Hirvonen J, Jantti M, Syrjala H, Lautala P, Akerblom H K
Forensic Sci Int. 1980 Nov-Dec;16(3):213-26. doi: 10.1016/0379-0738(80)90205-4.
Of the fifty-seven cases of cot death studied two-thirds were younger than 3 months, which is also the peak age of infantile hypoglycaemia. Findings from routine necropsy and histology were scarce; in eleven cases they could be regarded as potentially fatal. About half of the infants had had a mild virus-type infection approximately one week before death. Special attention was paid to endocrine pancreas. Insulitis or lymphocytes in the septa were discovered in twelve cases. Hyperplasia of the islets of Langerhans was a common observation; the hyperplasia being either nesidioblastosis-like with clusters of islets around ducti, or diffuse. The average proportion of islet tissue in the whole pancreas parenchyma was around 5% in infants aged 1--6 months, the percentage being significantly greater than in age-matched controls (4.3%). The pancreatic insulin content was also higher in the cot death cases. Serum insulin values were low (mean 4.8 +/- 1.2 microU/ml) in cot deaths; in the controls they were twice as high (mean 11.6 +/- 1.6 microU/ml) (p less than 0.005). The cause of death in this group of cot deaths could thus be (congenital?) hyperplasia of the islets, possibly combined with a lesion in the B-cells caused by a virus. The mechanism of death would be hypoglycaemia.
在研究的57例婴儿猝死病例中，三分之二的婴儿年龄小于3个月，而这也是婴儿低血糖的高发年龄段。常规尸检和组织学检查结果很少；11例可被视为潜在致命性的。约一半的婴儿在死亡前约一周曾患轻度病毒感染。特别关注了内分泌胰腺。在12例中发现了胰岛炎或间隔中的淋巴细胞。胰岛细胞增生是常见现象；增生表现为导管周围有胰岛簇的成胰岛细胞增生样，或呈弥漫性。在1至6个月大的婴儿中，胰岛组织在整个胰腺实质中的平均比例约为5%，该百分比显著高于年龄匹配的对照组（4.3%）。婴儿猝死病例的胰腺胰岛素含量也较高。婴儿猝死病例的血清胰岛素值较低（平均4.8±1.2微单位/毫升）；对照组的血清胰岛素值则是其两倍（平均11.6±1.6微单位/毫升）（p<0.005）。因此，这组婴儿猝死的死因可能是（先天性？）胰岛增生，可能还伴有病毒引起的B细胞病变。死亡机制为低血糖。
