Pathological changes of the heart in sudden infant death

Bajanowski, Thomas; Ortmann, C.; Teige, K; Wedekind, Horst; Zack, F.; Röse, I; Brinkmann, B.

doi:10.1007/s00414-003-0374-7

Cited by 28 publications

(13 citation statements)

References 81 publications

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“…Of course both fresh hemorrhages and siderophages in the pulmonary tissue can be found as consequences of several illnesses, e.g. in idiopathic pulmonary hemosiderosis [7,19,20], heart defects [2,3] or as a sign of immaturity of the pulmonary tissue [39], but in those cases it should be possible to demonstrate the basic illness from the autopsy findings as well [30].…”

Section: Discussionmentioning

confidence: 99%

Three subsequent infanticides covered up as SIDS

Bohnert¹,

Perdekamp²,

Pollak³

2004

Int J Legal Med

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Within a period of 9 years a young woman lost 3 daughters during infancy and each time death was attributed to the sudden infant death syndrome. The children had different fathers and died at the ages of 11 weeks, 7 weeks and 2 weeks, respectively. A fourth daughter survived and lives separated from the mother together with her father and is healthy. At autopsy the last of the three deceased infants did not reveal any pre-existing pathological organ findings, except for acute pulmonary emphysema and extensive intra-alveolar bleeding. As a consequence the strong suspicion of mechanical suffocation arose. Subsequent police investigations produced incriminating clues that the first two children had also been suffocated. On confrontation with the autopsy findings and investigation results, the woman confessed that she herself had killed the first two infants by pressing a cushion on their faces. In the case of the third death the baby had been smothered by the child's father who in agreement with the mother put a plastic film on mouth and nostrils.

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Section: Discussionmentioning

confidence: 99%

Three subsequent infanticides covered up as SIDS

Bohnert¹,

Perdekamp²,

Pollak³

2004

Int J Legal Med

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“…Postmortem examination [16,17], using a complete immunohistochemical panel [18,19], is warrant for the diagnosis of the disease, having a high index of diagnostic suspicion in patients who died during clozapine treatment associated with peripheral eosinophilia [20].…”

Section: Discussionmentioning

confidence: 99%

Sudden cardiac death due to hypersensitivity myocarditis during clozapine treatment

et al. 2004

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The case concerns the sudden death of a 29-year-old male during clozapine therapy started 2 weeks before. He had a history of treatment-resistant chronic schizophrenia. A complete immunohistochemical study was performed on heart specimens. Histologically, the heart presented diffuse eosinophilic infiltrates located around perivascular structures and focal myocyte necrosis with numerous interstitial eosinophils admixed with histiocytes. The diagnosis of acute myocarditis with an eosinophilic infiltrate was established as the cause of death. The autopsy findings and a detailed medical history supported the conclusion that clozapine-induced hypersensitivity myocarditis was the most likely cause of death.

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“…The investigation of sudden, unexpected death is an important and challenging issue in medico-legal autopsy practice, occasionally placing heavy demands on the forensic pathologist to provide satisfactory answers to the investigating authorities in specific cases [2,3,5,9,10,20,33]. Apart from Mallory-Weiss syndrome and ruptured oesophageal varices [33], acute necrotising oesophagitis has been described as the source of fatal upper gastrointestinal bleeding in association with carcinoma of the oesophagus [1,29] and after medications had failed to transit the oesophagus and acted locally ultimately producing necrotising oesophagitis [18].…”

Section: Discussionmentioning

confidence: 99%

Black oesophagus: a rare disorder with potentially fatal outcome

Tsokos

Herbst

2005

Int J Legal Med

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Black oesophagus is a rare pathological condition of unknown aetiology characterised by a full length, circumferential black discolouration of the entire oesophageal mucosa. The disease is sporadically encountered during upper gastrointestinal endoscopy. We used conventional histology, enzyme histochemistry and immunohistology to examine five autopsy cases (four males, one female; age range 43-86 years) of black oesophagus. On microscopical examination, the esophageal mucosa was entirely necrotic with demarcation by a leukocytic infiltrate in the upper submucosa. This infiltrate was dominated by neutrophilic granulocytes and scattered macrophages lacking haemosiderin deposits, placing the noxious mucosal injury in a time frame of approximately 24-72 h prior to death. Black oesophagus was established as the immediate cause of death in one case due to desanguination from the oesophagus and significantly contributed to the fatal outcome in a second case. Apart from a history of chronic alcohol consumption in four cases, no other pre-existing pathological or debilitating conditions could be established. The remarkably consistent pathomorphological picture of the disease seems to be the result of impaired microcirculation of the oesophageal mucosa due to prolonged hypotension of variable aetiology. The diagnosis of black oesophagus requires exclusion of other causes such as ingestion of caustic materials and should be based on histological examination.

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Pathological changes of the heart in sudden infant death

Cited by 28 publications

References 81 publications

Three subsequent infanticides covered up as SIDS

Three subsequent infanticides covered up as SIDS

Sudden cardiac death due to hypersensitivity myocarditis during clozapine treatment

Black oesophagus: a rare disorder with potentially fatal outcome

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