NSERM, U676, AVENIR RO5230HS Team, Paris, France.
Pediatrics. 2011 Aug;128(2):e458-63. doi: 10.1542/peds.2010-3557. Epub 2011 Jul 11.
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.
我们在此呈现了一例罕见病例，一例患有双胎输血综合征的双卵双胎儿在宫内发生了胎儿-胎儿输血，之后其体内共存了 2 套成熟、功能正常且平衡的免疫系统。一例双绒毛膜-双羊膜妊娠合并双胎贫血-红细胞增多序列症导致 1 名胎儿死亡。在双层胎盘上发现异常血管强烈提示存在功能性血管吻合，从而导致存活胎儿发生了血液嵌合体。在 2 岁时进行的遗传学、表型和免疫学分析显示，尽管未检测到组织嵌合体，但存活的双胎中存在嵌合的淋巴和髓样细胞，这表明早期输血导致了相互免疫耐受。
