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Noorbhai IZ, Fraser JF, Lee JD. Abstract TP136: A Retrospective Study of Moyamoya in a Unique, Primarily Caucasian Southern US Population. Stroke 2020. [DOI: 10.1161/str.51.suppl_1.tp136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Moyamoya (MM) is an uncommon cerebrovascular disease characterized by bilateral, progressive stenosis and occlusion at the terminal portion of the internal carotid arteries around the circle of Willis. MM has a higher prevalence in East Asian population; however, an increasing number of cases of MM are being reported in the US and may reflect a different entity often termed moyamoya syndrome (MMS). A study from 2005 to 2008, reported a 4-fold increase in the prevalence of MM in the US. In this study, we sought to describe the clinical features of patients diagnosed with MMS in a unique, primarily Caucasian Southern US population.
Materials and Methods:
We performed a retrospective chart review of patients evaluated at our institution from August 2012 to December 2018. Data collected included age, sex, ethnicity, comorbid medical conditions, and laboratory values.
Results:
Seventy-seven patients with MM were included (52 female and 25 male), average age at time of diagnosis was 42 for females and 48 for males. 81% were Caucasian while 17% were African American, and 3% were Asian. Hypertension was the most common comorbidity affecting these individuals (60%), with hyperlipidemia being the second most common (36%). Autoimmune disorders affected about 22% of this population. The average BMI of females and males was 35 and 29, respectively. Lipid analysis showed similarity in profiles between males and females, and no significant trends were appreciated respective to BMI and age. Interestingly, 85% of individuals had an elevation of sedimentation rate (ESR), Factor VIII, or C - reactive protein (CRP) at the time of diagnosis.
Conclusions:
Women are affected in a 2:1 ratio as compared to men; which is a consistent trend reported in other studies. Hypertension remains the most common comorbidity affecting these individuals. Though the etiology of MMS remains unclear, various autoimmune disorders have been reported in small case series. While ESR, factor VIII activity, and CRP are non-specific markers of inflammation, the high prevalence of these markers in this population further support an autoimmune or immunological component in MM. Additional prospective studies are needed to further elucidate this relationship.
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