Abstract
Ring finger protein (RNF) 213 is known as a susceptibility gene for moyamoya disease (MMD), which is characterized
by bilateral carotid folk stenosis. Cerebral angiopathy after viral infection has
been known to present angiographical appearance resembling MMD, however its pathogenesis
and genetic background are not well known. We report a case of reversible cerebral
angiopathy after viral infection in a pediatric patient with genetic variant of RNF213 mutation. The patient had developed a severe headache after hand, foot, and mouth
disease. Magnetic resonance imaging and magnetic resonance angiography (MRA) performed
2-3 weeks after disease onset revealed bilateral carotid folk stenosis and an old
cerebral infarction in the left putamen. The patient's headache spontaneously resolved
and the follow-up MRA showed a complete spontaneous resolution of the arterial stenosis
after 9 months. We were able to determine genetic predisposition to angiopathy by
identifying the RNF213 c.14576G>A (rs112735431, p.R4859K) mutation. Based on the present case, we hypothesize
that an RNF213 variant might play an important role for the onset of postviral cerebral angiopathy.
Key Words
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Article info
Publication history
Published online: December 07, 2019
Accepted:
November 21,
2019
Received in revised form:
October 29,
2019
Received:
September 27,
2019
Footnotes
Grant Support: This research was supported by JSPS KAKENHI (Grant Number 18K08931).
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.104549
Copyright
© 2019 Elsevier Inc. All rights reserved.
