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

Author:

Sundholm Anna1,Burkill Sarah23,Waldenlind Elisabet1,Bahmanyar Shahram4,Nilsson Remahl A Ingela M1

Affiliation:

1. Department of Clinical Neuroscience, Karolinska Institutet and Department of Neurology, Karolinska University Hospital, Sweden

2. Centre for Pharmacoepidemiology, Department of Medicine, Karolinska Institutet, Solna, Sweden

3. Saw Swee Hock School of Public Health, National University of Singapore, Singapore

4. Centre for Pharmacoepidemiology, Department of Medicine, Solna, Karolinska Institutet and Centre for Psychiatry Research, Karolinska Institutet, Sweden

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.

Funder

Karolinska University Hospital Department of Neurology

Swedish Headache Society

Stiftelsen Tornspiran

Publisher

SAGE Publications

Subject

Neurology (clinical),General Medicine

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