Histologische Lungenbefunde beim pl�tzlichen Kindstod

Abstract

The lungs of 79 children who had died between the ages of 1 week and 2 years old were histologically examined. 59 of these children could be categorized as cases of Sudden Infant Death because of the history and postmortem findings. In the remaining 20 cases a definite cause of death could be established. This is the same collective on which the histological investigations of the lymphatic tissue has been carried out. Morphological changes which are typical for a virus pneumonia were found in a substantially higher frequency in the cases of Sudden Infant Death than in the control cases. The validity of these findings and their possible significance for the cause of death are discussed.

Reaction patterns in selected lymphatic tissues associated with sudden infant death (SID)

“…The cases were subdivided into 3 groups as follows [1,7] (Table 1): -A: no pathological findings, no previous history of illness (SIDS cases, N = 12), -B: minimal to intermediate changes ("SIDS+" [8,9,10], N = 23); -C: pathological changes relevant to the cause of death (non-SIDS, N = 15);…”

“…In a series of 56 sudden infant death (SID) cases Entrup & Brinkmann [1] described different types and/or grades of inflammatory lung changes. Correlations to the various reaction pattern of the lymphatic tissues [2] showed that 77% of cases with pulmonary inflammation had different varieties of the florid type of reaction compared to only 17% of control cases.…”

Detection and significance of adenoviruses in cases of sudden infant death

“…All infant deaths (n=118) in which postmortem examinations had been carried out at the Institute of Forensic Medicine in MOnster in the period 1991-1993 were included in this study. The investigation comprised examination of the scene of death, a full autopsy Lung histology (samples from all five lobes; haematoxylin and eosin, alcian blue-PAS, semi-thin sections) allowed the definition of a subgroup (n=27) showing different grades of interstitial pneumonia (IP; classification according to Schfifer [22], Entrup and Brinkmann [10]). On the basis of further autopsy findings and histopathology the cases were finally divided into 13 unnatural deaths and 105 natural deaths, which included 93 cases of SIDS and were further subdivided into cases with no morphological signs of virus infection (69 SIDS cases and 9 cases with defined natural cause of death) and 27 cases with signs of virus infection (various grades of IP; see Fig.…”

“…Viral infections of the respiratory system and the digestive tract have been considered to act as trigger mechanisms in the sudden infant death syndrome (SIDS) [5,24,30]. Although changes associated with viral infections are defined histologically [10,22,23], it is difficult to demonstrate a viral origin, because the histological changes are neither virus specific nor attributable to a specific type of virus [10,22,23]. The detection of a specific type of virus would verify the diagnosis, and we have therefore developed a nested PCR approach for the detection of adenovirus (AV) DNA and tested its applicability and specificity in autopsy samples.…”

Possibility of separating toxins from bacteria associated with sudden infant death syndrome using anion exchange chromatography.

“…Histological examination of lymphatic tissue from SIDS cases reveals changes typical of viral pneumonia in a higher proportion of SIDS babies than controls. 9 In addition to viruses, toxigenic bacteria have been isolated from SIDS babies. '0l Viral infection may well enhance potency of bacterial toxins as influenza virus enhances activities of several bacterial toxins in infant ferrets.6 12 Furthermore, synergy between different bacteria may have an important role in SIDS.…”