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DOI: 10.1055/s-2008-1081458
© Georg Thieme Verlag KG Stuttgart · New York
Moyamoya Vasculopathy in a Child after Hemolytic Uremic Syndrome: A Possible Etiopathogenesis
Publication History
received 03.01.2008
accepted 10.06.2008
Publication Date:
31 July 2008 (online)

Abstract
Moyamoya disease is a cerebral vasculopathy of unknown etiology frequently seen in the Asian population. We report a case of moyamoya vasculopathy in an African-American child who had renal failure followed by cerebral ischemia. Our patient presented with hemolytic uremic syndrome (HUS) and renal failure, and later developed seizures. We believe that in this patient HUS led to the pathogenesis of moyamoya disease. We suggest that patients with HUS who develop any neurological symptoms should be investigated for moyamoya vasculopathy for early diagnosis and treatment.
Key words
hypertension - renal failure - seizures - moyamoya disease
References
- 1 Aoyagi M, Ogami K, Matsushima Y, Shikata M, Yamamoto M, Yamamoto K. Human leukocyte antigen in patients with moyamoya disease. Stroke. 1995; 26 415
- 2 Bloom B, Simes DC. An unusual case of vascular catastrophe. Crit Care Resusc. 2006; 8 341
- 3 Fukui M, Kono S, Sueishi K, Ikezaki K. Moyamoya disease. Neuropathology. 2000; 20 ((Suppl S61)) 2000
- 4 Horn P, Bueltmann E, Buch CV, Schmiedek P. Arterio-embolic ischemic stroke in children with moyamoya disease. Childs Nerv Syst. 2005; 21 104
- 5 Hoshimaru M, Takahashi JA, Kikuchi H, Nagata I, Hatanaka M. Possible roles of basic fibroblast growth factor in the pathogenesis of moyamoya disease: an immunohistochemical study. J Neurosurg. 1991; 75 267
- 6 Imaizumi T, Hayashi K, Saito K, Osawa M, Fukuyama Y. Long-term outcomes of pediatric moyamoya disease monitored to adulthood. Pediatr Neurol. 1998; 18 321
- 7 Joo SP, Kim TS, Lee JH, Lee JK, Kim JH, Kim SH. et al . Moyamoya disease associated with Behcet's disease. J Clin Neurosci. 2006; 13 364
- 8 Natori Y, Ikezaki K, Matsushima T, Fukui M. Angiographic moyamoya, its definition, classification, and therapy. Clin Neurol Neurosurg. 1997; 99 ((Suppl 2)) S168
- 9 Numaguchi Y, Gonzalez CF, Davis PC, Monajati A, Afshani E, Chang J. et al . Moyamoya disease in the United States. Clin Neurol Neurosurg. 1997; 99 ((Suppl 2)) S26
- 10 Ray PE, Liu XH. Pathogenesis of Shiga toxin-induced hemolytic uremic syndrome. Pediatr Nephrol. 2001; 16 823
- 11 So Y, Lee HY, Kim SK, Lee JS, Wang KC, Cho BK. et al . Prediction of the clinical outcome of pediatric moyamoya disease with postoperative basal/acetazolamide stress brain perfusion SPECT after revascularization surgery. Stroke. 2005; 36 1485
- 12 Tanigawara T, Yamada H, Sakai N, Andoh T, Deguchi K, Iwamura M. Studies on cytomegalovirus and Epstein-Barr virus infection in moyamoya disease. Clin Neurol Neurosurg. 1997; 99 ((Suppl 2)) S225
- 13 Taylor CM, Williams JM, Lote CJ, Howie AJ, Thewles A, Wood JA. et al . A laboratory model of toxin-induced hemolytic uremic syndrome. Kidney Int. 1999; 55 1367
- 14 Vliet JA van der, Zeilstra DJ, Roye SF Van, Merx JL, Assmann KJ. Renal artery stenosis in moyamoya syndrome. J Cardiovasc Surg (Torino). 1994; 35 441
- 15 Yamada H, Deguchi K, Tanigawara T, Takenaka K, Nishimura Y, Shinoda J. et al . The relationship between moyamoya disease and bacterial infection. Clin Neurol Neurosurg. 1997; 99 ((Suppl 2)) S221
- 16 Yoshimoto T, Houkin K, Takahashi A, Abe H. Angiogenic factors in moyamoya disease. Stroke. 1996; 27 2160
- 17 Yoshimoto T, Houkin K, Takahashi A, Abe H. Evaluation of cytokines in cerebrospinal fluid from patients with moyamoya disease. Clin Neurol Neurosurg. 1997; 99 ((Suppl 2)) S218
Correspondence
M. SinglaMD, MS
Department of Pediatrics
University of Illinois at Chicago
College of Medicine
840 S. Wood St. M/C 856
Chicago
IL 60612
USA
Phone: +1/203/508/42 29
Fax: +1/312/413/15 26
Email: msingla@uic.edu