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- Krishna Upadhya, MD, MPH*
- Peter Rowe, MD†
- *Fellow in Adolescent Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Md.
- †Professor of Pediatrics, Division of General Pediatrics & Adolescent Medicine, Johns Hopkins School of Medicine, Baltimore, Md.
Author Disclosure
Drs Upadhya and Rowe have disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.
Case Study
A 16-year-old obese girl presents to your office for evaluation of headaches. On physical examination, you document a body mass index (BMI) of 40 kg/m2 and optic disk swelling. After negative results on head imaging, the patient undergoes a lumbar puncture that shows elevated opening pressure of 30 cm H2O. You diagnose idiopathic intracranial hypertension (IIH). You know that the patient's weight is likely to be a major factor in this illness, but you have been working with her over several years to lose weight without success. To obtain the most up-to-date information on the link between IIH and weight gain, you conduct a literature search. You find a recent article that posed the question: How do BMI and rate of weight gain affect the risk for IIH? (1) This case-control study demonstrated that higher BMI is associated with greater risk for IIH. The authors also found that a 5% to 15% weight gain over 1 year is associated with increased risk for IIH among both obese and nonobese patients. You wonder if you can use this information to help motivate your patient to lose weight.
Introduction
Case-control studies start with a disease and compare affected patients (cases) and unaffected individuals (controls) to evaluate potential risk factors. Like cohort studies, case-control studies are observational, meaning …
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