Moyamoya Syndrome may Result from Psoriasis

Abstract Objective: To analyze the relationship between psoriasis and Moyamoya syndrome, to explore the potential mechanism.Methods: A case series retrospective study analyzed 4 patients confirmed as Moyamoya syndrome by imaging in our hospital from 2017 through 2019; all of them had long-term of psoriasis prior to the Moyamoya syndrome -related stroke onset. The age of psoriasis occurrence and duration, the time and type of Moyamoya syndrome -related stroke onset, blood tests, imaging features, treatment and clinical outcomes were analyzed.Result: The average duration from psoriasis confirmation till the first-time of Moyamoya syndrome -mediated stroke onset was 17 ± 3.56 years. The average age of the initial stroke onset was 58.25 ± 11.52 years, included 3 cases of hemorrhagic and 1case of ischemic strokes. All the Moyamoya syndrome -related stenosis involved bilateral cerebral arteries, Suzuki grade III for 1 case, grade IV for 2 cases, and grade V for 1 case. Abnormal elevated plasma IL-6 were seen in 4 cases. 2 cases had abnormal elevated immunoglobulin E, and 2 cases had thrombocytosis. All the 4 cases underwent medication (antiplatelet agents and psoriasis control agents) instead of surgery. With an average follow-up time of 19 ± 12.35 months, 3 times of transient ischemic attack occurred in 3 patients, respectively and no hemorrhagic event occurred.Conclusion: Psoriasis may be a potential risk factor of Moyamoya syndrome formation. Moyamoya syndrome should be screened when the psoriasis patients presented with neurological symptoms.