Re: Conjoined twins with different genders
From: viv souter (vsouter@yahoo.com)
Thu Oct 16 15:52:01 2003
Hi Wolfgang
David forwarded me your email from the list. I am investigating another case of what appear to be monochorionic dizygous twins and I have heard of two further cases, aside from yours. While I think it is an uncommon phenomenon, I do not think it is extraordinarily rare. While the possibility that ART was a factor in our case, I do not necessarily think it was causative.
A common feature in the cases I have heard about is blood chimerism and you will see in our NEJM case, the initial zygosity studies (on blood) were consistent with monozygosity as a result of the chimerism. Consequently if the twins had been same sex, DNA testing on their blood would have suggested these dizygous twins were monozygous, consistent with their monochorionicity.
We postulated a fusion event as the cause of our unusual twins. Rowena Spencer has is a proponent of fusion rather than fission as the cause of amny conjoined twins.
I am not in the least surprised there are other cases out there.
I think we don't know the half about twins and how they arise.........
Viv (Souter)
"Wolfgang Moroder, M.D." <wolfgang.moroder@tin.it> wrote:
Too bad I did not know it, David! We could have met in Paris to discuss
the case. I have awesome ultrasound images taken in the first trimester
which demonstrate monochorionicity by showing the single coelomic space
and the paired yolk sacs in a 8 shape. Best regards Wolfgang
At Thu, 16 Oct 2003, David Nyberg wrote:
>
>Wolfgang
>
>you should definitely get together with my wife, Viv Souter, who was the author of that paper in the NEJM. She is putting together a series of similar cases and also working on some related topics with twins.
>
>regards,
>
>David
>
>On Thu, 16 Oct 2003, Wolfgang Moroder, M.D. wrote:
>
>> Art, the monochorionic pregnancy with discordant sex did NOT originate
>> from ART: that is it what distiguishes my case from the one described in
>> the NEJM. I know, I should write a letter to the journal.
>> Wolfgang
>>
>> At Thu, 16 Oct 2003, art fougner, md wrote:
>> >
>> >Wolfgang -
>> >
>> >is your case associated with Assisted Repro Technology or au naturel
>> >(sp)?
>> >
>> >art
>> >
>> >At Wed, 15 Oct 2003, Wolfgang Moroder, M.D. wrote:
>> >>
>> >>OK, let' s get more serious. I am working on a case of monochorionic
>> >>twins with discordant gender, discordant karyotype on fibroblast culture
>> >>and mixed blood (both karyotypes - XX,XY) in both's blood lymphocytes at
>> >>birth - that is the evidence of a common placental circulation, the
>> >>evidence that the twins were monochorionic, besides sonographic evidence
>> >>of monochorionicity by a first trimeste scan. Such a case has been
>> >>published by Souter in the NEJM : Volume 349:154-158 July 10, 2003
>> >>Number 2
>> >>http://content.nejm.org/cgi/content/short/349/2/154
>> >>There must be an infinite range of variation in nature - just look in
>> >>the animal species. Ciao Wolfgang
>> >>
>> >>At Wed, 15 Oct 2003, Mireille Bonneau wrote:
>> >>>
>> >>>#63280;, pour #30395;re grand, il est grand!!!!
>> >>>Un gage......
>> >>>
>> >>>Le 14/10/03 21:54, ?Philippe Jeanty, MD, PhD#61044; a
>> >>>#23984;rit?
>> >>>
>> >>>> Grand cornichon :)
>> >>>>
>> >>>> -----Original Message-----
>> >>>> From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net] On Behalf Of
>> >>>> Philippe Coquel
>> >>>> Sent: Tuesday, October 14, 2003 2:22 PM
>> >>>> To: Multiple recipients of list ULTRASOUND
>> >>>> Subject: Re: Conjoined twins with different genders
>> >>>>
>> >>>> sorry
>> >>>> I didn't know
>> >>>> To all recipients of list Ultrasound list: delete my message
>> >>>> :-)))))))))))))))))))
>> >>>
>
>>>> >>>>>>> ----- Original Message -----
>> >>>> From: "Philippe Jeanty, MD, PhD"
>> >>>> To: "Multiple recipients of list ULTRASOUND"
>> >>>> Sent: Tuesday, October 14, 2003 9:14 PM
>> >>>> Subject: RE: Conjoined twins with different genders
>> >>>>
>> >>>>> Shuut it was supposed to become a case of the week !!!!!!!!
>> >>>>>
>> >>>>> -----Original Message-----
>> >>>>> From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net] On Behalf Of
>> >>>>> Philippe Coquel
>> >>>>> Sent: Tuesday, October 14, 2003 2:01 PM
>> >>>>> To: Multiple recipients of list ULTRASOUND
>> >>>>> Subject: Conjoined twins with different genders
>> >>>>>
>> >>>>> During the Isuog meeting, somebody gave photographs of conjoined twins
>> >>>> with
>> >>>>> different genders to Ph Jeanty
>> >>>>> Philippe, could you send more informations about this case
>> >>>>> Ph
>> >>>>>
>
>>>> >>>>>>>> ----- Original Message -----
>> >>>>> From: "art fougner, md"
>> >>>>> To: "Multiple recipients of list ULTRASOUND"
>> >>>>> Sent: Tuesday, October 14, 2003 8:47 PM
>> >>>>> Subject: Re: Conjoined twins?
>> >>>>>
>> >>>>>> Conjoined Twins with different genders? Doubt it. Papers here are
>> >>>>>> talking about a set of pre-op conjoined twins from the Philippines -
>> >>>>>> cephalopagus as were the Egyptian twins.
>> >>>>>>
>> >>>>>> art
>> >>>>>>
>> >>>>>> At Mon, 13 Oct 2003, Ann Polin wrote:
>> >>>>>>>
>> >>>>>>> Forgive me if there is something that I am missing, but does anyone
>> >>>> know
>> >>>>>>> anything about the Greek conjoined twins that were joined at the temple
>> >>>>>>> and just separated? According to the article on CNN (see the website
>> >>>> at:
>> >>>>>>> http://www.cnn.com/2003/WORLD/europe/10/12/italy.twins.ap/index.html
>> >>>>>>> they were a boy and a girl.
>> >>>>>>>
>> >>>>>>> --
>> >>>>>>> Ann Polin, BS, RDMS
>> >>>>>>> Program Chair
>> >>>>>>> Diagnostic Ultrasound, R130D
>> >>>>>>> Bellevue Community College
>> >>>>>>> 3000 Landerholm Circle SE
>> >>>>>>> Bellevue, WA 98007-6484
>> >>>>>>> USA
>> >>>>>>> Telephone: +1 (425) 564-4181
>> >>>>>>> Fax: +1 (425) 564-4193
>> >>>>>>> Email: apolin@bcc.ctc.edu
>> >>>>>>>
>> >>>>>> --
>> >>>>>> art fougner, md
>> >>>>>> ich bin ein New Yorker
>> >>>>>>
>> >>>mirbonneau@wanadoo.fr S1 SCF 93 Neuilly-Plaisance
>> >>>secr#24395;aire de l'AGEOL
>> >>
>> >>--
>> >>Wolfgang Moroder, MD
>> >>Prenatal Unit
>> >>Bolzano General Hospital Italy
>> >>
>> >--
>> >art fougner, md
>> >ich bin ein New Yorker
>> >
>>
>> --
>> Wolfgang Moroder, MD
>> Prenatal Unit
>> Bolzano General Hospital Italy
>>
>--
>David Nyberg, MD
>10401 E McDowell Mtn Ranch Rd
>#2-372
>Scottsdale, AZ 85255
>ph cell 480-797-0993
>fax 480-512-8737
>work 480-512-3850
>
--
Wolfgang Moroder, MD
Prenatal Unit
Bolzano General Hospital Italy
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