Idiopathic giant cell myocarditis (IGCM) is a rare cause of arrhythmia, heart failure and death in children. The etiology of IGCM is unknown. Endomyocardial biopsy and histological examination are essential for diagnosis. In our case, a one-month-old baby boy with no prior medical history died during breastfeeding. The gross autopsy and drug screen failed to disclose a cause of death. Hemotoxylen Eosin (H&E) stained cardiac tissue slides showed widespread and multifocal necrosis accompanied by mixed inflammatory infiltrate. Admixed with the infiltrate were fibroblastic proliferation and multinucleated giant cells in the absence of sarcoid like granuloma. Although myocarditis is usually thought to be a disease of older children, infants can also be affected. This entity can be the cause of some cases of sudden unexpected death in infancy.
Deep vein thrombosis and pulmonary embolisms are two of the most common venous thromboembolic events which cause maternal death in Western European countries and the United States. In this case study, a 21-year-old woman delivered a healthy 2,600 g male infant via emergency caesarean section due to an indication of fetal distress following the start of her labor with vertex presentation at the 40th gestational week. After being discharged 10 days after her initial hospitalization, she had to be readmitted seven days later and died suddenly. An autopsy was performed to determine the cause of death in the hospital. The autopsy revealed the lumen of both the femoral and popliteal veins were filled with thrombosis while the lumen of the pulmonary arteries were filled with ante-mortem thrombosis. Additionally, histopathological findings consistent with pulmonary thromboembolism were detected. The aim of this report is to emphasize venous thromboembolic events as they relate to cause of death in the postpartum period following caesarean sections.
Colchicine is a drug which has a very narrow therapeutic range. This drug has been commonly used for Familial Mediterranean Fever (FMF), Behçet's disease, gout arthritis and acute pseudo gout attacks. In this study, the investigation reports and autopsy reports written by the Council of Forensic Medicine of Ankara between the years 2010-2014 were retrospectively analyzed to find out presence in the cases related to colchicine. Six cases were identified as colchicine intoxication, while three of them used colchicine for medical purpose. In four cases, colchicine was found to have been used for suicidal purpose. Among these four cases, two used colchicine for treatment. In all of our cases, colchicine was detected in bile specimen. Alveolar pulmonary edema and petechial hemorrhage were observed in the lung in all cases. Colchicine was detected in blood in four of the cases. In two cases, the concentration was found to be in therapeutic ranges (0,012 mg/L and 0,018 mg/L), while the other two, in lethal levels (0.099 mg/L and 0,264 mg/L). The most frequent histopathological finding is alveolar pulmonary edema in colchicine intoxication autopsies. Colchicine is widely used alkaloid drugs with narrow therapeutic ranges. More than 0.8 mg / kg in the acute high dose has usually fatal effects. The deaths resulted from colchicine intoxication are mainly suicide-oriented. Similar to other suicides with medicines, they are common among women. In our cases, colchicine was used for intention of suicide in four incidents (66, 66%).
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