Discordant evolution of asymptomatic proteinuria in identical twins.

Abstract:

:We describe a pair of 17-year-old identical twin brothers with asymptomatic proteinuria, one of whom showed focal segmental glomerulosclerosis (FSGS) while the other showed immunoglobulin M (IgM) nephropathy. For each twin, audiological examination was normal. There was no family history of renal failure, deafness, or hematuria. HLA typing revealed an identical phenotype consisting of A25, A33, B44, B54, Cw1, Cw7, DR7 and DRB1. There is still controversy about whether minimal change disease, IgM nephropathy, and FSGS are discrete entities or different aspects of the same disease. The coexistence of IgM nephropathy and FSGS in identical twins suggests that the same genetic factors may be involved in the development of both diseases. However, although the brothers are identical twins, they had different eating habits and body weight. The twin who preferred to eat a protein-rich diet and who was heavier developed early proteinuria and manifested FSGS on renal biopsy. The discordant evolution of asymptomatic proteinuria in identical twins may provide a clue for the existence of environmental factors on the progression from IgM nephropathy to FSGS. Therefore, this report provides indirect support for the hypothesis that IgM nephropathy and FSGS represent different aspects in the spectrum of a single disease.

journal_name

Nephron

journal_title

Nephron

authors

Kim HY,Oh H,Lee YH,Huh W,Kim YG,Kim DJ,Ko YH,Kim MK

doi

10.1159/000045394

subject

Has Abstract

pub_date

1999-06-01 00:00:00

pages

174-9

issue

2

eissn

1660-8151

issn

2235-3186

pii

45394

journal_volume

82

pub_type

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