Leila Poorsaadat, Baharak Tasorian, Mohammad Sadegh Fakhari, Reza Mohammadi
Idiopathic intracranial hypertension (IIH) is a rare but significant complication in patients with systemic lupus erythematosus (SLE). Its diagnosis and management can be challenging, particularly in cases of recurrence. We report the case of a 26-year-old Persian female with a history of SLE and hypertension who presented with persistent headaches and bilateral papilledema. Diagnostic workup, including lumbar puncture, revealed elevated cerebrospinal fluid (CSF) pressure consistent with IIH, without evidence of infection or other secondary causes. Initial treatment with acetazolamide led to symptom resolution and normalization of CSF pressure. However, following the discontinuation of acetazolamide after a year of symptom-free follow-up, she experienced a recurrence of IIH. High-dose acetazolamide was readministered, resulting in remission. The patient was managed with continued follow-up and a multidisciplinary approach, including adjustments to her SLE and hypertension treatments. This case underscores the importance of long-term monitoring in patients with SLE who develop IIH. It highlights the potential for IIH recurrence after treatment withdrawal, emphasizing the need for individualized management strategies and a multidisciplinary approach to ensure optimal outcomes.