Disk edema subsequent to renal transplanation

A 12-year-old child was discovered (following successful renal transplantation) to have asymptomatic bilateral disk edema with preservation of optic nerve function. He had been maintained on cyclosporine, imuran and prednisone. Evaluation revealed normal intracranial imaging and normal CSF though under elevated intracranial pressure. The contributing possibilities to this papilledema are considered, and include a secondary pseudotumor cerebri syndrome of childhood and toxic effects of cyclosporine. The indications for treatment for pseudotumor cerebri are discussed, and clinicians are reminded to separate what we think about a case from how we behave in taking care of the patient.