Department of Internal Medicine, Ito Hospital, Tokyo 150-8308, Japan.
Division of Diabetes, Metabolism and Endocrinology, Department of Medicine, Toho University Graduate School of Medicine, Tokyo 143-8541, Japan.
Endocr J. 2023 Feb 28;70(2):141-148. doi: 10.1507/endocrj.EJ22-0319. Epub 2022 Oct 5.
Graves' disease has been reported to affect the clinical features of moyamoya disease (MMD), an occlusion of the circle of Willis. This study aimed to clarify the characteristics of MMD in patients with Graves' disease. This was a single-center, retrospective study. The prevalence and clinical features of MMD patients among all patients with thyroid disease who visited Ito Hospital from January 2005 to December 2019 were evaluated. The relationship between MMD and hyperthyroidism was analyzed in new-onset Graves' disease patients during the same period. Of all 394,422 patients with thyroid disease, 88,180 had Graves' disease, and 40 had MMD with Graves' disease, i.e., the prevalence was 45.36 per 100,000 patients with Graves' disease (0.0454%). The median age at onset of MMD was 39 years (interquartile range, 31-54 years), with a male to female ratio of 1:12. The most common time that MMD was diagnosed was within 1 year after the onset of Graves' disease, in 9 of 40 patients (22.5%), and 19 of 40 patients (47.5%) underwent bypass surgery for MMD. In MMD with Graves' disease, headache was the most frequent symptom, and ischemic types of stroke and bilateral lesions were common. Of 23,347 patients with new-onset Graves' disease, 7 were diagnosed with MMD and the incidence of MMD was 5.94 patients per 100,000 person-years. Most patients developed MMD symptoms during hyperthyroidism. Although MMD is a rare condition, it should be noted that it can occur with Graves' disease.
格雷夫斯病已被报道会影响 Willis 环闭塞性疾病（MMD）的临床特征。本研究旨在阐明格雷夫斯病患者 MMD 的特征。这是一项单中心、回顾性研究。评估了 2005 年 1 月至 2019 年 12 月期间在 Ito 医院就诊的所有甲状腺疾病患者中 MMD 患者的患病率和临床特征。同时分析了同期新发格雷夫斯病患者中 MMD 与甲状腺功能亢进症的关系。在所有 394422 例甲状腺疾病患者中，88180 例为格雷夫斯病，40 例为合并格雷夫斯病的 MMD，即患病率为每 100000 例格雷夫斯病患者 45.36 例（0.0454%）。MMD 的发病中位年龄为 39 岁（四分位间距 31-54 岁），男女比例为 1:12。MMD 诊断时间最常见的是在格雷夫斯病发病后 1 年内，40 例患者中有 9 例（22.5%），40 例患者中有 19 例（47.5%）接受了 MMD 搭桥手术。在合并格雷夫斯病的 MMD 中，头痛是最常见的症状，缺血性脑卒中类型和双侧病变较为常见。在 23347 例新发格雷夫斯病患者中，有 7 例诊断为 MMD，MMD 的发病率为每 100000 人年 5.94 例。大多数患者在甲状腺功能亢进症期间出现 MMD 症状。虽然 MMD 较为罕见，但应注意它可能与格雷夫斯病同时发生。
