[Sarcoidosis synchronously detected in identical twins]

Area of Science:

• Immunology
• Genetics
• Pulmonology

Background:

• Sarcoidosis is an inflammatory disease characterized by granuloma formation.
• Genetic predisposition is suspected in sarcoidosis development.
• Synchronous sarcoidosis in identical twins is exceptionally rare.

Observation:

• Identical 22-year-old male twins presented with synchronous symptoms of sarcoidosis, including fever, cough, and abnormal chest imaging.
• Both twins exhibited cervical and hilar lymphadenopathy and bilateral lung lesions.
• Ocular involvement (bilateral uveitis) was noted in only the elder twin.

Findings:

• Histopathological examination of cervical lymph nodes revealed epithelioid cell granulomas without caseous necrosis, confirming sarcoidosis.
• Both twins were positive for HLA-D antigens DR 2 and DR 12.
• Neither twin was positive for the HLA antigen DRw 52, which is common in Japanese sarcoidosis patients.

Implications:

• The synchronous occurrence suggests a strong genetic component in sarcoidosis susceptibility.
• Further research into specific human leukocyte antigen (HLA) associations is warranted.
• This case provides valuable insight into the genetic underpinnings of sarcoidosis.