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Case ReportOpen Access
Noonan Syndrome, Metabolic Syndrome and Stroke-inthe- Young: Coincidence, Causal or Contribution?
Eu-ahsunthornwattana J 
,
Trachoo O ,
Dejsuphong D ,
Tunteeratum A ,
Srichan K ,
Sura T
,
Trachoo O ,
Dejsuphong D ,
Tunteeratum A ,
Srichan K ,
Sura T A 34-year-old Thai woman developed acute left hemiparesis with dysarthria from subcortical infarction of the right
MCA territory eighteen months after being diagnosed with Noonan syndrome, diabetes mellitus, dyslipidaemia, and
hypertension. Further investigations suggested atherosclerosis as a cause. Modifying her risk factors was difficult, partly
because of limited adherence. Three years later, she had another attack of ischaemic stroke in the same area. Unlike the three
previously reported cases, the causation of strokes in this patient appeared to be a more ‘complex’ interaction between genetic
defect and environment including possible subtle arterial abnormalities, metabolic risk factors, and mental insufficiency.
Keywords: Noonan syndrome, Cerebral infarction, Metabolic syndrome, Diabetes mellitus, Multifactorial causality
MCA territory eighteen months after being diagnosed with Noonan syndrome, diabetes mellitus, dyslipidaemia, and
hypertension. Further investigations suggested atherosclerosis as a cause. Modifying her risk factors was difficult, partly
because of limited adherence. Three years later, she had another attack of ischaemic stroke in the same area. Unlike the three
previously reported cases, the causation of strokes in this patient appeared to be a more ‘complex’ interaction between genetic
defect and environment including possible subtle arterial abnormalities, metabolic risk factors, and mental insufficiency.
Keywords: Noonan syndrome, Cerebral infarction, Metabolic syndrome, Diabetes mellitus, Multifactorial causality
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