Acute glomerulonephritis in both members of a pair of identical twin-brothers

• Published in: The Japanese Journal of Nephrology Vol. 6; no. 3; pp. 209 - 218
• Main Authors: Nouchi, Fumio, Arai, Shigeaki, Ogawa, Toru, Ota, Hideo, Kato, Tositsugu
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of Nephrology 1964
• ISSN: 0385-2385; 1884-0728
• DOI: 10.14842/jpnjnephrol1959.6.209

Although it is well confirmed in various diseases, that there are closer resemblances between the members of an identical twin-pair than between the members of a binovular one, only a few cases of glomerulonephritis in both twin-pair members are reported. Since the first report by Galton (1876), in total 224 twin-pairs are found in the literatures in this country and abroad in respect of glomerulonephritis. But in only 24 out of these 224 pairs, the disease occurred in both twin members. This paper describes rare cases of a pair of identical twin-brothers, aged 14, both affected with acute glomerulonephritis after acute infection of the upper air tract. Case 1.A twin had an acute infection of the upper air tract May 5, 1962. After only one day's treatment, he neglected it in spite of the illness not getting better. On May 27 edema of his face was noticed and hypertension (160/110 mmHg), heavy albuminuria, and hematuria were detected. Clinical examinations revealed markedly decreased renal functions and azotemia over 100 mg/dl. In September he became uremic and died October 10. The course of the disease was that of the subacute glomerulonephritis. Autopsy revealed markedly contracted kidneys. Case 2.Another twin took concomitantly the same infection, After two weeks' treatment he became well. As his twin-brother had been admitted to the hospital, he was examined for precaution's sake and was found to have a slight albuminuria. He was also admitted to the hospital on July 23. On admission renal functions, blood pressure, and the other clinical findings were within normal. But during the hospitalization for over 18 months, the renal functions tended gradually to decline and the urinary findings were only slightly improved. The renal needle biopsy performed 4 months after the infection revealed moderate changes of chronic stage of glomerulonephritis. These cases are thought to be an example to show, on the one hand, the close effect of the treatment of the antecedent infection on the severeness of glomerulonephritis and, on the other hand, the resemblance in the course (unfavorable in these cases) of the disease in identical twins.