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Infectious and inflammatory disorders might increase the risk of developing idiopathic intracranial hypertension - a national case-control study.

ABSTRACT: OBJECTIVE:To investigate whether conditions causing inflammatory activation are associated with increased risk of idiopathic intracranial hypertension. METHODS:All newly diagnosed idiopathic intracranial hypertension patients (cases) in Sweden between 2000-2016 were identified using pre-determined algorithms (n?=?902) and matched with five controls from the general population and five individuals with an obesity diagnosis (n?=?4510) for age, sex, region, and vital status. National health registers provided information on infections, inflammatory disorders and dispensed medications. Conditional logistic regression was used to estimate odds ratios and 95% confidence intervals. RESULTS:Compared to general population controls, the cases had fourfold increased odds of having an infection (odds ratio?=?4.3, 95% confidence interval 3.3-5.6), and threefold increased odds of an inflammatory disorder the year prior to idiopathic intracranial hypertension diagnosis (odds ratio?=?3.2, 95% confidence interval 2.4-4.3). Organ specific analyses showed that odds were increased for the study diseases in the respiratory organ, kidney organ and gastrointestinal tract, but not for female genital infections. Similar results were found when comparing idiopathic intracranial hypertension with obese controls though the odds ratios were of lower magnitude. Sub-analyses on exposure to anti-infectious and anti-inflammatory drugs confirmed the increased odds ratios for idiopathic intracranial hypertension patients. CONCLUSIONS:These findings suggest that major inflammatory activation may be a risk factor in idiopathic intracranial hypertension development.

SUBMITTER: Sundholm A

PROVIDER: S-EPMC7457460 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Infectious and inflammatory disorders might increase the risk of developing idiopathic intracranial hypertension - a national case-control study.

Sundholm Anna A Burkill Sarah S Waldenlind Elisabet E Bahmanyar Shahram S Nilsson Remahl A Ingela M AIM

Cephalalgia : an international journal of headache 20200525 10

<h4>Objective</h4>To investigate whether conditions causing inflammatory activation are associated with increased risk of idiopathic intracranial hypertension.<h4>Methods</h4>All newly diagnosed idiopathic intracranial hypertension patients (cases) in Sweden between 2000-2016 were identified using pre-determined algorithms (n = 902) and matched with five controls from the general population and five individuals with an obesity diagnosis (n = 4510) for age, sex, region, and vital status. National ...[more]

PMID: 32447976

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Project description:ObjectiveTo characterize the phenotype, headache-related disability, medical co-morbidities, use of symptomatic headache medications, and headache response to study interventions in the Idiopathic Intracranial Hypertension Treatment Trial (IIHTT).MethodsPatients with untreated IIH and mild vision loss enrolled in the IIHTT and randomized to acetazolamide (ACZ) and weight loss or placebo (PLB) and weight loss had prospective assessment of headache disability using the Headache Impact Test-6 (HIT-6) questionnaire. Subjects with headache at the baseline visit were assigned a headache phenotype using the International Classification for Headache Disorders version 3 beta (ICHD-3b). Medication overuse was determined using the participants' reported medication use for the preceding month and ICHD-3b thresholds for diagnosing medication overuse headache. We investigated relationships between headache disability and various other clinical characteristics at baseline and at 6 months.ResultsHeadache was present in 139 (84%) of the 165 enrollees at baseline. The most common headache phenotypes were migraine (52%), tension-type headache (22%), probable migraine (16%), and probable tension-type headache (4%). Fifty-one (37%) participants overused symptomatic medications at baseline, most frequently simple analgesics. A similar amount of improvement in the adjusted mean (± standard error) HIT-6 score occurred in the ACZ (-9.56 ± 1.05) and PLB groups (-9.11 ± 1.14) at 6 months (group difference -0.45, 95% CI -3.50 to 2.60, P = .77). Headache disability did not correlate with any of the studies, variables of interest, which included: the lumbar puncture opening pressure at baseline or at 6 months, body mass index, the amount of weight lost, papilledema grade, perimetric mean deviation, or the use of hormonal contraception. Headache disability was significantly associated with patient-reported quality of life in the physical, mental, and visual domains.ConclusionsHeadache was common, of varied character, disabling, and associated with poorer quality of life in our cohort of patients with mild visual impairment. The lack of correlation between headache disability and cerebrospinal fluid (CSF) pressure at baseline and at the end of the randomized phase of the study implies that headache in IIH may be related to factors other than intracranial hypertension, and that specific headache treatment is needed in addition to therapies directed at lowering CSF pressure.

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Infectious and inflammatory disorders might increase the risk of developing idiopathic intracranial hypertension - a national case-control study.

Publications

Infectious and inflammatory disorders might increase the risk of developing idiopathic intracranial hypertension - a national case-control study.

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