Anaphylactic deaths in Maryland (United States) and Shanghai (China): A review of forensic autopsy cases from 2004 to 2006

Suicide of a man with known allergy to fish protein by ingesting tinned fish

“…Although Edston and Van Hage-Hamsten [2] found elevated heart blood tryptase levels in cases such as traumatic deaths, deaths after heroin-injection and unexplained deaths, in the present case the elevated tryptase level seems to be part of an anaphylactic reaction. The high number of mast cells in the pulmonary and cardiac tissue has also been described before in deaths due to anaphylaxis [5,13] just as the fact that the CD117 stain, which visualizes the mast cell membrane, showed more mast cells than the Giemsa stain, which visualizes the granules contained in the mast cells. This suggests degranulation of the mast cells and can be regarded as further evidence of an anaphylactic reaction.…”

Death Caused by Honey Bee Stings: Case Report

“…Pulmonary edema and swelling in laryngeal area detected at autopsy confirmed the diagnosis of anaphylaxis [6][7][8][9].…”

“…Like most cases of sudden death, underlying coronary atherosclerosis appears to be the principal mechanism. External factors that affect mortality include environmental temperature and site of sting [6][7][8][9].…”

Deaths from bee stings: a report of three cases from Pretoria, South Africa

“…Shen et al reviewed anaphylactic deaths in Maryland and Shanghai and concluded that "the postmortem diagnosis of anaphylactic deaths is usually based on exclusion and circumstantial evidence." [24] A reasoned conclusion as to the probable cause of death can only be arrived at if there is due regard for all relevant perspectives, including clinical / medical history, information pertaining to the terminal event(s), anatomical (autopsy / histology) findings, as well as biochemical / humoral findings. [5][6][7][21][22][23][24] We support the proposals by Riches et al in the classification of these deaths, in an attempt to achieve greater clarity and insight into these often tragic deaths.…”