A Pair of Dizygotic Twins Born to Two Carrier Families of Sickle Cell Disease in Scheduled Caste Communities of Orissa, India
Authors: Ranbir S. Balgir
Abstract: The sickle cell disease is a genetically inherited commonly encountered hematological disorder in the state of Orissa. It causes high degree of morbidity, mortality and fetal wastage in the poor vulnerable people. For the first time, a carrier couple of sickle cell disease had delivered twin offspring with carrier as well as the homozygous sickle cell disease or homozygous sickle cell disease and normal offspring. The suspected cases of hemoglobinopathies suffering from anemia are routinely referred from different peripheral Primary Health Centres (PHCs) and hospitals in the state of Orissa to our centre for detailed investigations and genetic/marriage counseling. Out of these referral cases, two scheduled castes, i.e. Domb and Pana, families with twin children were referred from Kalahandi and Kandhamal districts of Orissa, respectively and were studied in details. The present study reports for the first time a rare occurrence of dizygotic twins (sickle cell trait and sickle cell disease in one family and sickle cell disease and normal child in another family) in a singleton pregnancy in the sickle cell carrier parents, respectively from Kalahandi and Kandhamal districts of Orissa, India. It is true that twin gestation does not change the preconception probability, but this study clearly shows co-existence of two different genotypes in a singleton pregnancy. It is a rare occasion when a single pregnancy carries either two or more distinct abnormal genotypes at a time in a womb in human beings. Dizygotic twins are genetically different and, thus, provide means of appraisal of the expression of different genotypes under the same environmental conditions.