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Concordance of ulcerative colitis and endometriosis in monozygotic twin sisters: An infrequent but challenging association

Lucienne Pellegrini, Marta Patturelli, Alessia Dalila Guarino, Anna Testa

We describe a rare occurrence of UC and endometriosis in monozygotic twin sisters. The association between endometriosis and IBD assumes a critical clinical relevance due to the overlap of symptoms, making the diagnostic approach as well as medical and surgical therapeutic choices difficult. Furthermore, both conditions have a high risk for surgery, and the need for surgery for one or both diseases requires careful planning strategies. Finally, surgery related to IBD can involve the risk of infertility, which is already present in endometriosis. We collected all cases of endometriosis among our IBD patients and registered bowel disease data (IBD phenotype, age at diagnosis, disease pattern, immunosuppressive or biological therapies), extraintestinal manifestations, comorbidity, and exposure to surgery for IBD. We also calculated the prevalence of endometriosis in IBD patients.