Heart, liver and spleen pathology in chronic alcohol and drug users

Wong, Junie Li Chun; Viana, Juan Carlos Arango; Squires, Tim

doi:10.1016/j.jflm.2007.07.011

Cited by 11 publications

(7 citation statements)

References 20 publications

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“…This victim is usually “found dead” at home with a past history of drinking, and histopathologically the liver depicts fatty change rather than cirrhosis [ 14 , 15 ]. In chronic alcoholics occurrence of hepatomegaly is associated with death at a younger age [ 16 ]. Several attractive theories attribute such deaths to ethanol withdrawal induced hypoglycemia or hypomagnesemia, pulmonary fat embolization from fatty liver, or other facets of the alcohol withdrawal syndrome, including ethanol dependent maladaptive derangements of neurotransmitters.…”

Section: Discussionmentioning

confidence: 99%

Sudden unexplained death in alcohol misuse (SUDAM) patients have different characteristics to those who died from sudden arrhythmic death syndrome (SADS)

Sorkin

Sheppard

2017

Forensic Sci Med Pathol

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There is growing awareness of sudden unexplained death in alcohol misuse (SUDAM) in which there is no obvious cause of death, no evidence of acute alcohol toxicity or alcoholic ketoacidosis, and the heart is morphologically normal. This study describes the characteristics of a cohort with SUDAM from a tertiary cardiovascular referral center and compares the findings with those of individuals who died from sudden arrhythmic death syndrome (SADS). Cases in this retrospective cross-sectional study were identified from a database of referrals to our center spanning approximately 40 years. Cases with recorded heavy use of alcohol and non-alcohol users were selected, then limited to those with SUDAM or SADS aged 16 to 64 years. 62 cases of SUDAM and 41 cases of SADS were identified. The SUDAM group were older than the SADS group; mean age 35.8 years and 27.7 years respectively (P=0.0002). There was also a higher incidence of significant psychiatric illness in SUDAM (19.7%) than SADS (2.4%) cases. Post mortem liver examination was more likely to reveal heavy livers in SUDAM than SADS (2196.1g and 1572.4g respectively; P=0.0033) and more fatty liver change (24.2% and 2.4%). SUDAM tends to occur in individuals who are older and have heavier livers than those with SADS. Psychiatric illness is also more common. SADS, unlike SUDAM, is often associated with heritable channelopathies that may affect surviving family members. Therefore, differentiating between SUDAM and SADS identifies families likely to benefit from screening for these mutations, thus preventing further sudden arrhythmic deaths.

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Section: Discussionmentioning

confidence: 99%

Sudden unexplained death in alcohol misuse (SUDAM) patients have different characteristics to those who died from sudden arrhythmic death syndrome (SADS)

Sorkin

Sheppard

2017

Forensic Sci Med Pathol

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“…50 A study addressing organ weight disparities in chronic drug and alcohol users at forensic autopsy found that alcoholism positively correlated with heart and liver enlargement, as well as spleen enlargement in females. 51 Chronic drug use was associated with splenomegaly in men. However, they do not comment on whether these organs appeared macroscopically abnormal at autopsy, for example if the heart appeared dilated and floppy, and the liver fatty.…”

Section: Substance Misusementioning

confidence: 99%

Postmortem Organ Weights at a South African Mortuary

Peddle

Kirk²

2017

Am J Forensic Med Pathol

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“…Demographic parameters such as the age, sex, population grouping and the body length of an individual; as well as environmental conditions have an influence on organ weights (Kohli & Aggarwal;Prakash et al, 2013;Kumar et al, 2014). These factors vary vastly throughout the world and therefore, organ weight ranges should be formulated for each target population, allowing for the correct interpretation of cause of death (Wong et al, 2008). A review of anatomical textbooks and available literature, indicates extensive data with regard to the Northern hemisphere.…”

Section: Introductionmentioning

confidence: 99%

Post-Mortem Organ Weights at a Medico-Legal State Facility in the eThekwini Region

et al. 2017

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Organ weights may be influenced by various demographic parameters and environmental conditions, and they differ among populations. Numerous studies have been conducted in the Northern hemisphere, with paucity of literature regarding organ weights of many Southern hemispheric populations. This study aimed to document post-mortem organ weights of decedents in the eThekwini region, and to determine the influence of age, sex, population grouping and body length on the weight of these organs. The study utilised 500 decedent organs (n=500), obtained from a medico-legal state mortuary in the eThekwini region, KwaZulu-Natal, South Africa. It entailed gross examination and weighing of the thoracic viz. heart, right and left lungs, and abdominal organs viz. liver, spleen as well as the right and left kidneys. All organs attained maximum or peak weights at various age intervals, with the heart continuing to increase in weight until 80 years of age. Organ weights illustrated statistical significance with age. The heart, lungs and liver were the only organs that showed statistical significance with sex. However, mean spleen weights were higher in females than in males, while the weights of both kidneys were higher in males. Organ weights of White decedents were higher than those of other population groups. There was a positive correlation between body length and all organ weights. Post-mortem organ weights of the present study are comparably higher than those reported in the Northern hemisphere. Therefore, organ weights reported from one geographic location may not be applicable to another and may lead to erroneous references ranges and possibly hinder interpretation during autopsy settings.

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Heart, liver and spleen pathology in chronic alcohol and drug users

Cited by 11 publications

References 20 publications

Sudden unexplained death in alcohol misuse (SUDAM) patients have different characteristics to those who died from sudden arrhythmic death syndrome (SADS)

Sudden unexplained death in alcohol misuse (SUDAM) patients have different characteristics to those who died from sudden arrhythmic death syndrome (SADS)

Postmortem Organ Weights at a South African Mortuary

Post-Mortem Organ Weights at a Medico-Legal State Facility in the eThekwini Region

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