Department of Forensic Medicine, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing 400016, China.
Department of Forensic Medicine, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing 400016, China.
Leg Med (Tokyo). 2021 Nov;53:101930. doi: 10.1016/j.legalmed.2021.101930. Epub 2021 Jun 9.
The aim of this study was to detect the postmortem serum total IgE levels in frozen corpses and identify whether the death incident caused by an anaphylaxis in forensic medicine. Autopsy cases with pathological death (total, n = 106; 4-214 h postmortem) include cardiac disease (n = 15), pulmonary infection (n = 12), central nervous system disorder (n = 6), pulmonary emboliszn (n = 7), hapetic disease (n = 5), kidney disease (n = 6), enteric disease (n = 10), necrotizing pancreatitis (n = 7), diffuse peritonitis (n = 6), MODS (n = 6), toxicosis (n = 5:), anaphylactic shock (n = 7), bronchial asthma (n = 8) and other disease (n = 6) were examined. Results showed that there was no significant difference between serum IgE levels and ages, postmortem intervals (PMIs), gender as well as survival time. Serum IgE levels of deaths due to anaphylactic shock and bronchial asthma were higher than that of other groups. Forensic pathology examination results showed the main pathology changes of bronchial asthma were mucous congestion in bronchial lumen and eosinophils infiltration in bronchial mucosa. The main pathological features of anaphylactic shock were laryngeal edema and eosinophils infiltration in multiple organs (lung and spleen). This research proved that there was a great significance for IgE to infer whether the individual died due to an anaphylaxis even for a long PMI in frozen corpses. Furthermore, we can also preliminarily determine the type of allergic death combined with the examination of forensic pathology. These findings further verify the feasibility of postmortem serum IgE in the diagnosis of forensic causes of death and broaden the application scope of this marker.
本研究旨在检测冷冻尸体死后血清总 IgE 水平,并确定法医病理学中是否由过敏反应引起死亡事件。尸检病理性死亡(共 106 例;死后 4-214 小时)包括心脏病(n=15)、肺部感染(n=12)、中枢神经系统疾病(n=6)、肺栓塞(n=7)、肝脏疾病(n=5)、肾脏疾病(n=6)、肠道疾病(n=10)、坏死性胰腺炎(n=7)、弥漫性腹膜炎(n=6)、多器官功能障碍综合征(n=6)、中毒(n=5)、过敏性休克(n=7)、支气管哮喘(n=8)和其他疾病(n=6)。结果显示,血清 IgE 水平与年龄、死后间隔时间(PMI)、性别和生存时间无显著差异。过敏性休克和支气管哮喘死亡患者的血清 IgE 水平高于其他组。法医病理学检查结果显示,支气管哮喘的主要病理变化为支气管腔黏液充血和支气管黏膜嗜酸性粒细胞浸润。过敏性休克的主要病理特征是喉头水肿和多个器官(肺和脾)的嗜酸性粒细胞浸润。本研究证明,即使在冷冻尸体中 PMI 较长的情况下,IgE 对于推断个体是否因过敏反应而死亡也具有重要意义。此外,结合法医病理学检查,我们还可以初步确定过敏死亡的类型。这些发现进一步验证了死后血清 IgE 在法医死因诊断中的可行性,并拓宽了该标志物的应用范围。