Thyroid Autoantibodies and the Clinical Presentation of Moyamoya Disease: A Prospective Study

Lanterna, Luigi Andrea; Galliani, Silvia; Zangari, Rosalia; Conti, Luciano; Brembilla, Carlo; Gritti, Paolo; Colleoni, Maria Luisa; Bernucci, Claudio

doi:10.1016/j.jstrokecerebrovasdis.2017.11.037

Cited by 9 publications

(9 citation statements)

References 23 publications

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“…Thyroid disease was detected in 23.8% of this German population, but the specific type of thyroid disease was not specified ( 2 ). In a 2018 study of 37 Italian Caucasian patients, an association was found between the presence of autoantibodies to thyroid antigens and a more aggressive presentation of MMS ( 4 ). However, this study only focused on TgAb and TPOAb, with no information about TRAb, and none of the patients included had hyperthyroidism at the time of diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Association of Graves’ disease and Moyamoya syndrome in a Caucasian woman from Western Europe: vascular effects of anti-TSH receptor antibodies?

Pierman,

Vandermeeren,

Jonas

et al. 2024

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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Summary Moyamoya syndrome (MMS) refers to a rare cerebrovascular disorder characterized by progressive stenosis of the intracranial internal carotid arteries and their proximal branches, leading to an increased risk of stroke. While prevalent in Asia, this condition is considerably less common in Western countries, including Europe. The association between MMS and Graves’ disease (GD) has been well documented, primarily in Asian and American populations, notably Latin Americans. In this report, we report the first case of GD with MMS in a Caucasian woman from Western Europe. The precise mechanisms underpinning the correlation between these two conditions remain poorly elucidated but are hypothesized to involve hemodynamic alterations, the toxic effects of anti-thyroid-stimulating hormone receptor antibodies, or a shared genetic predisposition. Our clinical case underscores the significance of thyroid disease screening in suspected MMS cases, as the management of thyroid dysfunction may suffice to improve neurological symptoms. Learning points The association between Graves’ disease (GD) and Moyamoya syndrome (MMS) can manifest in a Caucasian European patient. Screening for thyroid disease is essential when MMS is suspected, as treating GD might effectively alleviate neurological symptoms. The mechanisms linking GD and MMS remain incompletely understood but may involve hemodynamic shifts, the toxic effect of anti-TSH receptor antibodies, or shared genetic factors.

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Section: Discussionmentioning

confidence: 99%

Association of Graves’ disease and Moyamoya syndrome in a Caucasian woman from Western Europe: vascular effects of anti-TSH receptor antibodies?

Pierman,

Vandermeeren,

Jonas

et al. 2024

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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“…A large cohort study of moyamoya disease also showed that autoimmune disease and infection may be potential environmental triggers ( 13 , 14 ). In conclusion, increasing molecular and clinical evidence revealed that immune-inflammation-related responses may be an essential triggering factor of moyamoya disease, just below the genetic factor ( 15 – 18 ).…”

Section: Introductionmentioning

confidence: 90%

“…An upregulated expression of various inflammatory factors, such as monocyte chemoattractant protein-1, interleukin-1β, and stromal cell-derived factor-1α, was found in the plasma of patients with moyamoya disease (10)(11)(12). A large cohort study of moyamoya disease also showed that autoimmune disease and infection may be potential environmental triggers (13,14). In conclusion, increasing molecular and clinical evidence revealed that immune-inflammation-related responses may be an essential triggering factor of moyamoya disease, just below the genetic factor (15-18).…”

Section: Introductionmentioning

confidence: 92%

Clinical value of the systemic immune-inflammation index in moyamoya disease

Liu

Jin

et al. 2023

Front. Neurol.

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BackgroundMoyamoya disease (MMD) is a rare cerebrovascular disorder with unknown etiology. The underlying pathophysiological mechanism of moyamoya disease remains to be elucidated, but recent studies have increasingly highlighted that abnormal immune response may be a potential trigger for MMD. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) are inflammatory markers that can reflect the immune-inflammation state of the disease.ObjectiveThe purpose of this study was to investigate SII, NLR, and PLR in patients with moyamoya disease.MethodsA total of 154 patients with moyamoya disease (MMD group) and 321 age- and sex-matched healthy subjects (control group) were included in this retrospective case–control study. Complete blood count parameters were assayed to calculate the SII, NLR, and PLR values.ResultsThe SII, NLR, and PLR values in the moyamoya disease group were significantly higher than those in the control group [754 ± 499 vs. 411 ± 205 (P < 0.001), 2.83 ± 1.98 vs. 1.81 ± 0.72 (P < 0.001), and 152 ± 64 vs. 120 ± 42 (P < 0.001), respectively]. The SII in the medium-moyamoya vessels of moyamoya disease was higher than that in the high-moyamoya vessels and low-moyamoya vessels (P = 0.005). Using the receiver operating characteristic (ROC) curve analysis to predict MMD, the highest area under the curve (AUC) was determined for SII (0.76 for SII, 0.69 for NLR, and 0.66 for PLR).ConclusionBased on the results of this study, patients with moyamoya disease admitted for inpatient care due to acute or chronic stroke have significantly higher SII, NLR, and PLR when compared to blood samples drawn from completely healthy controls in a non-emergent outpatient setting. While the findings may suggest that inflammation plays a role in moyamoya disease, further studies are warranted to corroborate such an association. In the middle stage of moyamoya disease, there may be a more intense imbalance of immune inflammation. Further studies are needed to determine whether the SII index contributes to the diagnosis or serves as a potential marker of an inflammatory response in patients with moyamoya disease.

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“…Currently, multiple studies have shown that thyroid autoantibodies may be important triggers for stroke and other cerebrovascular accidents in patients with MMD. After analyzing the prognosis and progression of 37 patients with MMD, Luigi found that the clinical manifestations of MMD patients may be significantly influenced by the concentration of thyroid autoantibodies in the serum, and when the concentration of thyroid autoantibodies in the serum increases, the risk of cerebrovascular accidents in patients also increases ( 29 ). At the same time, the study found that the concentration of thyroid autoimmune antibodies in patients with MMD was significantly higher than that in the normal population.…”

Section: Autoimmune Antibodymentioning

confidence: 99%

Research progress on moyamoya disease combined with thyroid diseases

Zhang,

Liu,

Tan

et al. 2023

Front. Endocrinol.

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Moyamoya disease (MMD), also known as abnormal cerebral vascular network disease, is characterized by progressive occlusion or stenosis of the internal carotid and cerebral arteries, as well as the formation of an abnormal cerebral vascular network. It can occur anywhere in the world but is most common in China, Japan, and the Republic of Korea. In recent years, there have been increasing reports on the coexistence of thyroid diseases and MMD, but the mechanism of their coexistence is still unclear. For this article, we used keywords such as “moyamoya disease”, “thyroid”, “Grave disease”, “thyrotoxicosis”, and “thyroid autoimmune antibodies” to search for 52 articles that met the requirements in medical databases such as PubMed and Web of Science. This article also reviews the research on the role of thyroid hormone, the mechanism of immune antibodies, the possible correlation between thyroid diseases and MMD disease genes, and the treatment methods, and discusses the possible relationship between MMD and thyroid diseases to provide a reference for the pathogenesis and treatment of MMD with thyroid diseases.

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Thyroid Autoantibodies and the Clinical Presentation of Moyamoya Disease: A Prospective Study

Cited by 9 publications

References 23 publications

Association of Graves’ disease and Moyamoya syndrome in a Caucasian woman from Western Europe: vascular effects of anti-TSH receptor antibodies?

Association of Graves’ disease and Moyamoya syndrome in a Caucasian woman from Western Europe: vascular effects of anti-TSH receptor antibodies?

Clinical value of the systemic immune-inflammation index in moyamoya disease

Research progress on moyamoya disease combined with thyroid diseases

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