Heterogeneous clinical characteristics of identical twins concordant for systemic lupus erythematosus: a report of one pair of twins.

Lupus is a mysterious disease without definite etiology and pathogenesis. The heterogeneous clinical manifestation of systemic lupus erythematosus (SLE) increases the delay and difficulty of diagnosis and the complexity of pathogenesis. Even in twins with identical genome and similar environmental milieu, the incidence of concordance for SLE is not high. Identical twins, concordant for SLE with discordance to disease onset and expression, are reported. Besides genetics, multiple factors are responsible for the pathogenesis of SLE.