Association between histological alterations in the thymus and sudden infant death syndrome

Varga, Ivan; Bódi, Ildikó; Mestanova, Veronika; Kovac, Martin; Klein, Martin

doi:10.1016/j.jflm.2018.02.007

Cited by 6 publications

(6 citation statements)

References 24 publications

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“…despite divergent outcomes. [23][24][25][26][27][28][29][30][31][32][33] Goldwater et al discovered an increased thymus weight in SIDS cases, which may be the consequence of subclinical infections. 27 Several other studies regarding thymus weight observed comparable or contradictory findings.…”

Section: Introductionmentioning

confidence: 99%

Age-related cytokine imbalance in the thymus in sudden infant death syndrome (SIDS)

Qu,

Preuss,

Hagemeier

et al. 2023

Pediatr Res

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Background Sudden infant death syndrome (SIDS) has been considered to be triggered by a combination of underlying immune dysregulation and infections. The thymus is a crucial lymphatic organ responsible for T cell development in infancy. We hypothesized that an altered thymic immune status may be detectable by intrathymic cytokine profiling in SIDS. Methods 27 cytokines in protein lysates of thymus tissue and thymus weights were assessed in 26 SIDS cases and 16 infants who died of other reasons. Results Seventeen out of 27 cytokines were increased in thymic tissue of SIDS compared to controls without infections, and the most significant discrepancy was in infants younger than 20 weeks. The thymic cytokine profiles in SIDS cases were similar to those in controls with severe infection; however, the magnitude of the cytokine concentration elevation in SIDS was less pronounced, indicating sub-clinical infections in SIDS. In contrast to SIDS, intrathymic cytokine concentrations and thymus weight were increased with age in control children. Conclusions Elevated thymic cytokine expression and thymus weight, as well as impaired age-related alterations in SIDS, may be influenced by subclinical infection, which may play a role in initiating SIDS in infants with a compromised immune response. Impact Statement Increased thymic weight and cytokine concentration may suggest possible subclinical infection in SIDS. Elevated thymic weight and cytokine concentration mainly in SIDS cases aged <20 weeks. Age-related impairment in the thymic weight and cytokine expression may be impaired by subclinical infection in SIDS.

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Section: Introductionmentioning

confidence: 99%

Age-related cytokine imbalance in the thymus in sudden infant death syndrome (SIDS)

Qu,

Preuss,

Hagemeier

et al. 2023

Pediatr Res

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“…Support is found in one study (Varga, Bódi, Mešťanová, Kovác ˇ, & Klein, 2018), but the findings were claimed to be confounded because of definitional issues (Byard, 2019). The authors found evidence of suppressed proliferation and maturation of T-lymphocytes in the thymuses of probable SIDS cases (Varga et al, 2018). Enhanced macrophage activity suggested increased lymphocyte apoptosis with decreased thymic dendritic cell and myoid cell numbers.…”

Section: Discussionmentioning

confidence: 94%

“…It remains to be determined if size of the thymus plays a role in SIDS deaths. Support is found in one study (Varga, Bódi, Mešťanová, Kovác ˇ, & Klein, 2018), but the findings were claimed to be confounded because of definitional issues (Byard, 2019). The authors found evidence of suppressed proliferation and maturation of T-lymphocytes in the thymuses of probable SIDS cases (Varga et al, 2018).…”

Section: Discussionmentioning

confidence: 94%

Increased thymus weight in sudden infant death syndrome compared to controls: The role of sub‐clinical infections

Goldwater

Kelmanson

Little

2020

American J Hum Biol

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Objective: The goal of the present investigation is to analyze thymus, brain, heart, liver, and kidney weights in SIDS victims compared to controls. Background: Epidemiologic risk factors for SIDS (eg, male gender, genetic, obstetric, environmental, smoke exposure, nonbreastfeeding, etc.) are consistent with an infectious process underlying many of these deaths. Methods: Data from autopsy reports on 585 SIDS victims and comparison deaths (n = 294 control, n = 291 SIDS) were analyzed. Cases were obtained from Australia (n = 184 controls, n = 98 SIDS) and Russia (n = 122 controls, n = 181 SIDS). Log 10 transform of thymus and other organ weights was computed because variables were skewed. Multivariate analysis of variance (MANOVA) of standardized log values were age-adjusted by multivariate analysis of covariance (MANCOVA). The standardized log 10 thymus residual adjusted for age, brain and liver weights was computed for the final analysis.Results: After controlling for age by MANCOVA, thymus, body, brain and liver weights were significantly higher among SIDS compared to non-SIDS victims. The largest difference as between covariate-adjusted log 10 non-SIDS thymus weight differed (mean = 1.423, 95% CI: 1.393-1.452) and log 10 non-SIDS thymus weight (mean = 1.269, 95% CI: 1.243-1.294) were significantly different (P < .0001). Heart weight was significantly lower in SIDS victims. Discussion: When adjusted for confounders (age, body, and organ weights), SIDS victims have a significantly heavier thymus and brain compared to non-SIDS controls who died of trauma. This finding supports previously published studies that link infection to SIDS deaths.

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“…According to previous studies, in the period from 1975 to 2020, only 10 cases of this pathology were registered in children aged < 1 year of life, while the prevalence of males among them (70%) was noted, nine out of ten children had initial symptoms or signs associated with the respiratory system, and Respiratory distress was observed in six patients, and surgical thymectomy was successfully performed in all patients without any postoperative complications [9,24]. However, when detecting thymus hyperplasia, it is necessary to remember about the possibility of a secondary process against the background of various diseases, as well as neoplasms [10,14].…”

Section: Discussionmentioning

confidence: 95%

“…All cases of sudden death of children without signs of violent death are usually a matter of concern for forensic medical experts [7][8][9]. According to R. W. Byard, all autopsies of SVSD should undergo a structured examination aimed at identifying the main causes of sudden death [10].…”

Section: Discussionmentioning

confidence: 99%

Sudden infant death syndrome as a result of thymic-lymphatic dysgenesis

Mussabekova,

Burkova,

Dobler

et al. 2024

J CLIN MED KAZ

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Sudden infant death syndrome is one of the leading causes of post-neonatal mortality. The thymic-lymphatic condition in children is a clinically rare manifestation and difficult to diagnose condition, assessed as a background, realized in a number of cases of sudden death syndrome. However, the clinical and histopathological manifestations of thymic-lymphatic status may not be clearly expressed. We present an unusual case of sudden infant death syndrome as a result of thymic-lymphatic dysgenesis complicated by acute adrenal insufficiency.

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Association between histological alterations in the thymus and sudden infant death syndrome

Cited by 6 publications

References 24 publications

Age-related cytokine imbalance in the thymus in sudden infant death syndrome (SIDS)

Age-related cytokine imbalance in the thymus in sudden infant death syndrome (SIDS)

Increased thymus weight in sudden infant death syndrome compared to controls: The role of sub‐clinical infections

Sudden infant death syndrome as a result of thymic-lymphatic dysgenesis

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