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

Sterzik, Vera; Drendel, Vanessa; Will, Michael V.; Bohnert, Michael

doi:10.1016/j.forsciint.2012.02.002

Cited by 16 publications

(11 citation statements)

References 14 publications

(25 reference statements)

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“…A second case is reported by Sterzik and colleagues [17]: a 31-year-old man with a fish allergy, severe depression and reports of expressing to other people a desire to buy fish to commit suicide. He was found dead with two partially eaten canned fish containers next to him.…”

Section: Discussionmentioning

confidence: 93%

Suicide Attempt by Anaphylaxis - Case Report

Marcelino¹,

Ferreira²,

Duarte³

et al. 2018

Arch Microbiol Immunology

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Section: Discussionmentioning

confidence: 93%

Suicide Attempt by Anaphylaxis - Case Report

Marcelino¹,

Ferreira²,

Duarte³

et al. 2018

Arch Microbiol Immunology

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“…Very rarely food substances may be consumed during suicide attempts. The case of fish anaphylaxis was described above [45] and two cases have also been reported from Japan of deaths due to hypernatremia following the ingestion of large amounts of soy sauce [74,75].…”

Section: Miscellaneousmentioning

confidence: 89%

“…New food labelling legislation has been enacted in response to this trend, but is not without problems, and forensic practitioners can undoubtedly expect to see an increase in both civil and criminal cases related to food allergy deaths in the future [39,44]. While in most case exposure to food allergens is unintentional, it has rarely been found in suicides [45].…”

Section: Anaphylaxismentioning

confidence: 99%

Death by food

Byard

2017

Forensic Sci Med Pathol

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Although death from food is not an uncommon finding in forensic facilities worldwide, the range of underlying lethal mechanisms and associated conditions that should be sought at the time of autopsy is quite disparate. Deaths may occur from i) infectious agents including bacteria, viruses, protozoa, cestodes, nematodes and prions; ii) natural toxins including amanita toxins, tetrodotoxin, ciguatera and scombroid; iii) anaphylaxis; iv) poisoning; v) mechanical issues around airway and gut obstruction and/or perforation; and vi) miscellaneous causes. Food-related deaths are important in terms of global mortality, and thus autopsies need to be comprehensive with full ancillary testing. Medicolegal matters may involve issues concerning likely exposure to infectious agents, possible foods ingested, the declared content and possible components of food, the significance of toxicological analyses, and aspects of duty of care in cases of café coronary syndrome and gastroenteritis while in care.

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“…Furthermore, sudden anaphylactic fatalities that occur inside a hospital, sometimes in the emergency room, or under medical treatment, are also usually subjected to forensic autopsies [ 2 ]. Anaphylactic shock is usually associated with accidental events [ 3 ] rather than suicide [ 4 ]; as far as we know, it has never been indicated in a homicide. It is well-recognized that macroscopic autopsy findings, such as organ congestion and soft tissue edema [ 5 ], as well as conventional histology examination, are not necessarily specific for the diagnosis of lethal anaphylaxis [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Postmortem diagnostics of assumed suicidal food anaphylaxis in prison: a unique case of anaphylactic death due to peach ingestion

Tambuzzi

Gentile

Boracchi

et al. 2021

Forensic Sci Med Pathol

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Suicidal ingestion of food which the victim is aware they are allergic to is an exceptional occurrence in the forensic field. To the best of our knowledge, no cases of suicidal food anaphylaxis have been reported to date. Therefore we present the first case described in the literature. A 30-year-old prisoner was found dead inside his cell with the remains of a peach remains next to his body, and a handwritten farewell note in his pocket. The autopsy revealed only non-specific findings, while laboratory investigations (serological, toxicological, histological, and immunohistochemical) played a pivotal role in determing the cause and manner of death. In particular, a high titer of both total and specific IgE antibodies was detected, as well as an increase of the tryptase level in cadaveric blood. Moreover, a massive concentration of salicylates was measured in the gastric contents. Microscopically, cellular residues characterized by a vegetal structure were observed in the gastric contents and elements suggestive of mast cells were detected in the glottis, lungs, and myocardium. The immunohistochemical investigation with anti-CD117 and anti-tryptase antibodies showed positivity for mast cells, some of which appeared degranulated. Such findings were entirely consistent with an acute systemic anaphylactic reaction triggered by allergy. Therefore, the prisoner’s death was attributed to self-induced food anaphylaxis caused by the ingestion of peaches. This conclusion was achieved based only on circumstantial data, anamnestic information, autopsy findings, and multiple laboratory results. This integrated approach should be used to pursue a post-mortem diagnosis of anaphylaxis.

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

Cited by 16 publications

References 14 publications

Suicide Attempt by Anaphylaxis - Case Report

Suicide Attempt by Anaphylaxis - Case Report

Death by food

Postmortem diagnostics of assumed suicidal food anaphylaxis in prison: a unique case of anaphylactic death due to peach ingestion

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