Korean J Gastroenterol.  2010 Jan;55(1):68-72. 10.4166/kjg.2010.55.1.68.

A Case of Monozygotic Twins with Crohn's Disease

• Park SK
• Kim KJ
• Ye BD
• Byeon JS
• Myung SJ
• Yang SK
• Kim JH
• Chi HS

• KMID: 1775929
• DOI: http://doi.org/10.4166/kjg.2010.55.1.68

Abstract

Although the incidence and prevalence rates of IBD in Korea are still lower than Western populations, they have been increasing rapidly during the past decades. Crohn's disease (CD) tends to run in families because it is thought to be related to genetic susceptibility coupled with environmental factors. A large number of monozygotic and dizygotic twin pairs with inflammatory bowel disease have been reported in western countries. The population relative risk in first-degree relatives is considered to be about equal in both Koreans and westerners. To our best knowledge, there is no report in monozygotic twins with CD in Korea. This case report is the first documented occurrence of concordant CD occurring in monozygotic twins in Korea.

Keyword

Crohn's disease; Familial; Monozygotic twins

MeSH Terms

Adolescent
Antimetabolites/therapeutic use
Azathioprine/therapeutic use
Colonoscopy
Crohn Disease/*diagnosis/drug therapy/genetics
Diseases in Twins/*diagnosis/drug therapy/genetics
Humans
Male
Pedigree
Tomography, X-Ray Computed
Twins, Monozygotic/*genetics

Figure

• 

  Fig. 1. Abdomen CT findings. (A) Twin-1, mesenteric inflammatory mass with small abscess cavity was accompanied by fistula tract connected with the ileum (black arrow). (B) Twin-1, stricture was seen in the pelvic ileum (black arrow). (C) Twin 2, multifocal segmental bowel wall thickening was seen in the ileum (black arrow).

• 

  Fig. 2. Colonoscopic findings. (A) Twin-1, multiple ulcers with exudates were noted in the terminal ileum. (B) Twin-2, multiple ulcers with exudates were noted in the terminal ileum.

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  Fig. 3. Small bowel series findings. (A) Twin-1, segmental edematous wall thickening was seen in pelvic ileum (black arrow). (B) Twin-2, bowel wall thickening was seen in the ileum (black arrow).

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  Fig. 4. The pedigree of patients. In second-degree family, only twins have Crohn's disase, and the others do not have inflammatory bowel disease.

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  Fig. 5. Monozygotic twins proven by AmpFLSTRⓇ IdentifierTM PCR Amplification kit. PCR of 16 STR concurred in twins. (A, C) Twin-1, (B, D) Twin-2.

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