title: Prenatal exposure to disulfiram implicated in the cause of malformations in discordant monozygotic twins.
abstract: Female monozygotic (MZ) twins were discordant for congenital structural anomalies: Twin A had a reduction defect of the right forearm; Twin B had a cleft palate. Both infants were small for gestational age. Specific prenatal exposures were identified at different times in the first trimester of pregnancy: crack cocaine, marijuana, disulfiram, heavy ethanol exposure, and cigarettes. The mother's hospitalization in a drug abuse program and incarceration allowed for identification of exposure timing. The cleft palate could have been related to either disulfiram or alcohol exposure; the limb abnormality most likely corresponded to the timing of disulfiram exposure. Discordance of anomalies in these twins may reflect differences in developmental timing, differences in susceptibility to one or more teratogens, or random events occurring within very complex developmental programs, with the thresholds for malformation affected by one or multiple teratogenic compounds.
authors.affiliation: Department of Pediatrics, University of North Carolina at Chapel Hill 27599, USA.
authors.forename: P J
authors.initials: PJ
authors.lastname: Reitnauer
authors.forename: N P
authors.initials: NP
authors.lastname: Callanan
authors.forename: R A
authors.initials: RA
authors.lastname: Farber
authors.forename: A S
authors.initials: AS
authors.lastname: Aylsworth
mesh_terms: D000014:Abnormalities, Drug-Induced; D000328:Adult; D000427:Alcohol Deterrents / Q000009:adverse effects*; D000428:Alcohol Drinking; D002972:Cleft Palate / Q000139:chemically induced; D004221:Disulfiram / Q000009:adverse effects*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D011859:Radiography; D011884:Radius / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000187:drug effects; D012907:Smoking; D019966:Substance-Related Disorders; D014430:Twins, Monozygotic; D014457:Ulna / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000187:drug effects
chemical_list: D000427:Alcohol Deterrents; D004221:Disulfiram