title: Caucasian familial moyamoya syndrome with rare multisystemic malformations.
abstract: Moyamoya disease is an idiopathic progressive steno-occlusive disorder of the intracranial arteries located at the base of the brain. It is associated with the development of compensatory extensive network of fine collaterals. Moyamoya disease is considered syndromic when certain genetic or acquired disorders such as polycystic kidney disease, neurofibromatosis, or meningitis are also present. Although the genetic contribution in moyamoya is indisputable, its cause and pathogenesis remain under discussion. Herein, we report a rare occurrence of moyamoya syndrome in two European Caucasian siblings in association with unusual multisystemic malformations (polycystic kidney disease in one, and intestinal duplication cyst in the other). The karyotype was normal. No mutation in the RFN213 gene was found, and none of the HLA types linked to moyamoya disease or described in similar familial cases were identified. By describing these multisystemic associations, polycystic kidney disease for the second time, and intestinal malformation for the first time in the literature, our report expands the phenotypic variability of moyamoya syndrome. The coexistence of disparate malformations among close relatives suggests an underlying common genetic background predisposing to structural or physiological abnormalities in different tissues and organs.
authors: Neurology Department, Faro Hospital EPE, Faro, Portugal. nzwalo@gmail.com
authors: Hipólito
authors: H
authors: Nzwalo
authors: Vera
authors: V
authors: Santos
authors: Cátia
authors: C
authors: Gradil
authors: José Pedro
authors: JP
authors: Vieira
authors: Carla
authors: C
authors: Mendonça
mesh_terms: D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology; D002533:Cerebral Angiography; D002648:Child; D005260:Female; D006801:Humans; D009072:Moyamoya Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000235:genetics / Q000473:pathology; D035781:Siblings