title: Moya moya syndrome in a child with pyruvate kinase deficiency and combined prothrombotic factors.
abstract: A 13-year-old Greek girl with pyruvate kinase deficiency and moya moya angiographic pattern is reported. She also had raised serum lipoprotein (a) concentration and was homozygous for the C677T mutation of the methylenetetrahydrofolate reductase gene. She presented with neonatal onset of anemia, hemolytic and aplastic crises, especially during infections, stroke, and also progressive motor and mental deterioration. A digital cranial angiography at 13 years revealed the typical angiographic findings of moya moya angiopathy. This is likely the first patient with pyruvate kinase deficiency and moya moya syndrome and also the combination of elevated serum lipoprotein (a) concentration and the C677T mutation of the methylenetetrahydrofolate reductase gene to be reported. In patients with pyruvate kinase deficiency and moya moya syndrome, a search for raised serum lipoprotein (a) concentrations and the C677T mutation of the methylenetetrahydrofolate reductase gene should be considered.
authors.affiliation: Second Department of Pediatrics, University of Athens, P & A Kyriakou Children's Hospital, Athens, Greece.
authors.forename: Angeliki
authors.initials: A
authors.lastname: Skardoutsou
authors.forename: Konstantinos A
authors.initials: KA
authors.lastname: Voudris
authors.forename: Sotiria
authors.initials: S
authors.lastname: Mastroyianni
authors.forename: Eleni
authors.initials: E
authors.lastname: Vagiakou
authors.forename: George
authors.initials: G
authors.lastname: Magoufis
authors.forename: Peter
authors.initials: P
authors.lastname: Koukoutsakis
mesh_terms: D000293:Adolescent; D002533:Cerebral Angiography / Q000379:methods; D005260:Female; D006801:Humans; D008074:Lipoproteins / Q000097:blood; D008279:Magnetic Resonance Imaging / Q000379:methods; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000235:genetics*; D009072:Moyamoya Disease / Q000201:enzymology* / Q000209:etiology* / Q000235:genetics / Q000473:pathology; D009154:Mutation; D011770:Pyruvate Kinase / Q000172:deficiency*
chemical_list: D008074:Lipoproteins; D042965:Methylenetetrahydrofolate Reductase (NADPH2); D011770:Pyruvate Kinase