Twenty-nine-year-old twin brothers having the amyloidogenic transthyretin (
ATTR) Val30Met gene developed the clinical symptoms of familial amyloidotic
polyneuropathy (FAP) in 1995. The twins had the same educational backgroun
d and lived in the same district. FAP manifestations were similar in both c
ases, although electromyographic examinations revealed sensorimotor polyneu
ropathy in No. 1 and sensory polyneuropathy in No. 2. DNA analysis revealed
that they were monozygotic twins. In addition to environmental factors, ge
netic factors may play an important role in determining the onset of FAP.