PDF(Pubmed)
Abstract：
Anaphylaxis is a rare but well-known cause of sudden unexpected death, although data from forensic autopsies in anaphylactic deaths are limited. Herein, a retrospective study of a series of allergic deaths from 2009 through 2019 in Shanghai, China, was conducted to investigate the demographic, medical, and forensic pathological characteristics of fatal anaphylaxis to improve medicolegal understanding on anaphylactic death. Sixty-two autopsy cases of anaphylactic death were registered in this study. Males dominated the cases (74.2%) against females (25.8%), with an average age of 38.8 years. Medications (98.4%), particularly antibiotics (72.6%), were the most frequent cause of anaphylaxis, and 44 cases (71.0%) occurred in clinics administered illegally by unlicensed clinicians. The anaphylactic symptoms began within a few minutes to less than 1 h in 53 cases, with dyspnea (56.5%) and sudden shock (46.8%) being the most common clinical signs. Thirty cases (48.4%) of anaphylaxis resulted in death within 1 h. Laryngeal edema and multiple tissue eosinophil infiltration (85.5%) were the most prevalent autopsy findings, followed by pulmonary edema and congestion (24.2%), which were considered to be non-specific but suggestive. The comorbidities were mainly cardiovascular disease (33.9%), pneumonia (8.1%) and asthma (8.1%). Serum IgE were measured in 11 of 62 cases, ranging from 43.3 to 591 IU/ml, severed as a helpful marker. Therefore, we suggested a thorough analysis of allergen exposure, clinical history and autopsy findings is required for the diagnosis of anaphylactic death currently.
摘要：
过敏反应是一种罕见但众所周知的猝死原因，尽管来自过敏性死亡的法医尸检数据有限。在这里，2009年至2019年上海一系列过敏性死亡的回顾性研究，中国,是为了调查人口统计，medical,和致命过敏反应的法医病理学特征，以提高法医学对过敏性死亡的认识。在这项研究中登记了62例过敏性死亡的尸检病例。男性占多数(74.2%),女性占多数(25.8%),平均年龄38.8岁.药物（98.4%），特别是抗生素(72.6%)，是过敏反应最常见的原因，44例(71.0%)发生在无证临床医生非法管理的诊所。53例患者的过敏性症状在几分钟内开始至不到1小时。呼吸困难（56.5％）和突然休克（46.8％）是最常见的临床体征。30例(48.4%)过敏反应导致1h内死亡。喉水肿和多组织嗜酸性粒细胞浸润(85.5%)是最常见的尸检结果。其次是肺水肿和充血（24.2%），它们被认为是非特异性的，但具有启发性。合并症主要为心血管疾病（33.9%），肺炎(8.1%)和哮喘(8.1%)。62例患者中有11例检测血清IgE，范围从43.3到591IU/ml，被切断作为一个有用的标记。因此,我们建议对过敏原暴露进行彻底分析，目前诊断过敏性死亡需要有临床病史和尸检结果.
