[Diffuse gastropathy and gastritis--a main or secondary finding concerning the cause of death?].

On the basis of the autopsy results in three cases, extensive pathomorphological changes were demonstrated in the stomach, such as Ménétrier's disease and diffuse superficial gastritis. For these cases of sudden death, no cause could be found that could be verified by morphological or toxicological means. Analogous to clinical experience on the protein deficiency syndrome and food allergies and based on the knowledge that the intestinal tract also represents an immune organ, as well as the finding of diffuse changes in the gastric mucosa ideas have been developed regarding hypersensitive immunological reactions which might have not only local but also systemic effects comparable with anaphylactic reactions of different origins. Diffuse gastropathy or gastritis should not simply be assessed as a secondary finding. If other explanations are lacking and there are indications of intensive cellular immune reactions, the possibility arises of reconstructing lethal pathophysiological mechanisms.