Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 6, 2024; 12(10): 1830-1836
Published online Apr 6, 2024. doi: 10.12998/wjcc.v12.i10.1830
Moyamoya syndrome may result from psoriasis: Four case reports
Zhi-Ying Chen, Xiao-Qin Yu, Yuan-Yuan Xiang, Ling-Hua Liu, Xiao-Ping Yin
Zhi-Ying Chen, Xiao-Qin Yu, Yuan-Yuan Xiang, Xiao-Ping Yin, Department of Neurology, The Affiliated Hospital of Jiujiang University, Jiujiang 332000, Jiangxi Province, China
Ling-Hua Liu, Department of Dermatology, The Affiliated Hospital of Jiujiang University, Jiujiang 332000, Jiangxi Province, China
Co-first authors: Zhi-Ying Chen and Xiao-Qin Yu.
Author contributions: Chen ZY and Yu XQ contributed equally to this work as co-first authors; Chen ZY contributed to manuscript drafting and revision, data collection and interpretation; Yu XQ, Xiang YY and Liu LH contributed to data collection and interpretation; Yin XP contributed to study concept and design, and manuscript drafting and revision.
Supported by National Natural Science Foundation of China, No. 82260249.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare there is no conflicts of interest regarding the publication of this paper.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Ping Yin, PhD, Academic Editor, Department of Neurology, The Affiliated Hospital of Jiujiang University, Xunyang East road, Jiujiang 332000, Jiangxi Province, China. xiaopingbuxiao@126.com
Received: January 1, 2024
Peer-review started: January 1, 2024
First decision: January 21, 2024
Revised: January 28, 2024
Accepted: March 11, 2024
Article in press: March 11, 2024
Published online: April 6, 2024
Abstract
BACKGROUND

Moyamoya syndrome (MMS) is a group of diseases that involves more than one underlying disease and is accompanied by moyamoya vascular phenomena. Psoriasis is a chronic immune skin disease closely linked to high blood pressure and heart disease. However, psoriasis-related MMS has not been reported.

CASE SUMMARY

We collected data on patients with stroke due to MMS between January 2017 and December 2019 and identified four cases of psoriasis. Case histories, imaging, and hematological data were collected. The average age of the initial stroke onset was 58.25 ± 11.52 years; three cases of hemorrhagic and one case of ischemic stroke were included. The average duration from psoriasis confirmation to the initial MMS-mediated stroke onset was 17 ± 3.56 years. All MMS-related stenoses involved the bilateral cerebral arteries: Suzuki grade III in one case, grade IV in two cases, and grade V in one case. Abnormally elevated plasma interleukin-6 levels were observed in four patients. Two patients had abnormally elevated immunoglobulin E levels, and two had thrombocytosis. All four patients received medication instead of surgery. With an average follow-up time of 2 years, two causing transient ischemic attacks occurred in two patients, and no hemorrhagic events occurred.

CONCLUSION

Psoriasis may be a potential risk factor for MMS. Patients with psoriasis should be screened for MMS when they present with neurological symptoms.

Keywords: Moyamoya syndrome, Psoriasis, Stroke, Interleukin-6, Immune, Hypertension, Case report

Core Tip: As we all known that moyamoya syndrome (MMS) is a special subtype of intracranial arterial disease. Herein, we analyzed the clinical characteristics and prognosis of MMS-related ischemic and hemorrhagic stroke in patients with psoriasis retrospectively, and also, analyzed the probable mechanisms of psoriasis-related MMS, so as to make a reference for diagnosis and early etiology treatment. Finally we suspect that psoriasis may be a potential risk factor of MMS formation. Whereby, we considered that MMS should be screened in patients with psoriasis when they presented neurological symptoms.