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Monozygotic twins with Crohn's disease: a case report
Gastroenterology
|November 1, 1980
Summary
Identical twins developed Crohn's disease, showing genetic influence on disease onset but not specific manifestations. Environmental factors likely impact disease presentation and location in genetically susceptible individuals.
Area of Science:
- Gastroenterology
- Genetics
- Immunology
Background:
- Crohn's disease (CD) is a chronic inflammatory bowel disease with a complex etiology.
- Genetic factors are implicated in CD pathogenesis, but the precise role in clinical variability remains unclear.
Observation:
- Identical twins, confirmed by genetic and dermatoglyphic analysis, both developed Crohn's disease within an 8-month period.
- Both twins presented with terminal ileum, colon, and rectal involvement, alongside arthritis.
- Clinical heterogeneity was observed, with one twin experiencing severe esophagitis and pancreatitis, and the other severe arthritis and oral mucosal lesions.
Findings:
- The development of Crohn's disease in genetically identical individuals suggests a strong genetic predisposition.
- Despite identical genetics, significant differences in disease manifestation and affected sites were noted.
- Parenteral nutrition effectively managed the complex symptoms in both affected twins.
Implications:
- This case challenges traditional views on the role of genetics in determining the specific clinical phenotype of Crohn's disease.
- Environmental or epigenetic factors likely play a crucial role in modulating disease expression and localization in genetically susceptible individuals.
- Further research is needed to elucidate the interplay between genetic susceptibility and environmental triggers in Crohn's disease heterogeneity.
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