Pediatric IIH: Age, Gender, and Anthropometric Features
Ophthalmology, November 2016
In a retrospective international study, Sheldon et al. examined anthropometric and maturational characteristics at diagnosis in children with idiopathic intracranial hypertension (IIH). The researchers defined 3 subgroups of IIH patients based on measures of body mass index (BMI), height and weight Z-scores, and sexual maturation.
IIH cases among pediatric patients aged 2 to 18 years were identified retrospectively based on diagnostic code, pediatric neuro-ophthalmologist databases, or both; of these, 233 cases were confirmed according to updated diagnostic criteria (2013).
The researchers found that boys (n = 72) had a moderate association between age and BMI Z-scores (Pearson’s correlation coefficient [PCC], 0.50; p < .001). Among girls (n = 161), a weak association was noted (PCC, 0.34; p < .001). The age threshold at which the average patient was more likely to be overweight at diagnosis was 6.7 years in girls and 8.7 years in boys, while the age threshold for obesity at diagnosis was 12.5 years in girls and 12.4 years in boys. Compared with age- and gender-matched reference values, early adolescent patients were taller for age (girls, p = .002; boys, p = .02). Data on pubertal status were available for 57 of the patients (25%). Prepubertal participants (n = 12) had lower average BMI Z-scores (0.95 ± 1.98) compared with pubertal participants (n = 45; 1.92 ± 0.60). However, this result did not reach statistical significance.
The researchers noted that through the use of updated criteria and pediatric-specific assessments, their study identified 3 subgroups of pediatric IIH: a young group that is not overweight, an early adolescent group that is either overweight or obese, and a late adolescent group that is mostly obese. Their data also suggest that the early adolescent group with IIH may be taller than age- and gender-matched reference values. They concluded that understanding these features may help to illuminate the complex pathogenesis of pediatric IIH.
The original article can be found here.