title: Systemic lupus erythematosus in identical twins: a case report.
abstract: In this report we describe the case of identical twin sisters that developed systemic lupus erythematosus (SLE). These patients have in common major histocompatibility complex class I and class II alleles and identical red blood cell antigens, which is a clear indication of monozygotic twins. Both twins showed high titers of anti-dsDNA antibody. However, only one of them manifested signs of lupus psychosis and was positive for the LE test, rheumatoid factor, anti-Scl 70, anti-SSA, and antiribosomal P antibodies. Both sisters lived together; therefore, the environmental factors were considered to be the same. Interestingly, these patients expressed different types of autoantibodies and the manifestation of disease was also quite different. When one of the twins was diagnosed with SLE, we began to closely follow up signs of the disease in the other twin periodically. This enabled us to promptly diagnose the second twin with SLE and she was successfully treated without progression of the disease. It is important to mention that following up the subsequent history of an identical twin diagnosed with SLE allowed early detection of the disease in the other twin.
authors.affiliation: Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata, 951-8510, Japan, kurodat@med.niigata-u.ac.jp
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kuroda
authors.forename: Takashi
authors.initials: T
authors.lastname: Harada
authors.forename: Yoko
authors.initials: Y
authors.lastname: Wada
authors.forename: Akihisa
authors.initials: A
authors.lastname: Oyanagi
authors.forename: Yuko
authors.initials: Y
authors.lastname: Ohfuchi
authors.forename: Syuichi
authors.initials: S
authors.lastname: Murakami
authors.forename: Shintaroh
authors.initials: S
authors.lastname: Hirose
authors.forename: Hisashi
authors.initials: H
authors.lastname: Hasegawa
authors.forename: Masaaki
authors.initials: M
authors.lastname: Nakano
authors.forename: Fumitake
authors.initials: F
authors.lastname: Gejyo