Graves' disease in monozygotic twins - a case report

Area of Science:

• Endocrinology
• Genetics
• Environmental Health

Background:

• Autoimmune thyroid diseases, such as Graves' disease and Hashimoto's thyroiditis, arise from an immune response against self-thyroid antigens.
• The co-occurrence of hyperthyroidism in twins with Graves' disease is exceptionally rare, with limited documentation in medical literature.

Purpose of the Study:

• To report a unique case of monozygotic twins who consecutively developed Graves' disease.
• To explore potential contributing factors in the etiology of Graves' disease within a familial context.

Main Methods:

• Presentation of a case series involving monozygotic female twins diagnosed with Graves' disease within a five-year period.
• Review of relevant family history, including maternal thyroid conditions and lifestyle factors such as cigarette smoking.
• Description of therapeutic interventions and outcomes, specifically carbamizole treatment.

Main Results:

• Both monozygotic twins were diagnosed with Graves' disease sequentially.
• The mother of the twins experienced hyperthyroidism and underwent thyroid surgery prior to the twins' diagnosis.
• Both the mother and the twins were identified as cigarette smokers.
• Carbamizole treatment successfully normalized thyroid-stimulating hormone and thyroxine levels in the twins.

Conclusions:

• This case supports the multifactorial hypothesis for Graves' disease, emphasizing the interplay of genetic susceptibility and environmental triggers.
• Cigarette smoking is implicated as a significant environmental factor potentially contributing to the development of Graves' disease in genetically predisposed individuals.