Sudden infant death syndrome: a possible clue to causation

Goldwater, Paul N.; Williams, Vaughan; Bourne, Anthony J.; Byard, Roger W.

doi:10.5694/j.1326-5377.1990.tb125473.x

Cited by 33 publications

(18 citation statements)

References 6 publications

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“…For petechial haemorrhages both systemic and local factors have been invoked; for example, the possible systemic effects on vascular integrity of hypoxia,16microbial toxins,17 hyperthermia,18 and CO 2 rebreathing,19 or of transient hypertension increasing transcapillary pressure in either the pulmonary or systemic circuits,20 21 or local effects such as that on intrathoracic organs of negative pressures during forced inspiratory movements against an obstructed airway 2223 Some of these mechanisms could apply to agonal haemorrhages at other sites such as the lungs or nose, but the differences in epidemiological associations suggest that other factors are required to explain the effects of age, bed sharing, and sleep position on the incidence of pulmonary and nasal haemorrhage.…”

Section: Discussionmentioning

confidence: 99%

Nasal and intrapulmonary haemorrhage in sudden infant death syndrome

2001

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Background-Fresh intrapulmonary and oronasal haemorrhages in cases of sudden infant death syndrome (SIDS) might be markers for accidental or intentional smothering inappropriately diagnosed as SIDS. Aim-To compare the incidence, epidemiological association, and inter-relation of nasal haemorrhage, intrapulmonary haemorrhage, and intrathoracic petechiae in infant deaths certified as SIDS. Methods-In SIDS cases from a large nationwide case-control study, a wide range of variables were compared in cases with and without reported nasal haemorrhage and, in a subgroup of cases, in those with and without pathologically significant intrapulmonary haemorrhage. Results-Nasal haemorrhage was reported in 60 of 385 cases (15%) whose parents were interviewed. Pathologically significant intra-alveolar pulmonary haemorrhage was found in 47% of 115 cases studied, but was severe in only 7%. Infants with nasal haemorrhage had more haemorrhage into alveoli and air passages than age matched cases without nasal haemorrhage. In multivariate analysis, nasal haemorrhage was associated with younger infant age, bed sharing, and the infant being placed non-prone to sleep. Intrapulmonary haemorrhage was associated with the same three factors in univariate analysis, but in multivariate analysis only younger infant age remained statistically significant. There was no significant association between nasal or intra-alveolar haemorrhages and intrathoracic petechiae. Conclusions-Nasal and intrapulmonary haemorrhages have common associations not shared with intrathoracic petechiae. Smothering is a possible common factor, although is unlikely to be the cause in most cases presenting as SIDS.

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Section: Discussionmentioning

confidence: 99%

Nasal and intrapulmonary haemorrhage in sudden infant death syndrome

2001

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“…It is clear that consistently higher cross linked fibrin degradation products are found frequently in SIDS sera compared with other deaths. 22 This would indicate that in SIDS, a clotting perturbation has indeed occurred. Beckwith referred non-specifically to unreferenced experimental findings that ''fibrinolysins are released when the heart perfuses anoxic tissues, and that they are not released when the heart stops suddenly''.…”

Section: Liquid Bloodmentioning

confidence: 99%

“…N Liquid (unclotted) blood within the chambers of the heart, 17 20 and increased cross linked fibrin degradation products 22 (seen in toxaemia/sepsis); in this context, curlin protein represents contact phase bacterial components which can activate the proinflammatory pathway, 80 81 involving reactions with fibrinogen and fibronectin 82 which can lead to depletion of coagulation factors resulting in a hypocoagulability state. 22 N The finding of an empty bladder in most SIDS cases 17 77 suggests decreased renal perfusion (toxaemic shock) during the last sleep.…”

Section: Prone Sleeping Position and The Changing Prevalence Of Sidsmentioning

confidence: 99%

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Sudden infant death syndrome: a critical review of approaches to research

Goldwater

2003

Archives of Disease in Childhood

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“…Can fibrin degradation products be formed as a result of a mechanism other than DIC? One study showed consistently higher levels of cross‐linked fibrin degradation products in SIDS sera compared with other deaths [56]. This indicates that in SIDS a clotting perturbation does occur.…”

Section: Pathological Findings In Sidsmentioning

confidence: 98%

SIDS pathogenesis: pathological findings indicate infection and inflammatory responses are involved

Goldwater¹

2004

FEMS Immunology and Medical Microbiology

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This article explores the pathological evidence that supports the hypothesis that infection and inflammation are underlying mechanisms in SIDS. It reviews the pathological findings in relation to the risk factors reported for SIDS and compares these findings with other hypotheses suggested as causes of these unexplained deaths in infants. The roles of environmental factors and bacterial products such as soluble curlin detectable in SIDS sera in triggering cytokine cascades and aberrant inflammatory responses resulting in a toxic shock-like event are also explored. Areas for future research are outlined.

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Sudden infant death syndrome: a possible clue to causation

Cited by 33 publications

References 6 publications

Nasal and intrapulmonary haemorrhage in sudden infant death syndrome

Nasal and intrapulmonary haemorrhage in sudden infant death syndrome

Sudden infant death syndrome: a critical review of approaches to research

SIDS pathogenesis: pathological findings indicate infection and inflammatory responses are involved

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