Yilmaz Riza, Yuksekbas Ozlem, Erkol Zerrin, Bulut Erkut R, Arslan Murat N
Council of Forensic Medicine, Istanbul, Turkey.
Am J Forensic Med Pathol. 2009 Dec;30(4):346-9. doi: 10.1097/PAF.0b013e3181c0e7bb.
To determine the frequency of anaphylactic deaths at autopsies performed in Turkey between January 2001 and June 2006 and to review the circumstances of death and autopsy findings.
The Council of Forensic Medicine database in Istanbul was searched for anaphylactic deaths. Postmortem reports and medical records were reviewed to determine the circumstances of death. Data about basic demographics, medical history, drugs responsible for allergic reactions, and pathologic findings at autopsy were collected.
A total of 36 anaphylactic deaths from drugs were identified for the study period. Death was due to antibiotics in 26 cases, analgesics in 7 cases, an intraoperative drug in 1 case, an H2 receptor in 1 case, and intravenous contrast medium in 1 case. Out of 36 cases, 19 were male and 17 female. They were aged between 1 and 74 years with the median age of 26.7 years. Death occurred within 1 hour of the onset of anaphylaxis in 27 cases. Findings at autopsy included nonspecific pulmonary edema and congestion, upper airway edema, cerebral hypoxia, and cutaneous edema. Serum tryptase levels were not measured in all cases.
Anaphylactic reaction is an uncommon cause of sudden death. In many cases, no specific macroscopic or microscopic findings were detected at autopsy. When serum tryptase levels cannot be determined, in the presence of typical clinical records, eye witness reports and autopsy findings can be useful diagnostic aids.
确定2001年1月至2006年6月在土耳其进行尸检的过敏性死亡频率，并回顾死亡情况和尸检结果。
在伊斯坦布尔法医委员会数据库中搜索过敏性死亡病例。回顾尸检报告和病历以确定死亡情况。收集有关基本人口统计学、病史、引起过敏反应的药物以及尸检病理结果的数据。
在研究期间共确定了36例药物过敏性死亡病例。26例死亡原因是抗生素，7例是镇痛药，1例是术中用药，1例是H2受体阻滞剂，1例是静脉造影剂。36例中，男性19例，女性17例。年龄在1岁至74岁之间，中位年龄为26.7岁。27例在过敏反应发作后1小时内死亡。尸检结果包括非特异性肺水肿和充血、上呼吸道水肿、脑缺氧和皮肤水肿。并非所有病例都检测了血清类胰蛋白酶水平。
过敏反应是猝死的罕见原因。在许多病例中，尸检未发现特异性宏观或微观结果。当无法测定血清类胰蛋白酶水平时，结合典型的临床记录、目击者报告和尸检结果可作为有用的诊断辅助手段。
