Does low birthweight predispose to Perthes?? disease? Perthes?? disease in twins

Abstract

Out of 320 patients on the Northern Ireland Perthes' database, five were known to be twins. We observed that the low birthweight twin in each case was the affected child. It is proposed that environmental factors associated with low birthweight are involved in the aetiology of Perthes' disease.

A Twin Study of Perthes Disease

“…16 This finding is consistent with evidence that children with LCPD are of relatively small stature, 26,27 have disproportionately reduced arterial caliber, 28 and may exhibit delayed skeletal maturation. 29 However, there were no differences between the birth weights of affected and unaffected twins in our study.…”

“…5 Two earlier studies that drew twins from LCPD registries were unable 3 + nd); expressions are equivalent. to support a genetic cause 5,16 but included only 11 twin pairs (3 monozygotic pairs). Our study in 81 twin pairs provides much stronger evidence of an environmental etiology for LCPD.…”

“…Only 2 studies have used twins to investigate the etiology of LCPD. 5,16 These were both small series drawn from LCPD registries and reported a total of 11 pairs in which 1 twin had the disease. Although these studies could not show a genetic basis for LCPD, it was noted that the twin with the lowest birth weight was universally affected in the smaller series of 5 twin pairs.…”

“…Although these studies could not show a genetic basis for LCPD, it was noted that the twin with the lowest birth weight was universally affected in the smaller series of 5 twin pairs. 16 Twin studies are useful for delineating the importance of environmental and genetic factors. They can be used to study variation in environment (across pairs) and genetic constitution, because "identical" (monozygotic) twins share almost 100% of genes and "nonidentical" (dizygotic) twins ∼50%.…”

Legg-Calvé-Perthes Disease and Risks for Cardiovascular Diseases and Blood Diseases

“…This indicates that an ischemic vascular insult can lead to typical osteonecrosis of the growing femoral head in rats, resembling LCPD in children. More evidence for the possible role of vascular abnormalities in the pathogenesis of LCPD comes from identification of common risks for LCPD and cardiovascular diseases, including low birth weight 12,33,34 . Maternal and passive smoking during pregnancy has been implicated in the pathogenesis of atherosclerosis 35,36 , hypertension among children 37 and LCPD 8 .…”