Benign intracranial hypertension associated with budesonide treatment in children with Crohn's disease

Oral budesonide in adult studies is a potent corticosteroid with decreased systemic bioavailability and an improved adverse effect profile in comparis on with prednisone. It has recently been introduced for the treatment of in flammatory bowel disease in Europe, Canada, and Israel. Benign intracranial hypertension has rarely been associated with corticosteroid therapy but ha s not been reported in association with budesonide therapy. Three adolescen ts with Cretin's disease and poor nutritional status developed benign intra cranial hypertension while receiving oral budesonide. All three patients ha d previously received multiple courses of prednisone during the course of t heir disease, without developing intracranial hypertension. Benign intracra nial hypertension resolved after medication withdrawal and did not recur wi th subsequent use of prednisone. Evaluation for benign intracranial hyperte nsion should be considered in patients with inflammatory bowel disease who develop headache while receiving oral budesonide. Thus side effect may be a ssociated with poor nutritional status.