Immunohistochemical and molecular-pathological diagnosis of myocarditis in cases of suspected sudden infant death syndrome (SIDS) – A multicenter study

Dettmeyer, R.; Baasner, Anne; Haag, C.; Bruch, Simone; Schlamann, Marc

doi:10.1016/j.legalmed.2009.02.003

Cited by 23 publications

(5 citation statements)

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“…Detection of viral nucleic acid using polymerase chain reaction (PCR) or reverse-transcriptase (RT)-PCR has also been employed to increase the diagnostic sensitivity for myocarditis (14). In cases of suspected sudden infant death syndrome (SIDS), immunohistochemistry to characterize inflammatory cells and molecular methods to detect viral genome in myocardium, has significantly improved diagnosis of myocarditis with up to 25% of suspected SIDS cases ultimately classified as myocarditis (16)(17)(18).…”

Section: Reviewmentioning

confidence: 99%

Myocarditis at Post-Mortem Examination: A Forensic Perspective

Edgecombe

Veinot

2011

Academic Forensic Pathology

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Myocarditis is an uncommon cause of death but its myriad clinical presentations, young target population, diverse etiologies and potential to cause sudden unexpected death warrant its review. Myocarditis has been defined as myocardial necrosis and/or degeneration in the presence of an inflammatory infiltrate adjacent to the damaged myocytes. The type of predominant inflammatory cell present may assist with elucidating its pathoetiology. Ancillary testing as an adjunct to routine histopathological examination, such as immunohistochemical or immunofluorescence staining or detection of viral nucleic acid are of debatable diagnostic use in either the biopsy or autopsy setting. Myocarditis may clinically and/or histologically mimic other disease entities such as acute or organizing myocardial infarction, or hematological malignancy. There are no macroscopic pathognomonic features suggestive of myocarditis, thus in cases of unexplained sudden death it is vital to sample the heart extensively to rule out myocarditis. It is important to recognize that myocarditis may be an incidental finding in an autopsy. To attribute the cause of death to myocarditis, all relevant case findings including scene investigation, autopsy and ancillary testing including toxicology should be assessed.

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Section: Reviewmentioning

confidence: 99%

Myocarditis at Post-Mortem Examination: A Forensic Perspective

Edgecombe

Veinot

2011

Academic Forensic Pathology

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“…Dettmeyer et al . [92] subsequently showed that viruses when found in the myocardium are associated with inflammatory change and, therefore, these changes are pathologic. The changes were only found in myocardium from SIDS cases and were not found in unexpected unnatural sudden deaths.…”

Section: Discussionmentioning

confidence: 99%

A perspective on SIDS pathogenesis. The hypotheses: plausibility and evidence

Goldwater

2011

BMC Med

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Several theories of the underlying mechanisms of Sudden Infant Death Syndrome (SIDS) have been proposed. These theories have born relatively narrow beach-head research programs attracting generous research funding sustained for many years at expense to the public purse. This perspective endeavors to critically examine the evidence and bases of these theories and determine their plausibility; and questions whether or not a safe and reasoned hypothesis lies at their foundation. The Opinion sets specific criteria by asking the following questions: 1. Does the hypothesis take into account the key pathological findings in SIDS? 2. Is the hypothesis congruent with the key epidemiological risk factors? 3. Does it link 1 and 2? Falling short of any one of these answers, by inference, would imply insufficient grounds for a sustainable hypothesis. Some of the hypotheses overlap, for instance, notional respiratory failure may encompass apnea, prone sleep position, and asphyxia which may be seen to be linked to co-sleeping. For the purposes of this paper, each element will be assessed on the above criteria.

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“…Histopathological hallmarks can be myocyte hypertrophy, myocardial disarray, increased interstitial fibrosis, deep trabeculations with CD34 + -endothelium and a ''spongy myocardium'' as well as small vessel disease or arterial dysplasia [38]. Beside the cases of virus-induced myocarditis [38], more effort should be taken into further research to find out the incidence of genetic cardiomyopathies in cases of suspected Sudden Infant Death Syndrome (SIDS) as well as in cases of older children, dieing suddenly and presenting morphological findings pointing to a primary genetic cardiomyopathy [36]. Nevertheless, up to now the frequency of primary arrythmogenic disorders misdiagnosed as Sudden Infant Death Syndrome (SIDS) is unknown.…”

Section: Discussionmentioning

confidence: 99%