Heldring Nina, Kahn Lydia, Zilg Brita
Department of Forensic Medicine, Swedish National Board of Forensic Medicine, Retzius väg 5, SE-171 65 Stockholm, Sweden; Karolinska Institutet, Solnavägen 1, SE-171 77 Solna, Sweden.
Department of Forensic Medicine, Swedish National Board of Forensic Medicine, Retzius väg 5, SE-171 65 Stockholm, Sweden; Karolinska Institutet, Solnavägen 1, SE-171 77 Solna, Sweden.
Forensic Sci Int. 2021 Jun;323:110814. doi: 10.1016/j.forsciint.2021.110814. Epub 2021 Apr 28.
Diagnosing anaphylactic shock postmortem is challenging since differential diagnoses exist and the forensic pathologist often faces subtle findings and lacks relevant information which prevents reaching an opinion of certainty. This review provides an overview of the literature covering research and existing recommendations on the postmortem diagnosis of anaphylactic shock. In order to harmonize the approach and provide guidance for diagnosing deaths from anaphylactic shock in the six forensic centers in Sweden, a guidance protocol aligned with the notion of a holistic view in the approach was devised. Areas in need of further studies include both immunohistological and biochemical investigations to stratify quantitative approaches based on condition and anaphylactic trigger and to lay the ground for and possibly establish alternative matrices.
死后诊断过敏性休克具有挑战性，因为存在鉴别诊断，法医病理学家常常面临细微的发现且缺乏相关信息，这使得难以得出确定性的意见。本综述概述了有关过敏性休克死后诊断的研究及现有建议的文献。为了统一方法并为瑞典六个法医中心诊断过敏性休克死亡提供指导，制定了一个与整体观方法理念相一致的指导方案。需要进一步研究的领域包括免疫组织学和生化研究，以根据病情和过敏触发因素对定量方法进行分层，并为替代基质奠定基础甚至可能确定替代基质。
