Omalu Bennet, Hammers Jennifer, DiAngelo Constance, Moore Steve, Luckasevic Todd
Chief Medical Examiner, San Joaquin County, California, USA.
J Forensic Nurs. 2011 Sep;7(3):153-6. doi: 10.1111/j.1939-3938.2011.01112.x.
Isolated eosinophilic coronary arteritis (IECA) has been reported as a cause of sudden unexpected death and has recently been recognized as a newly emerging vasculitic disease. We identified eight case reports and two case series of sudden death due to IECA in the medical literature and we present two new cases of sudden death due to IECA. Our cases further support the proposition that IECA may be a newly emerging distinct vasculitis, which can go undiagnosed and present with sudden death. At autopsy IECA presents with isolated non-necrotizing predominantly eosinophilic inflammation of the coronary arteries without vasculitis in any other organ or blood vessel. The mean age of death of our two cases and the previously reported cases of IECA is 47 years, comprising 13 females and 3 males with a range of 34-64 years. All cases died suddenly and unexpectedly. Past medical history of recurrent chest pain was documented in 63% of cases. The patho-etiology of IECA may involve an aberrant immune response or hypersensitivity reaction. Elucidation of the pathology of IECA may be translated into definitive diagnostic, interventional, and preventive modalities, which will further reduce the person years of life lost to heart disease.
孤立性嗜酸性粒细胞性冠状动脉炎（IECA）已被报道为意外猝死的一个原因，并且最近被公认为一种新出现的血管炎性疾病。我们在医学文献中确定了8例因IECA导致猝死的病例报告和2个病例系列，并且我们呈现2例因IECA导致猝死的新病例。我们的病例进一步支持了IECA可能是一种新出现的独特血管炎的观点，这种血管炎可能未被诊断出来并表现为猝死。尸检时，IECA表现为冠状动脉孤立性非坏死性、主要为嗜酸性粒细胞性炎症，而其他任何器官或血管均无血管炎。我们这2例病例以及先前报道的IECA病例的平均死亡年龄为47岁，包括13名女性和3名男性，年龄范围为34 - 64岁。所有病例均突然意外死亡。63%的病例有复发性胸痛的既往病史。IECA的病理病因可能涉及异常免疫反应或超敏反应。对IECA病理学的阐明可能转化为明确的诊断、干预和预防方法，这将进一步减少因心脏病而损失的人年数。
