title: Systemic connective tissue features in women with fibromuscular dysplasia.
abstract: Fibromuscular dysplasia (FMD) is a non-atherosclerotic disease associated with hypertension, headache, dissection, stroke, and aneurysm. The etiology is unknown but hypothesized to involve genetic and environmental components. Previous studies suggest a possible overlap of FMD with other connective tissue diseases that present with dissections and aneurysms. The aim of this study was to investigate the prevalence of connective tissue physical features in FMD. A total of 142 FMD patients were consecutively enrolled at a single referral center (97.9% female, 92.1% of whom had multifocal FMD). Data are reported for 139 female patients. Moderately severe myopia (29.1%), high palate (33.1%), dental crowding (29.7%), and early-onset arthritis (15.6%) were prevalent features. Classic connective features such as hypertelorism, cleft palate, and hypermobility were uncommon. The frequency of systemic connective tissue features was compared between FMD patients with a high vascular risk profile (having had ⩾1 dissection and/or ⩾2 aneurysms) and those with a standard vascular risk profile. A history of spontaneous pneumothorax (5.9% high risk vs 0% standard risk) and atrophic scarring (17.6% high risk vs 6.8% standard risk) were significantly more prevalent in the high risk group, p<0.05. High palate was observed in 43.1% of the high risk group versus 27.3% in the standard risk group, p=0.055. In conclusion, in a cohort of women with FMD, there was a prevalence of moderately severe myopia, high palate, dental crowding, and early-onset osteoarthritis. However, a characteristic phenotype was not discovered. Several connective tissue features such as high palate and pneumothorax were more prominent among FMD patients with a high vascular risk profile.
authors.affiliation: Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: O'Connor
authors.affiliation: Cleveland Clinic Department of Cardiovascular Medicine, Cleveland, OH, USA.
authors.forename: Esther Sh
authors.initials: ESh
authors.lastname: Kim
authors.affiliation: Cleveland Clinic Department of Cardiovascular Medicine, Cleveland, OH, USA.
authors.forename: Ellen
authors.initials: E
authors.lastname: Brinza
authors.affiliation: Cleveland Clinic Genomic Medicine Institute, Cleveland, OH, USA.
authors.forename: Rocio
authors.initials: R
authors.lastname: Moran
authors.affiliation: Cleveland Clinic Department of Cardiovascular Medicine, Cleveland, OH, USA.
authors.forename: Natalia
authors.initials: N
authors.lastname: Fendrikova-Mahlay
authors.affiliation: Cleveland Clinic Department of C5 Research, Cleveland, OH, USA.
authors.forename: Kathy
authors.initials: K
authors.lastname: Wolski
authors.affiliation: Cleveland Clinic Department of Cardiovascular Medicine, Cleveland, OH, USA gornikh@ccf.org.
authors.forename: Heather L
authors.initials: HL
authors.lastname: Gornik
mesh_terms: D003238:Connective Tissue / Q000378:metabolism / Q000473:pathology*; D003240:Connective Tissue Diseases / Q000150:complications / Q000453:epidemiology* / Q000235:genetics; D005260:Female; D005352:Fibromuscular Dysplasia / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D015995:Prevalence; D012306:Risk; D012737:Sex Factors
keywords: FMD; epidemiology; female; fibromuscular dysplasia; genetics