Anaphylactic deaths in Auckland, New Zealand: a review of coronial autopsies from 1985 to 2005

Low, Irene; Stables, Simon

doi:10.1080/00313020600820831

Cited by 70 publications

(40 citation statements)

References 12 publications

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“…Anaphylaxis may be difficult to prove as a cause of sudden death as there can be a paucity of signs, but serum tryptase may be raised enabling the diagnosis to be made in the appropriate setting [416][417][418][419][420][421][422][423][424]. However care has to be taken with the interpretation of tryptase levels as elevation is not specific to an acute allergic reaction [425][426][427].…”

Section: Infections and Immunological Aetiologies Of Sudden Deathmentioning

confidence: 99%

Sudden adult death

Langlois

2009

Forensic Sci Med Pathol

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In the investigation of sudden death in adults, channelopathies, such as long QT syndrome, have risen to the fore in the minds of forensic pathologists in recent years. Examples of these disorders are touched upon in this review as an absence of abnormal findings at postmortem examination is characteristic and the importance of considering the diagnosis lies in the heritable nature of these conditions. Typically, a diagnosis of a possible channelopathy is evoked as an explanation for a 'negative autopsy' in a case of apparent sudden natural death. However, the one potential adverse effect of this approach is that subtle causes of sudden death may be overlooked. The intention of this article is to review and discuss potential causes of sudden adult death (mostly natural) that should be considered before resorting to a diagnosis of possible channelopathy. Nonetheless, it becomes apparent that many of the potential causes of sudden death can have a genetic basis. Thus, it becomes an important consideration that there may be a genetic basis to sudden death that extends beyond the negative autopsy.

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Section: Infections and Immunological Aetiologies Of Sudden Deathmentioning

confidence: 99%

Sudden adult death

Langlois

2009

Forensic Sci Med Pathol

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“…Seafood allergy is a universal health care issue [1,2,3,4,5] and is one of the most common forms of food allergies [6,7,8,9,10]. In the United States, seafood allergy affects 2.3% of the general population or approximately 6.9 million people [10].…”

Section: Introductionmentioning

confidence: 99%

Induction of Shrimp Tropomyosin-Specific Hypersensitivity in Mice

Leung¹,

Lee²,

Tang³

et al. 2008

Int Arch Allergy Immunol

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Background: Shellfish hypersensitivity is amongst the most common food allergies. The major shellfish allergen was identified as tropomyosin. Here, we investigated the immediate hypersensitivity responses, IgE and cell-mediated immune response in mice sensitized with recombinant shrimp tropomyosin. Methods: Shrimp tropomyosin was cloned and expressed as a His-tagged fusion recombinant protein in Escherichia coli. Three- to 4-week-old BALB/c mice were sensitized by intragastric administration of recombinant tropomyosin (0.1 mg) plus cholera toxin (10 µg) on days 0, 12, 19 and 26 and challenged on day 33. Mice fed with phosphate-buffered saline plus cholera toxin were included as controls. Animals were monitored for immediate hypersensitive responses and tropomyosin-specific IgE over time. In addition, shrimp tropomyosin-specific CD4+ T cells, interleukin-4 and interferon-γ levels were determined from in vitro splenocyte cultures. A passive cutaneous anaphylaxis assay was also conducted. Results: Mice fed with shrimp tropomyosin developed swelling of the snout, increased scratching behavior and shrimp tropomyosin-specific IgE. Sera from tropomyosin-sensitized mice elicited vascular leakage in naïve mice in the passive cutaneous anaphylaxis assay. Shrimp tropomyosin-specific CD4+ T cell proliferations and elevated interleukin-4 over interferon-γ levels were evident in splenocyte cultures of tropomyosin-fed mice upon tropomyosin stimulation. In contrast, shrimp tropomyosin-specific IgE, CD4+ T cells and hypersensitive responses were absent in the control mice. Conclusion: We have generated a BALB/c model of shrimp allergy. This model provides a useful tool for evaluating the immunopathogenic mechanisms involved in shellfish hypersensitivity.

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“…It is necessary for the forensic pathologist to obtain a thorough history, as the autopsy findings are variable. Postmortem findings in anaphylaxis have been studied in two case series of 56 [42] and 18 [41] patients. The most common finding was non-specific pulmonary edema and congestion in about 75% of cases.…”

Section: Discussionmentioning

confidence: 99%

“…Patients can present with respiratory distress, urticaria, angio-edema, vomiting, and diarrhea. The actual mechanism of death is either due to hypotensive shock secondary to peripheral vasodilation, or to airway obstruction and bronchospasm [41]. Death usually occurs within 1 h of the onset of anaphylaxis; however, it can be delayed for days [42].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Sudden death by laryngeal polyp: a case report and review of the literature

Tanguay

Pollanen

2008

Forensic Sci Med Pathol

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Sudden unexpected death in the context of bizarre or unusual behavior usually relates to acute drug intoxication or excited delirium. We report the case of a man who died suddenly while running naked on a public street. Although the initial death investigation was indicative of excited delirium or drug intoxication, autopsy revealed glottic obstruction by an inflammatory laryngeal polyp. Toxicologic studies were negative and investigation revealed presentation at a hospital the day before death with stridor. It is believed he developed airway obstruction while dressing at home and ran out on the street to find assistance. This case illustrates the importance of a thorough death investigation and a broad differential diagnosis when approaching a forensic autopsy.

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Anaphylactic deaths in Auckland, New Zealand: a review of coronial autopsies from 1985 to 2005

Cited by 70 publications

References 12 publications

Sudden adult death

Sudden adult death

Induction of Shrimp Tropomyosin-Specific Hypersensitivity in Mice

Sudden death by laryngeal polyp: a case report and review of the literature

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