A long-term competent chimeric immune system in a dizygotic dichorionic twin

Pediatrics. 2011 Aug;128(2):e458-63. doi: 10.1542/peds.2010-3557. Epub 2011 Jul 11.

Abstract

We present here a rare case that involved the long-term coexistence of 2 mature, functional, and equilibrated immune systems in a single child after fetofetal transfusion between dizygotic twins. A dichorionic diamniotic pregnancy complicated by twin anemia-polycythemia sequence resulted in the demise of 1 twin. The detection of abnormal vessels on the dichorionic plate strongly suggested the existence of functional vascular anastomoses leading to blood chimerism in the survivor. Genetic, phenotypic, and immunologic analyses at 2 years revealed chimeric lymphoid and myeloid cells in the surviving twin, although no tissue mosaicism was detected, which indicates that early transfusion led to mutual immune tolerance.

Publication types

  • Case Reports

MeSH terms

  • Chimerism*
  • Chorion / immunology*
  • Female
  • Fetal Death
  • Fetofetal Transfusion / diagnosis
  • Fetofetal Transfusion / immunology*
  • Humans
  • Immune System / embryology*
  • Immune System / immunology
  • Infant, Newborn
  • Male
  • Pregnancy
  • Time Factors
  • Twins, Dizygotic / immunology*
  • Young Adult