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Simultaneous left-sided, primary, spontaneous pneumothorax in identical twins
Constanza Castillo1, Antonio Baquerizo, Patricio Rodríguez
1Department of Internal Medicine, Head of the Respiratory Division, Faculty of Medicine, Universidad de la Frontera Temuco, Chile. eureka@telsur.cl
Summary
Identical twins experienced simultaneous primary spontaneous pneumothorax, a rare occurrence. Treatments, including surgery and observation, did not prevent recurrence in either twin, suggesting complex genetic factors.
Area of Science:
- Pulmonology
- Genetics
- Thoracic Surgery
Background:
- Presents a rare case of simultaneous primary spontaneous pneumothorax in identical twins.
- Highlights the unusual occurrence in Temuco, Chile.
Observation:
- One twin underwent video-assisted thoracoscopic surgery (VATS) with bullectomy and pleurodesis.
- The second twin was managed conservatively.
- Both individuals were non-smokers with normal alpha-1-antitrypsin levels and identical human leukocyte antigen (HLA) haplotypes.
Findings:
- Recurrence of pneumothorax was observed in both twins despite different management strategies.
- Contralateral pneumothorax occurred in the VATS-treated twin after three years.
- Ipsilateral pneumothorax occurred in the conservatively managed twin after two years.
Implications:
- Neither VATS nor conservative management prevented recurrence, indicating limitations in current treatment approaches for familial spontaneous pneumothorax.
- The exact mode of inheritance for familial spontaneous pneumothorax remains unclear, with proposed autosomal dominant and recessive patterns lacking definitive proof.
- Further research is necessary to elucidate the genetic underpinnings and potential associations with human leukocyte antigen (HLA) haplotypes in familial spontaneous pneumothorax.