Juvenile rheumatoid arthritis in mono-zygotic twins

Abstract

Aim: To describe the rate of juvenile idiopathic arthritis progression andto determine the degree of responsiveness to methotrexate and adalimmabmanagement in mono-zygotic twins with a methylene tetrahydrofolatereductase gene mutation.Methods: The study was a 5-month, twin concordance study. Thisincludes a retrospective study of medical records, activity and severity ofthe disease, complications, which included an objective clinical examinationof the patient, based on an assessment of the severity of the diseaseusing the disease activity score calculator for rheumatoid arthritis (DAS:28), liver function test, and folate cycle enzyme.Results: Based on the study conducted, mono-zygotic twins with the sameform of arthritis, which began at the same age with the same manifestationsyndrome and joint disease, combined with the same folate cyclemutation, with similar treatment regimen had different degrees of diseaseprogression and severity. The first twin had a complication of toxic hepatitisand a concomitant autoimmune thyroiditis. The second twin had amore serious progression with small joints ankylosis.Conclusion: The study shows that monozygotic twins with juvenile idiopathicarthritis with a similar defect in the folate cycle enzyme had differentrates of disease progression of varying severity and joint damage.Consequently, this requires further study in monozygotic twins with juvenilerheumatoid arthritis.