Cerebral vasculopathy associated with collateralization resembling moya moya phenomenon and with anti‐Ro/SS‐A and anti–La/SS‐B antibodies

Provost, Thomas T.; Moses, Howard; Morris, Edward L.; Altman, Joanne D.; Harley, John B.; Alexander, Elaine L.; Reichlin, Morris

doi:10.1002/art.1780340816

Cited by 19 publications

(13 citation statements)

References 10 publications

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“…An abnormal white matter signal on magnetic resonance imaging (MRI) may be seen in Sjogren syndrome (16). Cerebral vasculopathy has been reported in adult patients with circulating anti‐Ro/SSA and anti‐La/SSB antibodies (17). Other autoantibodies transmitted by the placenta may be implicated.…”

Section: Discussionmentioning

confidence: 99%

Central Nervous System Involvement in Neonatal Lupus Erythematosus

Prendiville

Cabral

Poskitt

et al. 2003

Pediatric Dermatology

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Computerized tomography (CT) of the brain was performed in 10 of 11 consecutive infants with neonatal lupus erythematosus (NLE) (five boys and six girls). Ten of the 11 infants had brain neurosonography. Nine of 10 infants had abnormal CT scans. There was diffuse, markedly reduced attenuation of the cerebral white matter in four infants studied in the first week of life, and also in an infant 5 weeks of age. Patchy reduced subcortical white matter attenuation was observed in another 5-week-old infant. Basal ganglia calcifications were present in two infants at 2 months of age, one of whom also had mild ventriculomegaly. A patient with macrocephaly studied at 4 months of age had enlarged ventricles and subarachnoid spaces consistent with benign macrocephaly of infancy. Cerebral ultrasound examination was abnormal in all five infants studied in the first week of life and in one infant at 2 months of age. Findings included subependymal cysts (4), echogenic white matter (3), and echogenic lenticulostriate vessels (3). Apart from one case of macrocephaly, there was no clinical evidence of neurologic disease and the subsequent development of these infants has been normal. Subclinical central nervous system (CNS) disease in NLE is likely to be a transient phenomenon that resolves as maternal antibodies are cleared from the infant's circulation. It is important to be aware of these neuroimaging abnormalities to avoid misdiagnosis of congenital viral infection in a newborn with multisystem NLE. The potential for neurologic sequelae is uncertain.

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Section: Discussionmentioning

confidence: 99%

Central Nervous System Involvement in Neonatal Lupus Erythematosus

Prendiville

Cabral

Poskitt

et al. 2003

Pediatric Dermatology

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“…A high prevalence of anti-Ro an tibodies has also been reported in lupus patients homozy gous for C2 or C4 deficiency [126,127], Recently, Provost et al [128] have reported a patient with cerebral vasculopathy who was positive for anti-Ro and anti-La antibodies.…”

Section: Clinical Significance O F Anti-ro (Ss-a) and Anti-la (Ss-b) mentioning

confidence: 99%

Pathogenic Significance and Diagnostic Value of Lupus Autoantibodies

Tomer

Buskila

Shoenfeld

1993

Int Arch Allergy Immunol

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Systemic lupus erythematosus (SLE) is characterized by a panoply of autoantibodies (more than 50). Some of them are more prevalent (anti-ds DNA > 80%) while others are less frequently detected, but highly specific for SLE (anti-Sm, 20%). In this review we will discuss the clinical significance of anti-RNP, anti-Ro, anti-La and anti-phospholipid antibodies. We will also summarize the clinical and experimental evidence for the pathogenic role attributed to each one of these antibodies.

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“…Molecular studies indicate that smooth muscle cells may show modulation from a contractile to a synthetic phenotype (23), and expiant studies of branches of scalp arteries from patients with Moyamoya have shown altered response to serum mitogens (24,25). In clinical practice, the value of measuring sedimentation rate, pro¬ tein S and C, antithrombin III, anticardiolipin antibodies, antinuclear factor, anti-Ro/SS-A and anti-La/SS-B anti¬ bodies remains to be determined (5,26,27), and therapy with steroids, vasodilators, antibiotics and nerve block ap¬ pear to be of questionable benefit. Therefore, attention has been given to revascularization of the ischemie area of the brain (28).…”

Section: Discussionmentioning

confidence: 98%

Concurrence of Graves' Disease and Dysplastic Cerebral Blood Vessels of the Moyamoya Variety

Tendler

Shoukri²,

Malchoff³

et al. 1997

Thyroid

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We describe two Caucasian women with the concurrence of Graves' disease and the moyamoya phenomenon (radiological evidence of collateral cerebral blood vessels like "puffs of smoke" due to cerebrovascular occlusive disease). One patient presented with acute cerebrovascular ischemia due to Moyamoya disease shortly after radioactive iodine therapy for Graves' disease and the second presented with Graves' disease 10 years after being diagnosed with moyamoya dysplastic cerebral vessels. The optimal treatment of hyperthyroidism in these patients is unknown; however, careful control of the hyperthyroidism by any modality seems reasonable. Our limited experience suggests that antithyroid drugs and radioactive iodine therapy are rational options. Thyroidectomy appears to be a safe therapeutic alternative, although long-term efficacy may be difficult to assure. Both of our patients had to be treated twice for hyperthyroidism. Whether Graves' disease and Moyamoya coexist because of an aggressive autoimmune mechanism is a concept that remains to be settled.

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Cerebral vasculopathy associated with collateralization resembling moya moya phenomenon and with anti‐Ro/SS‐A and anti–La/SS‐B antibodies

Cited by 19 publications

References 10 publications

Central Nervous System Involvement in Neonatal Lupus Erythematosus

Central Nervous System Involvement in Neonatal Lupus Erythematosus

Pathogenic Significance and Diagnostic Value of Lupus Autoantibodies

Concurrence of Graves' Disease and Dysplastic Cerebral Blood Vessels of the Moyamoya Variety

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