce pseudotumor cerebri. The authors report a 35-year-old patient diagnosed with acute promyelocytic leukemia who developed pseudo- tumor cerebri after receiving all-trans-retinoic acid. The patient was treated with 60 mg/day of all- trans-retinoic acid. Two weeks later, she had severe headache and blurred vision. The neurological examination revealed papilledema and decreased visual acuity. Other physical examinations were unremarkable. Brain CT was normal. Additionally, lumbar puncture was performed and the CSF finding was normal except for high CSF pressure. According to modified Dandy criteria, the diagnosis was pseudotumor cerebri. The patient's symptoms disappeared after all-trans-retinoic acid was discontinued. To our knowledge, this is the first case report in Thailand.

Keywords : Pseudotumor Cerebri, All-trans-retinoic Acid, Acute Promyelocytic Leukemia

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