Gluten sensitivity in monozygous twins: A long-term follow-up of five pairs

OBJECTIVE: The aim of this study was to investigate the role of genetic fac tors and the characteristics of five monozygous twin pairs with at least on e member affected by gluten sensitivity. METHODS: Five pairs of monozygous female twins, of whom one or both were af fected by gluten sensitivity (i.e., celiac disease or dermatitis herpetifor mis), were followed-up for 11-23 yr. RESULTS: Three pairs were concordant for celiac disease: the onset was comp arable and synchronous in two pairs; in the third, one member presented an overt malabsorption syndrome, and the other developed iron deficiency anemi a 10 yr later. Discordance for gluten sensitivity was found in the remainin g two pairs, one of whose members was diagnosed as having, respectively, ce liac disease and dermatitis herpetiformis. CONCLUSIONS: As no environmental factors were found to affect the phenotypi c expression of the disease, genetic factors seem to play a major role. The presence of overt or latent celiac disease in three of the four siblings o f the three concordant twins, and the association with cystic fibrosis in a ll three siblings of one of these families, further supports this hypothesi s. (Am J Gastroenterol 2000;95:1503-1505. (C) 2000 by Am. Cell. of Gastroen terology).