Association of moyamoya disease with thyroid autoantibodies and thyroid function: a case−control study and meta‐analysis

Lei, Chunyan; Wu, Bin; Ma, Zongqing; Zhang, S.; Liu, M.

doi:10.1111/ene.12425

Cited by 24 publications

(23 citation statements)

References 14 publications

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“…A recent study of patients with MMD reported a high incidence of elevated thyroid function and thyroid autoantibody levels. 2) 13) Thyrotoxicosis may be the trigger of the vascular attack in MMD patients that results in the increase in sympathetic nervous system sensitivity. 9) Choi et al have reported about coronary vasospasms with thyrotoxicosis in 6,923 subjects; they showed that the hyperthyroid state enhances the sensitivity of the vascular contractile responses to either norepinephrine (NE) or 5-hydroxytryptamine (5-HT).…”

Section: Discussionmentioning

confidence: 99%

Severe Cerebral Vasospasm in Patients with Hyperthyroidism

Yoon

et al. 2016

J Cerebrovasc Endovasc Neurosurg

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Cerebral vasospasm associated with hyperthyroidism has not been reported to cause cerebral infarction. The case reported here is therefore the first of cerebral infarction co-existing with severe vasospasm and hyperthyroidism. A 30-year-old woman was transferred to our hospital in a stuporous state with right hemiparesis. At first, she complained of headache and dizziness. However, she had no neurological deficits or radiological abnormalities. She was diagnosed with hyperthyroidism 2 months ago, but she had discontinued the antithyroid medication herself three days ago. Magnetic resonance imaging and angiography showed cerebral infarction with severe vasospasm. Thus, chemical angioplasty using verapamil was performed two times, and antithyroid medication was administered. Follow-up angiography performed at 6 weeks demonstrated complete recovery of the vasospasm. At the 2-year clinical follow-up, she was alert with mild weakness and cortical blindness. Hyperthyroidism may influence cerebral vascular hemodynamics. Therefore, a sudden increase in the thyroid hormone levels in the clinical setting should be avoided to prevent cerebrovascular accidents. When neurological deterioration is noticed without primary cerebral parenchyma lesions, evaluation of thyroid function may be required before the symptoms occur.

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Section: Discussionmentioning

confidence: 99%

Severe Cerebral Vasospasm in Patients with Hyperthyroidism

Yoon

et al. 2016

J Cerebrovasc Endovasc Neurosurg

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“…The association of GD and intracranial occlusive arteriopathy, complicated with ischemic strokes, is increasingly being reported in the scientific literature. [5][6][7] The pathogenesis has not been elucidated yet, but the association does not seem to be coincidental. The genetic association in GD is more well established than the genetic association in Moyamoya disease;…”

Section: Discussionmentioning

confidence: 99%

Familial Presentation of Intracranial Occlusive Arteriopathy and Ischemic Stroke in Patients with Graves’ Hyperthyroidism

Khandelwal¹,

Shah²,

Prakash³

et al. 2015

US Endocrinology

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Background:The comorbidity of intracranial occlusive arteriopathy and Graves’ disease (GD) is increasingly being reported.Methods:We describe two patients (mother and daughter) with GD, intracranial occlusive arteriopathy, and ischemic strokes.Results:Both patients were thyrotoxic at the time of the ischemic event, and the intracranial arterial stenosis was progressive while in thyrotoxic state. In one of the cases, there was no further progression of the disease after 1 year of follow up, once hyperthyroidism was well controlled.Conclusion:To the best of our knowledge, this is the first report of familial presentation of moyamoya-like vasculopathy in patients with GD in Latin population.

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“…Li et al 3) also demonstrated higher level of thyroid autoantibodies and thyroid function in pediatric MMD. A recent meta-analysis 8) showed that elevated thyroid autoantibodies (OR: 8.77; P < 0.001) and thyroid function (OR: 9.74; P = 0.003) were significantly associated with MMD development after reviewing two adults and one pediatric MMD studies. 7 – 9) Nevertheless, heterogeneity among studies such as patients’ age and inclusion criteria could be concerns to the interpretation.…”

Section: Introductionmentioning

confidence: 99%

Association of Hyperthyroidism and Thyroid Autoantibodies with Moyamoya Disease and Its Stroke Event: A Population-based Case-control Study and Meta-analysis

Ahn

Jeon

Kim

et al. 2018

Neurol. Med. Chir.(Tokyo)

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The aim of this study was to investigate the specific thyroid condition and thyroid autoantibodies in adult moyamoya disease (MMD) according to clinical presentation (ischemia vs. hemorrhage stroke). In addition, a meta-analysis was performed to reveal the association between adult MMD and elevated thyroid function, or autoantibodies. Prospectively collected data on 169 consecutive patients with MMD at a single institution were analyzed. Community-based controls matched for age and sex were selected for comparison. Penalized multinomial logistic regression analysis was used for factors affecting stroke. For meta-analysis, heterogeneity was evaluated by using the I2 test. If I2 < 50%, a fixed effect model was used. Fifty-four cases (32.0%) presented with ischemic stroke and 37 cases (21.9%) with hemorrhage stroke. Hyperthyroidism had a marginally increased risk of MMD with ischemic stroke with reference value of MMD without stroke [odds ratio (OR), 2.53; P = 0.055]. Anti-thyroperoxidase antibody (TPOAb) increased the risk of MMD presenting with ischemic stroke significantly (OR, 2.99; P = 0.020). A meta-analysis revealed that adult MMD was significantly associated with elevated autoantibodies (OR, 7.663; P = 0.002) and hyperthyroidism (OR, 10.936; P < 0.001). Elevated TPOAb and hyperthyroidism may play important roles in adult MMD with ischemic stroke. Studies focusing on targeted hyperthyroidism and thyroid autoantibodies are necessary in treating adult MMD patients in the future.

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Association of moyamoya disease with thyroid autoantibodies and thyroid function: a case−control study and meta‐analysis

Abstract: Evidence strongly suggests that elevated thyroid autoantibodies and elevated thyroid function are independently associated with MMD. These clinical variables may require regular monitoring in patients with MMD.

Cited by 24 publications

References 14 publications

Severe Cerebral Vasospasm in Patients with Hyperthyroidism

Severe Cerebral Vasospasm in Patients with Hyperthyroidism

Familial Presentation of Intracranial Occlusive Arteriopathy and Ischemic Stroke in Patients with Graves’ Hyperthyroidism

Association of Hyperthyroidism and Thyroid Autoantibodies with Moyamoya Disease and Its Stroke Event: A Population-based Case-control Study and Meta-analysis

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