Familial reflux in monozygotic twins

A case report of monozygotic twins with reflux nephropathy is presented. The possible mode of inheritance is either by multiple genes producing a cumulative effect or by an autosomal dominant gene of variable penetrance.     

Congenital diaphragmatic hernia in monozygotic twins

This is the third reported instance of identical twins, each with left-sided posterolateral congenital diaphragmatic hernia (CDH) (Bochdalek type), who have been operated upon successfully. The associated anomalies were mirror image undescended testicles. Comparative review of familial and sporadic cases of CDH revealed that males were more commonly affected in the former, while females were more commonly affected in the latter. There was no known etiology in either type. Both familial and sporadic cases shared a high incidence of associated anomalies (40% to 50%). Three anomalies were equally found in both types, mainly pulmonary hypoplasia, intestinal malrotation, and patent ductus arteriosus. Central nervous system anomalies were highly prevalent in the sporadic cases (55% to 75%), while cardiovascular and genitourinary anomalies (30% each) were the more common anomalies encountered in the familial cases.     

Thiemann disease in monozygotic female twins

Thiemann's disease is a hereditary necrosis of the epiphysis of the basal limb of the big toe. This paper describes its synchrone occurrence in monozygotic twins. The course is seen as being concurrent with the findings in literature. The etiopathology of Thiemann's disease is discussed showing the dominant heritage by this examination of twins.     

Discordant Hirschsprung's disease in monozygotic twins

Two pairs of twins are being reported where monozygocity was supported by the observed sharing of a single and common placenta and by ABO and HLA identity. Only one of each pair of twins was affected by long-segment Hirschsprung's disease; the other twins were entirely normal. Discordant Hirschsprung's disease in monozygotic twins is very rare. The etiology in such cases is influenced by genetic or by environmental intrauterine factors rather than by postnatal influences, as suggested elsewhere.     

Concordant prune belly syndrome in monozygotic twins

We report 2 cases of concordant prune belly syndrome occurring in monozygotic twins. In addition to suggesting a genetic basis for this disease, our 12-year follow-up of these cases illustrates that these patients with an otherwise poor prognosis can have normal growth, development, and renal function with appropriate treatment.     

Mirror imaging cleft lip in monozygotic twins

Although genetic and environmental factors have been found to effect the occurrence of cleft lip, many aspects of its etiology are still unclear. The value of the studies on monozygotic twins has been accepted by many authors. Especially the concordant anomalies gain importance in the monozygotic twins who are influenced by the same genetic and environmental factors. Here we present a case of monozygotic twins with cleft lip deformities showing mirror image concordance.     

Concomitant germ cell tumors in monozygotic twins

Simultaneously occurring embryonal cell tumors in a 38-year-old set of monozygotic twin brothers are reported. This is the eighth documented case of testicular cancer in twins and it is unique since it is the first report to describe bilateral testicular tumors in 1 of the twin brothers. The role of genetics in the development of certain cancers warrants further study. This documentation of testicular tumors in serologically proved identical twins is used as a basis for discussion of the role of heredity as a possible significant factor in germ cell tumor pathogenesis.     

Median arcuate ligament compression syndrome in monozygotic twins

Twin 27-year-old women had symptomatic mesenteric ischemia caused by median arcuate ligament compression. Arteriography demonstrated severe celiac artery stenosis in one twin, celiac artery occlusion in the other, and proximal superior mesenteric artery narrowing with retrograde filling from a meandering mesenteric artery in both. Division of the ligament and direct celiac artery revascularization completely relieved symptoms in both patients. Median arcuate ligament compression of the celiac and superior mesenteric arteries can result in mesenteric ischemia. Documentation of this unusual syndrome in monozygotic twins suggests that the responsible anatomic relationships are congenital. (J VASC SURG 1994;19:934-8.)     

Anorectal malformation and Down's syndrome in monozygotic twins

Anorectal malformation (ARM) can be divided in high, intermediate, and low forms according to the level of termination of the rectum in relation to the pubococcygeal and ischiatic lines. Patients with Down's syndrome have a high incidence of gastrointestinal anomalies, such as tracheoesophageal fistula, duodenal obstruction, annular pancreas, Hirschsprung's disease, and ARM. In these children, ARM is generally low with or without a fistula. The mode of inheritance of ARM and its genetic relation with Down's syndrome is not known, even if the association (ARM-Down's syndrome) seems not to be coincidental. We describe here a very rare case of monozygotic twins born with the association of ARM and Down's syndrome.