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Triplets with systemic lupus erythematosus
Sona S Kamat1, Peri H Pepmueller, Terry L Moore
1Saint Louis University Health Sciences Center, St. Louis, Missouri 63104, USA.
Insights
This is the first case report of identical triplets diagnosed with systemic lupus erythematosus (SLE). Despite genetic identity, each triplet presented unique symptoms, highlighting the complex nature of SLE.
Area of Science:
- Pediatrics
- Immunology
- Genetics
Background:
- Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with complex etiology.
- Genetic factors are known to play a role in SLE development.
- Identical twins have shown varying SLE onset and phenotypes, suggesting non-genetic influences.
Observation:
- This report details the first known cases of identical triplets diagnosed with SLE.
- The triplets were diagnosed at ages 8, 9, and 11 years, in reverse birth order.
- Each triplet exhibited distinct clinical manifestations of the disease.
Findings:
- All three siblings presented with characteristic SLE symptoms including skin rash, fatigue, and biopsy-proven glomerulonephritis.
- Laboratory findings were consistent across all triplets, showing positive antinuclear antibodies, anti-native DNA, and anti-double-stranded DNA antibodies.
- Low complement levels were observed in all three patients, further confirming the SLE diagnosis.
Implications:
- This case underscores the multifactorial nature of SLE, involving both genetic predisposition and potential environmental or epigenetic factors.
- Studying identical triplets with SLE offers a unique model to investigate the interplay between genetics and disease expression.
- Further research into the specific triggers and modifying factors in SLE development is warranted.
Abstract:
We present herein the first case report of identical triplets who developed systemic lupus erythematosus (SLE). The children were diagnosed as having SLE in reverse birth order at ages 8, 9, and 11 years. Although genetically identical, each sibling manifested different clinical signs and symptoms; however, all 3 children did manifest skin rash, fatigue, and biopsy-proven glomerulonephritis at different ages. Findings of laboratory studies were similar, including positivity for antinuclear antibodies, anti-native DNA, and anti-double-stranded DNA, as well as low levels of complement. These findings confirmed SLE in each sibling.
