二卵性双生児に発見された膀胱尿管逆流症のHLA解析

Abstract

症例1は6歳女で, 二卵性双生児の妹に右膀胱尿管逆流症(VUR)が認められた.右側にgrade 3のVUR, 左側にgrade 1のVURを認めた.セフェム系抗生剤を投与した後, 両側膀胱尿管吻合術を施行し, 両腎とも正常は排泄を呈した.症例2は5歳女で, 膿尿を主訴とし, 右側にgrade4のVURを認めた.セフェム系抗生剤を投与した後, 両側膀胱尿管吻合術を施行した.この2症例のHLA ABC Locus A24-, B52, 53, Cwl-であった.母親にもVURの既往があり, 母親のHLA ABC LocusはA24-, B52, 55, Cwl-であった.長男もこの2症例の妹と同じHLA ABC Locusであったが, VURを示唆する所見や尿路感染の既往はなかった

We treated 2 cases of vesicoureteral reflux (VUR) in twins. Case 1: A 6-year-old girl had grade 3 VUR on the right side and grade 1 VUR on the left side. Case 2: A 5-year-old girl, the younger sister of case 1, had grade 4 VUR on the right side. We treated these patients with bilateral anti-reflux-therapy (Cohen's method). We analyzed the HLA ABC locus in this family and found that these twins and their mother (who had been treated for bilateral VUR in childhood) were of the same haplotype, but not a haplotype previously reported. We believe that familial VUR should be aggressively investigated.