Thursday, 24 May 2012
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55 WM With Fibrillary GN Confirmed by Biopsy 2008, CKD with Serum Creatinine 3.4, eGFR 18 ml/min, Nephrotic Syndrome 5-8 gm/d of Proteinuria, controlled HTN. Had a sudden decrease in visual acuity : Ophthalmology eval showed Bilateral Severe Papilledema, MRI Brain w/o contrast is Normal I got called about him, I told the Eye Dr I don't recall any correlation between CKD/ESRD and Papilledma except for Malignant HTN, Unless there is sinus thrombosis (from Massive Proteinuria, and coagulopathy) but he should have pain and hemorrhages on fundoscopy. Any Thoughts? What is next Step?  
Hello,

This sounds like idiopathic intracranial hypertension (IIH). There is an association between nephrotic syndrome and IIH (please see second reference below). I suppose venous thrombosis should be excluded before calling this idiopathic.

Jordan
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