Medical Dialogues
  • Dermatology
Login Register
This site is intended for healthcare professionals only
Login Register
  • MD Brand Connect
  • Vaccine Hub
  • MDTV
    • Breaking News
    • Medical News Today
    • Health News Today
    • Latest
    • Journal Club
    • Medico Legal Update
    • Latest Webinars
    • MD Shorts
    • Health Dialogues
  • Fact Check
  • Health Dialogues
Medical Dialogues
  • Medical News & Guidelines
      • Anesthesiology
      • Cardiology and CTVS
      • Critical Care
      • Dentistry
      • Dermatology
      • Diabetes and Endocrinology
      • ENT
      • Gastroenterology
      • Medicine
      • Nephrology
      • Neurology
      • Obstretics-Gynaecology
      • Oncology
      • Ophthalmology
      • Orthopaedics
      • Pediatrics-Neonatology
      • Psychiatry
      • Pulmonology
      • Radiology
      • Surgery
      • Urology
      • Laboratory Medicine
      • Diet
      • Nursing
      • Paramedical
      • Physiotherapy
  • Health news
      • Doctor News
      • Government Policies
      • Hospital & Diagnostics
      • International Health News
      • Medical Organization News
      • Medico Legal News
      • NBE News
      • NMC News
  • Fact Check
      • Bone Health Fact Check
      • Brain Health Fact Check
      • Cancer Related Fact Check
      • Child Care Fact Check
      • Dental and oral health fact check
      • Diabetes and metabolic health fact check
      • Diet and Nutrition Fact Check
      • Eye and ENT Care Fact Check
      • Fitness fact check
      • Gut health fact check
      • Heart health fact check
      • Kidney health fact check
      • Medical education fact check
      • Men's health fact check
      • Respiratory fact check
      • Skin and hair care fact check
      • Vaccine and Immunization fact check
      • Women's health fact check
  • AYUSH
    • Ayurveda
    • Homeopathy
    • Siddha
    • Unani
    • Yoga
  • State News
      • Andaman and Nicobar Islands
      • Andhra Pradesh
      • Arunachal Pradesh
      • Assam
      • Bihar
      • Chandigarh
      • Chattisgarh
      • Dadra and Nagar Haveli
      • Daman and Diu
      • Delhi
      • Goa
      • Gujarat
      • Haryana
      • Himachal Pradesh
      • Jammu & Kashmir
      • Jharkhand
      • Karnataka
      • Kerala
      • Ladakh
      • Lakshadweep
      • Madhya Pradesh
      • Maharashtra
      • Manipur
      • Meghalaya
      • Mizoram
      • Nagaland
      • Odisha
      • Puducherry
      • Punjab
      • Rajasthan
      • Sikkim
      • Tamil Nadu
      • Telangana
      • Tripura
      • Uttar Pradesh
      • Uttrakhand
      • West Bengal
  • Medical Education
      • Ayush Education News
      • Dentistry Education News
      • Medical Admission News
      • Medical Colleges News
      • Medical Courses News
      • Medical Universities News
      • Nursing education News
      • Paramedical Education News
      • Study Abroad
  • Industry
      • Health Investment News
      • Health Startup News
      • Medical Devices News
      • Pharma News
      • Pharmacy Education News
      • Industry Perspective
  • MDTV
      • Health Dialogues MDTV
      • Health News today MDTV
      • Latest Videos MDTV
      • Latest Webinars MDTV
      • MD shorts MDTV
      • Medical News Today MDTV
      • Medico Legal Update MDTV
      • Top Videos MDTV
      • Health Perspectives MDTV
      • Journal Club MDTV
      • Medical Dialogues Show
This site is intended for healthcare professionals only
LoginRegister
Medical Dialogues
LoginRegister
  • Home
  • Medical news & Guidelines
    • Anesthesiology
    • Cardiology and CTVS
    • Critical Care
    • Dentistry
    • Dermatology
    • Diabetes and Endocrinology
    • ENT
    • Gastroenterology
    • Medicine
    • Nephrology
    • Neurology
    • Obstretics-Gynaecology
    • Oncology
    • Ophthalmology
    • Orthopaedics
    • Pediatrics-Neonatology
    • Psychiatry
    • Pulmonology
    • Radiology
    • Surgery
    • Urology
    • Laboratory Medicine
    • Diet
    • Nursing
    • Paramedical
    • Physiotherapy
  • Health news
    • Doctor News
    • Government Policies
    • Hospital & Diagnostics
    • International Health News
    • Medical Organization News
    • Medico Legal News
    • NBE News
    • NMC News
  • Fact Check
    • Bone Health Fact Check
    • Brain Health Fact Check
    • Cancer Related Fact Check
    • Child Care Fact Check
    • Dental and oral health fact check
    • Diabetes and metabolic health fact check
    • Diet and Nutrition Fact Check
    • Eye and ENT Care Fact Check
    • Fitness fact check
    • Gut health fact check
    • Heart health fact check
    • Kidney health fact check
    • Medical education fact check
    • Men's health fact check
    • Respiratory fact check
    • Skin and hair care fact check
    • Vaccine and Immunization fact check
    • Women's health fact check
  • AYUSH
    • Ayurveda
      • Ayurveda Giuidelines
      • Ayurveda News
    • Homeopathy
      • Homeopathy Guidelines
      • Homeopathy News
    • Siddha
      • Siddha Guidelines
      • Siddha News
    • Unani
      • Unani Guidelines
      • Unani News
    • Yoga
      • Yoga Guidelines
      • Yoga News
  • State News
    • Andaman and Nicobar Islands
    • Andhra Pradesh
    • Arunachal Pradesh
    • Assam
    • Bihar
    • Chandigarh
    • Chattisgarh
    • Dadra and Nagar Haveli
    • Daman and Diu
    • Delhi
    • Goa
    • Gujarat
    • Haryana
    • Himachal Pradesh
    • Jammu & Kashmir
    • Jharkhand
    • Karnataka
    • Kerala
    • Ladakh
    • Lakshadweep
    • Madhya Pradesh
    • Maharashtra
    • Manipur
    • Meghalaya
    • Mizoram
    • Nagaland
    • Odisha
    • Puducherry
    • Punjab
    • Rajasthan
    • Sikkim
    • Tamil Nadu
    • Telangana
    • Tripura
    • Uttar Pradesh
    • Uttrakhand
    • West Bengal
  • Medical Education
    • Ayush Education News
    • Dentistry Education News
    • Medical Admission News
    • Medical Colleges News
    • Medical Courses News
    • Medical Universities News
    • Nursing education News
    • Paramedical Education News
    • Study Abroad
  • Industry
    • Health Investment News
    • Health Startup News
    • Medical Devices News
    • Pharma News
      • CDSCO (Central Drugs Standard Control Organisation) News
    • Pharmacy Education News
    • Industry Perspective
  • Home
  • Nephrology
  • Nephrology Cases
  • Rare case of...

Rare case of 18-month-old child with Moyamoya disease presenting with tubular dysfunction

Written By : Dr.Niharika Harsha B |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2023-05-09T20:00:41+05:30  |  Updated On 9 May 2023 8:00 PM IST
Rare case of 18-month-old child with Moyamoya disease presenting with tubular dysfunction
  • facebook
  • twitter
  • linkedin
  • whatsapp
  • Telegram
  • Email

A new finding in Moyamoya disease reported the occurrence of hypertension preceded by tubular dysfunction with an atypical hyponatremic-hypertensive syndrome (HHS). unilateral renal artery stenosis accounts for 8%-10% of renovascular hypertension in childhood and rarely causes hyponatremic-hypertensive syndrome (HHS).

Moyamoya disease is a progressive steno-occlusive cerebrovascular arteriopathy of unknown origin involving the distal intracranial internal carotid artery and its main branches and is a rare cause of pediatric stroke. It exhibits a distinguishing feature of the presence of a collateral network of overgrown and dilated small arteries from the circle of Willis that appear as a puff of smoke and hence the name Moyamoya. Different angiographic images are seen in certain disease conditions where such patients are characterized as Moyamoya syndrome. Majority of the pediatric cases present clinically as ischemic stroke, while some as transient ischemia and hemorrhagic stroke with hemiparesis. Sometimes intracranial bleeding is seen in some adult patients, but children have more epilepsy than adults. Extracranial sites like the carotid, pulmonary, coronary, and renal arteries also show steno-occlusive arterial changes.

Also Read: Majority of children getting treatment for Lyme disease improve in 6 months

Maria Luisa Conte et al presented a case of an atypical Moyamoya disease in the journal BMC Pediatrics. A18-month-old boy with a recent history of polyuria and polydipsia, having acute febrile gastroenteritis with neurological impairment, severe dehydration, hyponatremia, hypokalemia, kidney tubular dysfunction, and elevated aldosterone and renin even with normal blood pressure. Fluid and electrolyte levels were corrected, and the boy recovered completely.

Radiological findings:

  • An abdominal ultrasound showed a smaller right kidney.
  • A brain magnetic resonance and an electroencephalogram did not show any relevant abnormalities.
  • Five months later when the child experienced left-side hemiparesis after a traumatic concussion and severe hypertension, a brain tomography was done which documented cerebral ischemia.
  • Brain and kidney angiographic studies displayed puff of smoke findings of internal right carotid artery branches and a steno-occlusive pattern of the right renal artery, respectively.
Also Read: Elevated serum total IgE associated with eczema exacerbation in kids hospitalized for atopic dermatitis

Thus, the researchers diagnosed it to be Moyamoya disease with HHS secondary to unilateral renal artery stenosis. After an unsuccessful antiplatelet and antihypertensive pharmacological treatment, the boy underwent a renal angioplasty and a cerebral STA-MCA bypass (direct superficial temporal artery-to-middle cerebral artery bypass), significantly improving both neurological and kidney disease.

This is the first case of the atypical hyponatremic hypertensive syndrome as the onset of Moyamoya arteriopathy in a child, with hypertension following tubular dysfunction and driven by unilateral renal artery stenosis.

Further reading: Conte, M.L., La Scola, C., Mencarelli, F. et al. Moyamoya disease presenting with tubular dysfunction in a child: pitfalls in diagnosing an atypical hyponatremic-hypertensive syndrome. BMC Pediatr 23, 227 (2023). https://doi.org/10.1186/s12887-023-03926-1

BMC PediatricsPediatricsMoyamoya diseaseCase report
Source : BMC Pediatrics
Dr.Niharika Harsha B
Dr.Niharika Harsha B

    BDS, MDS

    Dr.Niharika Harsha B (BDS,MDS) completed her BDS from Govt Dental College, Hyderabad and MDS from Dr.NTR University of health sciences(Now Kaloji Rao University). She has 4 years of private dental practice and worked for 2 years as Consultant Oral Radiologist at a Dental Imaging Centre in Hyderabad. She worked as Research Assistant and scientific writer in the development of Oral Anti cancer screening device with her seniors. She has a deep intriguing wish in writing highly engaging, captivating and informative medical content for a wider audience. She can be contacted at editorial@medicaldialogues.in.

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

    Show Full Article
    Next Story

    Editorial

    U.S. FDA Drug Safety Alert: Warning Issued for Severe Itching After Stopping Long-Term Cetirizine or Levocetirizine Use

    U.S. FDA Drug Safety Alert: Warning Issued for Severe Itching After Stopping Long-Term Cetirizine or...

    Aspirin in Primary Prevention: Prudent Guideline-Based Approach

    Aspirin in Primary Prevention: Prudent Guideline-Based Approach

    Prediabetes and CKD: An Overlooked Interaction in Early Metabolic Disease

    Prediabetes and CKD: An Overlooked Interaction in Early Metabolic Disease

    Environmental Impact on Seborrheic Dermatitis, Tinea versicolor and Dandruff: The Role of Selenium Sulfide in Seborrheic Dermatitis Management

    Environmental Impact on Seborrheic Dermatitis, Tinea versicolor and Dandruff: The Role of Selenium...

    Real-World Case study: Darbepoetin Alfa for Chemotherapy-Induced Anemia in stage IV metastatic gallbladder cancer - Dr AVS Suresh

    Real-World Case study: Darbepoetin Alfa for Chemotherapy-Induced Anemia in stage IV metastatic...

    View All

    Journal Club Today

    Sleeping 2 Extra Hours on Weekends May Calm Teen Anxiety: Study Suggests

    Sleeping 2 Extra Hours on Weekends May Calm Teen Anxiety: Study Suggests

    View All

    Health News Today

    Health Bulletin 16/June/2025

    Health Bulletin 16/June/2025

    View All
    © 2022 All Rights Reserved.
    Powered By: Hocalwire
    X
    We use cookies for analytics, advertising and to improve our site. You agree to our use of cookies by continuing to use our site. To know more, see our Cookie Policy and Cookie Settings.Ok