Iron Deficiency Without Anaemia in a Young Female With Idiopathic Intracranial Hypertension: A Case Report Supporting Routine Iron Studies

TL;DR

A young woman with idiopathic intracranial hypertension showed improvement after treating iron deficiency, suggesting iron studies should be part of routine care.

Contribution

This case report suggests iron deficiency without anemia may contribute to idiopathic intracranial hypertension in young women.

Findings

A 19-year-old female with idiopathic intracranial hypertension had iron deficiency without anemia.

Her symptoms improved after lumbar puncture and iron supplementation.

The case supports screening for iron deficiency in young females with IIH symptoms.

Abstract

Idiopathic intracranial hypertension (IIH) is common in young, overweight women, but less recognised factors - such as iron deficiency - may also play a role. We report the case of a 19-year-old female with polycystic ovary syndrome who presented with headaches, pulsatile tinnitus, and transient visual obscurations; examination showed grade 1 papilledema. Neuroimaging demonstrated features of raised intracranial pressure (ICP) without mass lesion or venous sinus thrombosis, and lumbar puncture confirmed an elevated opening pressure of 39 cm H₂O. Blood tests revealed iron deficiency without anaemia (ferritin 21 µg/L, transferrin saturation 15%, hemoglobin [Hb] 121 g/L). Her symptoms improved after the lumbar puncture, and she was managed with iron supplementation and lifestyle advice for weight loss, with migraine prophylaxis also considered. This report highlights iron deficiency, even without overt anaemia, as a potential modifiable factor in IIH. Screening iron studies should be considered in young females presenting with IIH symptoms.

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