Nicklin Angela, Byard Roger W
Discipline of Pathology & Forensic Science SA, The University of Adelaide, Frome Road, Adelaide 5005, Australia.
J Forensic Sci. 2011 Mar;56(2):423-8. doi: 10.1111/j.1556-4029.2010.01683.x. Epub 2011 Feb 9.
Systemic lupus erythematosus is an autoimmune connective tissue disorder that affects multiple organs. While the clinical manifestations may vary in intensity over time and be associated with chronic disease, occasional cases occur where sudden and unexpected death has occurred. Cardiovascular disease is common, with accelerated atherosclerosis, intravascular thrombosis associated with antiphospholipid syndrome, and hypertensive cardiomegaly. Vasculitis with superimposed thrombosis may result in critical reduction in blood to vital organs, such as the heart and brain with infarction. Mesenteric ischemia may be caused by vasculitis, thrombosis, and accelerated atherosclerosis and may result in lethal intestinal infarction. Other diverse causes of sudden death include myocarditis, epilepsy, pulmonary hypertension, pulmonary thromboembolism, and sepsis. The autopsy evaluation of such cases requires careful examination of all organs with extensive histological sampling to include blood vessels, and microbiological sampling for bacteria, viruses, and fungi.
系统性红斑狼疮是一种影响多个器官的自身免疫性结缔组织疾病。虽然临床表现可能随时间强度有所不同，并与慢性疾病相关，但偶尔会出现突然意外死亡的病例。心血管疾病很常见，包括加速性动脉粥样硬化、与抗磷脂综合征相关的血管内血栓形成以及高血压性心脏肥大。伴有血栓形成的血管炎可能导致重要器官（如心脏和大脑）的血液供应严重减少并发生梗死。肠系膜缺血可能由血管炎、血栓形成和加速性动脉粥样硬化引起，并可能导致致命的肠梗死。其他导致猝死的不同原因包括心肌炎、癫痫、肺动脉高压、肺血栓栓塞和败血症。对此类病例的尸检评估需要仔细检查所有器官，进行广泛的组织学采样，包括血管，并进行细菌、病毒和真菌的微生物学采样。
