Pseudotumor cerebri as a reversible side effect of all-trans retinoic acid treatment in acute promyelocytic leukaemia

Headache and bilateral papilloedema in overweight young woman may be indicative of pseudotumor cerebri syndrome (PTC). ‘Idiopathic intracranial hypertension’ (IIH) refers to the PTC, provided that there are no symptomatic causes for elevated intracranial pressure. Such causes may be tumours, meningeal infiltration and cerebral venous sinus thrombosis as well as the use of certain medications including tetracycline, growth hormone or lithium [1]. Other drugs which have been linked to PTC are vitamin A derivatives such as isotretinoin for acne treatment and all‐trans‐retinoic acid (ATRA) which is successfully administered to treat acute promyelocytic leukaemia (APL) [1, 2]. ATRA‐induced PTC has been described by oncologists in several patients with APL, predominantly children and adolescents [3, 4] as well as some adults [5]. In contrast to previous reports, in which treatment was discontinued once PTC had been diagnosed, we describe the clinical course with continuous medication using neurological and ophthalmological monitoring in a patient with APL who developed PTC during treatment with ATRA. Finally, we will discuss a pathophysiological link between vitamin A and PTC.